CEO Series: Roisin Fallon- Williams, CEO of Birmingham & Solihull Mental Health NHS Foundation Trust

In our second edition of our CEO Series here on Leading Healthcare, we caught up with Roisin Fallon-Williams, CEO of Birmingham & Solihull Mental Health Trust.

Roisin gave us a reflective and insightful look at how her leadership has changed during Covid, as well as learnings she has acquired and advice for her colleagues in the NHS.

Roisin begins by telling us of her career path to becoming a CEO from her inception into the NHS as a mental health nurse.

Can you tell me about your background to becoming a CEO?

I was very passionate about championing better lives for people with a learning disability. I began to learn a lot about mental health and a lot about the impact of mental health in the environment, and the impact of trauma on people’s mental health. I got interested in that at that stage.

I always think of my introduction to the NHS starting before that; my mum was community midwife, so her office was our dining room table, her handover discussions about her patients were taken in the kitchen on our telephone and her team meetings with her colleagues happened in our house, someone else’s house or in the garden and her notes were kept in the loft.

One of the things learnt through growing up was the importance and the value of having somebody with that kind of professional background that communities rely on and depend on. It is interesting now in Covid to see that value from our local communities being replaced again; I think it had diminished, so it’s lovely to see that valuing of people who have chosen these careers caring for others being valued again. Here in Birmingham I’ve been CEO for a year. Prior to that I had been chief executive of community healthcare trust in Norfolk, and prior to that I had been a director and obviously a nurse in a number of mental health organisations.

How has your leadership adapted during the Covid-19 pandemic?

I think it has been a challenge to everybody, in terms of fairly immediately having to take a different stance to how you work, how you support people and how you put value on what is and isn’t important. for me, right from the start, I wanted to create a sense of calm, because I think we are running services and being part of the NHS, part of a public service, the pace is quite significant, we are dealing with very difficult things and this felt like a time where we needed to breathe and take a calm approach to what was an emergency and a critical situation.

I suppose adapting in that way was my first priority. We have a sense always that safety and quality are at the heart of what we do, and it really brought that home that actually our number one goal was to protect people. Whatever we did our focus had to be around protecting. Adapting to this, some of us are more about person to person contact, facial contact, eye contact, the ability to touch, particularly at the moment where we are dealing with a lot of people who are anxious and upset across the country. People are in grief and disbelief, losing family members, losing friends and adapting to showing our compassion.

One of our values is compassion, so showing our compassion about living our value of compassion in a very different way to the way we had previously been able to through that very focused eye to eye and touch etc. some people are still in a position to do that, but are doing it from behind a mask as opposed to a normative way, whereas others are doing it this way (video chat), showing compassion through the medium of technology.

What challenges have you faced at your trust?

Mental health trusts and probably community trusts as well, one of the challenges we faced at the beginning was that people talked about what health services would we stop doing. In other settings, care workers had to stop to be ready to fight the disease, such as elective surgery, some of the routine work has been stopped.

In mental health, our conversations about what we could stop rapidly became conversations about what we could start doing, and so one of our challenges has been keeping everything running, there has been nothing we’ve been able to stop running, our sense has been that for example had it been a short term crisis, we might have thought about some of our IPTS (intervention to psychological therapy services), being something that for a short time people could do without.

Actually what we realised really quickly, was that levels of anxiety were going to increase, not just in the people we already knew, but also in people who had never touched mental health services before; thinking about staff who were going to be providing care in very traumatic circumstances, they were going to need psychological support in a way they never have before. That was really quite a challenge at the beginning. Other challenges like how do we put in place services such as 24/7 crisis intervention services for the general public when you’ve never done that before, and you thought you would be managing over the next 18 months; but you do it in weeks.

What learnings have you acquired over the past few months in Covid?

I’ve learnt how important it is to be honest about what we can and can’t do, what we know and what we don’t know. To be really open about our weaknesses and our vulnerabilities. As leaders, as organisations, as a society, I’ve learnt that the power of collaboration and partnership, you know it philosophically at some level but it has really come home; we achieve nothing of great value on our own – teamwork has been so important. People who give their lives to public services have the ability in times of huge perusal stress and anxiety to give even more.

Our adaptive ability also, if I think about the use of technology, we are no different to other organisations; people have said it will take a long time, we won’t be able to do these things; the amount of training we need to give people to learn to use these technologies and these techniques that are available to them, the ability for us to do that as a substitute for face to face contact with our patients, is going to take time and do it in a very considered way. The ability to adapt to these things is much greater than we allow ourselves credit for.

Have you been able to keep care to patients personal despite the requirement to wear PPE?

You’ll have seen on social media, small things like having photographs on your apron, your name available there, your name on a headband or a hat, recognising and supporting people to understand the power of your eyes and what your eyes tell; people often say that you smile with your eyes, that’s been quite important. The use of technology in terms of being able to use our tablets on wards, showing people the tablet as a means of communicating. It has been very challenging for people in our deaf services, how can you have a transparent place in your mask, also in dementia services as well where we know that people rely heavily on the ability to read expression, to see people’s lips to recognise the are being spoken to and recognise what’s being said.

What technology would you like to see stay the most after Covid-19?

I would want us to build on all of the technological innovation that has happened, although my colleagues would say “some of this isn’t innovation”, it is about implementation. I happened to be talking to one of the team leaders a couple of weeks ago, and he said “we are never going to go back to that sludge back in our caves, are we?” – I thought, how wonderful, that really stuck with me; the use of those two terms, the sludgy way of working in caves rather than in this much more modern world.

I want us to build upon all the technological use that we have made in this period. Staff have asked us “are you going to make us all come back to work based in those buildings all the time?” And of course, the answer to that is “no”. The same with from a productivity and face to face timed care, face to face contact with patients, this is just a new type of face to face and we’ve been able to see more patients. Technology is an absolute solution in dealing with the capacity issues that we have got.

What advice would you give to other CEOs and teams?

Be a team. Be truly a team. Take care of each other. Live your values, really live your values, lots of us have got a value base to our work; some of us will use it and make it live all of the time and some of us won’t. Now is the time to make it live – really live it, will you support your colleagues and help them understand living those values is what will help you get through. Be kind to yourself first and foremost; if leaders fall foul of never practising what they preach, then I think we are in trouble.

Anything you would like to add?

Thank you for the opportunity to reflect, we are in this crisis, and so thank you for the opportunity to reflect.