Our social value lead for Wales, Prys Jenkins, invited Huw Thomas, Director of Finance at the Hywel Dda University Health Board to join this episode of the Portcast. Hywel Dda UHB is a local health board that provides healthcare services to a total population of around 380,000 people throughout Carmarthenshire, Ceredigion and Pembrokeshire. They have contracted with us for 5 years to support the health board embed social value in all of their activities and while our relationship with them is in its infancy, we have already delivered a Needs Analysis document across all 3 of its local authorities.
We discuss our recent partnership with them as well as their COVID vaccination programme, having been the first organisation in the UK to roll out the Moderna vaccine.
This transcript has been edited for concision and clarity
Prys Jenkins [00:00:59] Hello a croeso, welcome to another episode of the Social Value Portcast, the podcast series where we spotlight organisations from various sectors and industries across the UK, which embed social value as part of their day-to-day practices. I’m Prys Jenkins, Social Value Lead for Wales of the Social Value Portal, and joined with me here today is our guest, Huw Thomas, Director of Finance at Hywel Dda University Health Board. Diolch am ymuno gyda ni, thanks for joining us here today, Huw.
Huw Thomas [00:01:30] Diolch am y croeso, glad to be here.
Prys Jenkins [00:01:35] Hywel Dda University Health Board provides health care services to a total population of around 385,000 people throughout Carmarthenshire, Ceredigion and Pembrokeshire. They have contracted with us at Social Value Portal for five years to support the University Health Board embed social value in all of their activities across procurement, planning, recruitment, wellbeing and, in the future, patient outcomes. So, Huw, let’s kick off with the first question. Tell us a bit about you, who you are and what your role is within your organisation.
Huw Thomas [00:02:10] Diolch, Prys. So I’m Director of Finance for Hywel Dda University Health Board and have been here for some three years now. I’m from the patch originally, born and bred here, and I was lucky enough to get the opportunity to come back here as finance director. I guess it was at some point fairly early within the pandemic that I started to think that recovery from the pandemic needed to be one that was inclusive, one that really addressed our social inequalities within our patch and one that created and kept wealth within our communities as far as possible. That’s when I started to reach out to organisations who could support us and clearly Social Value Portal were there and able to help. I guess you brought to the fore for me the opportunity to think creatively about how we embed the Well-Being of Future Generations Act in the way in which we work and operate and hence the start of our work with you, Prys.
Prys Jenkins [00:03:26] Could you give us an overview of Hywel Dda Health Board and the motivation behind delivering social value?
Huw Thomas [00:03:33] Hywel Dda Health Board is an integrated NHS organisation – by integrated, I mean, we commission and provide services. We plan our services on the basis of delivering for the population of the three counties of West Wales that you’ve already outlined. And we provide, directly, services through four district general hospitals, our community services in those three counties, and commissioned services from primary care – so GP services, optometry, dentistry and the like. We commission tertiary and specialist services from other organisations. We also commissioned the ambulance service to provide our ambulance service in the West. We work very closely with some of our local authority partners as well in the provision of joint services through arrangements
with those organisations. So quite an all-encompassing organisation that deals with everything from mental health to physical health across those settings. In terms of our involvement, in terms of thinking on social value, I guess, you know, it’s a reflection that a recovery needs to be something that’s all-encompassing, a recovery needs to address the inequalities in our society. Otherwise, it’s not really a recovery and that’s been quite a powerful driving force for us. That’s united a number of policy objectives, a number of strategic objectives for the organisation in aligning me with the Director of Primary Care, Director of Public Health and our boards as a whole around this agenda.
Prys Jenkins [00:05:39] What are your short and medium-term ambitions when embedding social value into health board activities?
Huw Thomas [00:05:46] I think the work that we started off with the Social Value Portal has been incredibly powerful. If I reflect on the needs analysis, that has given us a view of deprivation of need across every geographical ward we have within our patch and across the seven well-being goals set out in the Well-Being of Future Generations Act that’s incredibly powerful. I think it will enable us to be almost laser-like in our focus now on addressing the specific issues which are affecting each of our communities. Each deprivation isn’t uniform, not in its cause or in its response, and being able to focus in on those areas of deprivation and those drivers of deprivation which differentially impact our communities, I think, is going to be incredibly powerful for us. So, from my perspective, the long term impact of this will be to change the way in which we respond to our communities needs from a healthcare perspective, but also respond to our communities needs in terms of our corporate objectives. So I want to get to a place where we can think very differently about our supply chain to make sure that we are engaging with our local communities and putting wealth back into our local communities, but also driving our recruitment activities so that we go into those areas where there aren’t the great job prospects that you might hope for and tailor our offering to reflect the needs of those people in those communities and give good opportunities for them developing good jobs for the future.
Prys Jenkins [00:07:55] Could you elaborate on what your team’s approach has been to the Well-Being of Future Generations Act? And how does social value fit into this approach?
Huw Thomas [00:08:03] Yeah, I think our approach to the Well-Being of Future Generations Act – I think it’s an interesting Act in the first instance and I think well ahead of its time, an excellent policy framework that I don’t think we fully realise the benefit of for some time in the NHS broadly in Wales. And now we are seeing the impact and opportunity that gives us with our recovery. In terms of our approach up till now, we were, I would say, approaching it through quite a piecemeal approach – some great examples of some great case studies individually. But the overarching framework was something that we neglected, partly because we had not mainstreamed it, and I take responsibility for that and think as we emerge now, mainstreaming the impact we can have through procurement, through finance, I think is a really key opportunity for us. I now do understand the full opportunity we’ve got through embracing the Act and understand the critical role that I have as a finance director to enable the organisation to really embrace that Act in terms of what we do in the corporate domain,
Prys Jenkins [00:09:40] I have to approach this topical question – has the pandemic changed the behaviours within the health board, and do you see the measurement of social value being a real benefit post-covid?
Huw Thomas [00:09:51] Absolutely. The pandemic has changed our outlook and approach. It’s certainly affected my thinking personally. I think in the public sector we’ve often thought of ourselves as consumers of value, not as creators of value. And that for me has been a key change through the pandemic. Society has had to make some very significant sacrifices to keep us all safe, to keep us all healthy and well, and as we emerge now it’s absolutely imperative that we in the public sector work differently as part of our role in society, as part of our role as anchor institutions within our communities, and think of ourselves as value creators, as creators of wealth. And that, I think, has been a very underplayed opportunity we have within the public sector and one that I’m now certainly keen to embrace.
Prys Jenkins [00:11:09] Thank you. Slightly away from the social value piece, how has Hywel Dda managed the vaccination rollout and its success in West Wales?
Huw Thomas [00:11:19] Gosh, I have to say there’s a great team who’ve been involved in our vaccination programme, and to a large extent the finance team has been looking in on on the work that’s been going on there. But in terms of the rollout, led by the Director of Public Health but also working in close collaboration with colleagues in Welsh Government and across health boards across Wales, it’s been a collective exercise of teams coming together to deliver what’s been an audacious challenge and deliver it in a really flexible, reflective way, reflecting on local communities. In contrast, if you’re in an urban setting, delivering through mass vaccination centres works because people have got the ability to get to those mass vaccination centres. In a rural setting, you have to think quite differently about how you approach it. There’s a huge debt of gratitude to our primary care teams at GPs, our pharmacists who’ve been working with us to deliver in a variety of settings across the patch, including working with colleagues like the Mid and West Wales Fire and Rescue Service to deliver in mobile units across our patch as well, getting to communities that are otherwise quite hard to reach and taking the vaccine to our communities rather than necessarily just expecting people to come to central units to collect their vaccine. So, a huge collective effort, a real team effort across the public sector which I think we will be looking back on with real pride in years to come.
Prys Jenkins [00:13:23] Do you think this type of social value measurement will change the way the health board will work in the future?
Huw Thomas [00:13:30] Absolutely, I think we’re fairly early in our journey with Social Value Portal. We’ve had our first piece of work done in many ways through the local needs analysis and the richness of that information, the richness of the data that’s coming out of that, is giving us an understanding of our communities that we’ve never had before. The data is incredibly rich but it’s also very simple to navigate and understand and to use in designing and thinking about the way in which we deliver services. So, yes, it is going to change. It’s going to change the way I think we approach clinical services and corporate services to best effect for our community. So, yeah, I do see it having a huge impact.
Prys Jenkins [00:14:30] And Huw, how have you worked to encourage social value delivery in the area and the community? What partnerships have supported you to do this?
Huw Thomas [00:14:40] As I say, I think we’re at a fairly early stage in our work if I’m honest and there is much, much more to do, this is a long-term project. I was reflecting on this yesterday with a colleague, and I think there are three things that we really need to think about. The first is mindset, how do we work with our partners to shift our mindsets into really embracing this as a key role of what we have to do in the public sector, in our
role as an anchor institution to influence our supply chain and our partners to do things differently as well? The second one is skill set, you know, this is a different skill set, it’s a different way of thinking. Is the way in which we procure goods and services historically in the NHS how we get best value for the pound we spend? Thinking very narrowly from a corporate perspective, this now broadens that out into the best value we can get for society. That’s a hugely different way of looking at procurement, a hugely different way of looking at the depth of our supply chain that comes through in our communities and there’s a piece of work to do to build our skill sets in that place, to navigate our complex procurement rules and bring in an approach that embraces social value. And the last thing then is toolsets, you know, it links closely to skill sets but we do need to make sure that we’re working on appropriate data sets, appropriate approaches and themes to really get the most out of delivering on our social value requirement.
Prys Jenkins [00:16:38] And just from a broader angle, how do you see the uptake of social value across other health boards, maybe in Wales or across the UK? And how does that fit in with other public and private sector organisations?
Huw Thomas [00:16:51] I think there will be a growing need to embrace this. I do think that there is an opportunity, now that regulations around procurement are in flux post-Brexit, to think differently about how we approach the market, think differently about how we approach our supply chain. I think, as I say, it comes back to thinking of the public sector as a value creator, not a user or a sink of value. So we need to embrace that approach. How is it currently? I think we’re in our infancy, I think we’ve got a great policy framework in Wales with the Well-Being of Future Generations Act so coalescing around that, I think would be quite critical, and I can see that certainly you’ve seen that in Welsh government’s approach and certainly seeing that from colleagues in other health boards and in our neighbouring local authorities. I think politically there will be an increased drive into thinking about what we do with procurement, in particular to buy local. But I think social value is much broader than that and I do wonder whether it will get the right response from organisations across the UK. I think in Wales we’ve got the right policy framework, we just need to make sure that we’re properly embracing that within the delivery arms of government, through the NHS, through our local authority partners, as I say.
Prys Jenkins [00:18:36] Diolch yn fawr, thank you for joining us on the podcast today Huw. But before we wrap up, I must ask you why is social value important to you personally and for the team at Hywel Dda?
Huw Thomas [00:18:47] Thanks, Prys, for that. Why is social value important to me? Social value is important to me and the team here because we are embedded as part of our society here. You cannot disentangle the health board from the environment and the society within which we live and work. And it’s important because I think we have all got a duty to make sure that everyone has a fair chance to contribute and benefit from the opportunities that we have as a health board and the challenges that we have as a health board. I want to make sure that we are as inclusive as possible in our work and in the impact that we have. We need to be very focused now in an environment that’s likely to be resource-constrained over the next few years to make sure we have the biggest possible impact on our communities. Social value is a key route into delivering that inclusive recovery.