Meet Matthew Swindells, the first joint chair for all four acute trusts in north west London

Matthew Swindells has just taken up his new role as joint chair for the four acute trusts in north west London. He will help guide the leadership teams at Chelsea and Westminster Hospital NHS Foundation Trust, The Hillingdon Hospitals NHS Foundation Trust, Imperial College Healthcare NHS Trust and London North West University Healthcare NHS Trust as we build on the increased collaboration over the past two years that has helped us respond to the pandemic. He has taken some time out of his first week to tell us a little about his background and motivation as well as what he sees his role delivering for staff, patients and local communities. 

Welcome, Matthew! Can you tell us a little about your background and how you came to this role?

I’ve worked in healthcare, one way or another, my whole career. I joined the NHS as a graduate management trainee straight from university and it’s essentially been a career of two halves since then. 

For the first 15 years, I worked on the ground in NHS hospitals, such as managing women’s and children’s services at Guy’s and St Thomas’ and being chief operating officer at Heatherwood and Wexham Park Hospital and then chief executive of the Royal Surrey County Hospital. For the next 15 years, I moved into a mix of national roles in health policy and leadership and an international role in digital healthcare. This included time as senior policy advisor to the then secretary of state for health, after which I moved to the United States to run Cerner’s global business before coming back to the UK as deputy chief executive and chief operating officer at NHS England. For the last couple of years, I’ve been an independent consultant, supporting digital transformation in health services around the world. 

My new role as Chair of the Acute Collaborative allows me to bring the frontline NHS and national and international elements of my career together. I am really looking forward to being able to draw on all this experience to support the leadership teams in all four trusts. 

What is your proudest career achievement so far?

Undoubtably, the standout achievement is being the health secretary’s policy advisor when we brought in the ban on smoking indoors. The impact on public health has been enormous, with thousands of lives saved across the country, despite some significant resistance to the legislation at the time. I’m also very proud of lots of the work we did at the Royal Surrey. It had been a really struggling hospital and, when I left, it was hugely improved, with clinical outcome measures bettered by only a few other trusts in the whole of the country—some of which, incidentally, were in north west London!

You’ve highlighted that you’re a local—what matters about living in north west London?

We moved to Ealing around 20 years ago and have been there ever since. We love the area and, while we considered moving further out of London, we decided to stay put. I love that this part of London has everything—the excitement of the inner city, diverse communities, a rich history and fantastic green spaces. It was an active decision to look to become an NHS chair in this patch—I think it matters that boards understand their populations. It doesn’t mean that everyone has to live in the area but it certainly helps. When we’re looking at how our hospitals develop it is important to know which housing estate in Hammersmith we’re talking about or the differences between Hayes and Uxbridge. Awareness of how important hospitals are to their local populations is crucial.

Alongside my huge affection for north west London, I’m also aware it has some big challenges. We serve some of the most affluent boroughs in the country through to some of the poorest. The COVID-19 pandemic has highlighted and exacerbated health inequalities, as did the Grenfell tragedy before it. There’s a huge amount for us all to do to make healthcare, as well as health, much fairer and more inclusive. 

There were once four acute trust chair roles in north west London, why will having just one role help now?

The NHS is facing a really important and interesting challenge right now—simultaneously focusing on improving the health of large populations and responding to local needs and preferences. The issues for Southall are both similar and very different to those for Knightsbridge, for example. One of the key routes to tackling this challenge is the move away from competition between NHS organisations and towards collaboration and creating more genuinely integrated care. 

We have all the pieces to help create one of the best health systems in the world in north west London. We have a highly skilled and diverse workforce with brilliant clinicians and managers, world-leading research and innovation and growing partnerships with our communities and stakeholders. If we bring together the best of what we see across our hospitals—clinical outcomes, patient experience, staff experience—and share it with one another, we have the potential to do something extraordinary. 

Having a chair in common across the four trusts will help our leadership teams to continue to improve their own organisations while also ensuring that, collectively, we become more than the sum of our parts.

What will your role mean to a nurse or a junior doctor or a porter or other staff in any of the hospitals across the four trusts? 

I am here to help carry the vision for how we move forward as a collaboration of acute providers. Put simply, I need to ensure we keep focused on our shared population and goals and that we don’t waste time protecting our old ways of doing things and instead learn from each other to develop better ways for everyone. My role won’t cause any immediate changes for most staff. Over time, I hope that I will be able to support our leadership teams with their efforts to create positive and inclusive working environments that enable us to keep and develop the staff we have and to attract many others. 

Can we expect to see structural change?

We are bringing together four independent institutions to plan and manage in partnership for better care overall. It is much better to use our time and energy on that rather than on internal organisational change. We do need to look at some governance changes but any changes at board level will be designed to improve things for our staff delivering excellent care and we will avoid the distraction of unnecessary reorganisation within the trusts themselves. Essentially, I have joined to help with the next step in a journey of collaboration that is already well underway, boosted by the effectiveness of the collective response to COVID-19. It’s time now to move on from working well with our partner trusts to being actively invested in each other’s success. To our patients and communities, the joins between our services and ways of working should become near invisible while the four organisations continue as separate organisations.

What are your priorities for the coming year?

Firstly, I want to spend the next couple of months speaking to as many people as possible and getting to know our organisations in more depth. I’m not walking into the chair role with a manifesto. I want to find out what really matters to staff and patients. I’m looking forward to working with the excellent leadership teams at each trust to understand how I can best support them and their goals. I plan to be a very visible chair and to get out and about though I will most definitely not be getting involved in any day-to-day management!

If you step back and take the perspective of our population, there are some obvious priorities. For example, ensuring that the best care available in north west London is available everywhere in north west London. We have to reduce waiting times for care and ensure access to care is fair to everyone in our population. Working ever closer with other NHS and care partners will also be key—if care can be better provided at home or by a GP, social worker or community nurse, then we must support that. And, finally, we have some big sustainability issues to get to grips with, not least improving much of our estate and getting on top of our finances for the long term. 

What do you think will be the biggest challenges for our four trusts in the next year or so?

As everyone will be aware, the NHS has a major workforce challenge. As we emerge from the extraordinary experience of the pandemic and into the pressures it has compounded, we have to create working environments than are so much better than what we accepted before. It’s vital that we are organisations where people feel passionately about their work and feel truly valued and included, whatever their background, role or place of work. It is our staff who will make or break collaboration—they will need the right space and support to work with our partners, patients and communities to change the way healthcare is provided. 

What are you most looking forward to about your new role?

Most of all, I am looking forward to getting back on the ground, walking hospital corridors and talking with staff who make a difference to patients every day. Hospitals have such potential for transforming health and lives. We have a huge opportunity, especially through data and technology, to help people stay well. I’m excited to help our organisations be some of the best places for creating and adopting new approaches, such as in genomic medicine or personalised healthcare.

You’re coming into your new role as we look to establish a formal acute provider collaborative and an integrated care board and integrated care partnership for north west London—how do you see these developments interacting?

I don’t think either the integrated care system or the acute provider collaborative can succeed without the other succeeding. Integrated care systems—and the boards and partnerships that will oversee them—have a huge agenda across multiple settings and will be key in helping us all to navigate the massive complexity of health and care. They have great  potential to transform health and reduce health inequalities but it will require all partners to work together to ensure that potential is delivered. 

The acute provider collaborative will be essentially a more formalised approach to the partnership journey our four trusts have been on for some time. We will need to deliver on that acute collaboration—to be more than the sum of our parts across all of acute care—as well as using our ideas, experience and expertise to benefit the whole of our integrated care system.