Reflections and learning from our outgoing joint Medical Director
Our Joint Medical Director, Dr Jonty Heaversedge, has been working in healthcare in south east London for 30 years. In that time, he has held many roles, including as a GP, educator and media doctor. During his time with the CCG and subsequently ICB, he has been instrumental in developing and championing system leadership across SEL.
Jonty is now moving to Singapore for an exciting new role. Before he goes, we sat down with him to discuss his career, his vision for the future of integrated care in south east London and his new role in sunny Singapore.
Q: What is your role in the ICB and ICS?
A: My role is Joint Medical Director. I work on the Integrated Care Board (ICB). We represent health and care across SEL and have a responsibility in the system for thinking about how we plan and pay for the care for people who live in south east London. There are many aspects to my role but at heart I try to bring a clinical perspective to our work as a Board and ensure we continue to improve the quality of care people using our health services in SEL experience.
Q: Can you tell us a bit about your career path and how you got to where you are now?
A: I’ve been working in south east London for nearly 30 years now. My career path has always been somewhat meandering; the common thread is that I want to help people, but there are many ways to do this and I’ve never had a set objective, or a particular goal that I want to attain. I am lucky because in many ways has this given me the flexibility to explore new opportunities as they’ve arisen.
I started my life in south east London as a practicing GP, but have done a number of other things over the last 28 years. As well as my clinical work as a GP I have worked as a psychotherapist, as teacher/trainer of medical students, I’ve worked in the media, which was incredibly exciting and brought lots of joy. I then worked in health service management – seeking to improve the care that local residents receive and think about how we design high quality, equitable health and care services for the future.
I’ve had a range of different experiences. I worked across London developing our strategic approach to primary care and building shared digital and data capabilities for the region. Most recently, I’ve been very involved in thinking about how we innovate in the healthcare system. I’ve been working in north west London as the Clinical Director for Imperial College Health Partners, an organisation that supports the system there to adopt and scale innovation to improve care processes for both patients and care professionals.
Q: Would you say that this sort of career is something that anyone in the NHS could do? Is it open to all, and what advice would you give them?
A: I feel very privileged to have been able to experience a number of different roles during my time in SEL, and I would definitely encourage other people be curious and keep learning throughout their career if they are able to do so. I recognise that being a doctor has given me some advantage, but I would say to anybody working in the NHS or the wider care sector that it’s important to explore new opportunities that stretch your knowledge and understanding. We all spend much longer in work now and I do think getting involved in a range of different professional experiences has broadened my perspective and brought me greater fulfilment and joy. But I would absolutely acknowledge that it has been easier for someone in my position as a clinician.
Q: What have been the biggest changes you’ve seen in the 30 years you’ve been working in south east London?
A: Over the last 30 years, we’ve seen significant changes in terms of the technological and treatment advances in health and care services. But I think what I have probably noticed most is the fundamental shift from being a service focused on illness to a service focused on health. This includes how we think about prevention and helping people to stay healthy and thinking about how we involve our local communities more in the work we do, including addressing the wider social and economic determinants of health that drive inequalities of outcome in our population. I think more than ever before, the inequity experienced by our communities has become a very strong priority for us in south east London and it’s a big challenge we’re facing.
Q: How can we address this challenge?
A: Change is not going to come about through the heroic leadership of individuals. It’s going to be the result of us helping to unleash the potential that exists within our local communities, our voluntary and community sector, and from our frontline clinicians and care professionals across south east London. What we then need to do is furnish them with the opportunity to be able to make a difference. Many of them at the moment don’t feel as though they have the time or the skills to contribute to change, even though they’re deeply motivated to make a difference.
One of the things that I’ve been focused on is thinking about how we enable people to develop the capabilities that they need to really start to tackle some of these challenges, within the complex environment that we work. Thinking about building system leadership and ensuring we make this accessible to people from across our communities and our care professions feels fundamental to addressing the challenges we face.
Q: You frequently mention innovation when you speak. Are we on the right track, or do we need a more radical approach to change?
A: You’re absolutely right; innovation is a passion of mine. However, it’s crucial to clarify what I mean by innovation. It’s not just about new ideas or inventions – or new technology. In reality, we already possess the ideas needed to transform the way we deliver healthcare. In south east London, we’ve encountered remarkable and radical ideas within our local communities, voluntary community sector, and provider organisations, so there’s no shortage of ideas.
The challenge lies in scaling these innovations within our system. My focus has shifted towards identifying fantastic ideas and providing the individuals and teams behind them with the skills to scale their work across south east London. For me, innovation is more about unleashing what already exists within the health and care system than going in search of new ideas.
Q: How do we bring it all together and stop silo working? How do we overcome the fragmentation and disconnection within the system to make integration and partnership approaches more effective?
A: That’s really what our system development work has focused on over the last couple of years – deepening partnership working and collaboration. This is not rocket science – as in any relationship it starts with being inquisitive and inclusive of other people’s perspectives, and appreciating and celebrating the contribution they make. Building trust across organisational and administrative boundaries takes time – we have spend many years emphasising differences in our system, we cannot suddenly turn this around overnight. We could all benefit from learning from each other and then building on the strong foundations of trust and connection that we are creating. This is not a passive process – it requires real effort, and this is hard with so many other demands on people’s time. I really think it will be the strength of relationships between our system partners that will determine our success as an integrated care system.
Q: You’ve emphasised the importance of leadership in south east London. How do we form connections across existing organisational boundaries? How do we learn from each other?
A: That isn’t going to be through central direction or diktat. It is going to come from creating the conditions for people to share what they’re doing – to inspire and energise each other and create a sense of permission in our system for people to reimagine the care they provide, share what they do, and be willing to learn from each other – in a much more systematic way than we do now. This has been at the heart of what we have been doing through our South East London System Leadership Academy – and in particular our ‘Connect Community’.
Q: What’s the most important leadership lesson you’ve learned in south east London?
A: The greatest lesson I’ve learned as a leader in south east London is that it’s not about me (I realise this might surprise some of my colleagues!). My natural tendency, perhaps influenced by my clinical background, was to be the problem solver and take a heroic leadership approach, believing that my individual efforts alone could drive change. However, I’ve come to realise that this isn’t the case.
Meaningful change will come from empowering others to be the agents of transformation. Letting go of the need to be the sole driver of change has been challenging, but crucial.
Curiosity, active listening, and fostering connections are also vital aspects of leadership. I often play a role in connecting people from different parts of the system to catalyse change. Courage is another essential trait in system leadership, especially in enabling those who may not feel confident to speak up and contribute to our work. My time in south east London has taught me that leadership isn’t about individual heroics, but empowering others and harnessing the potential within our system to drive change.
Q: What advice would you give to new and emerging leaders?
A: If I were to share some lessons with new and existing leaders, I’d emphasise curiosity. In challenging times, it’s essential to remain curious and seek connections with others facing similar challenges. Building strong connections, working across organisational boundaries, and developing partnerships are fundamental to tackling the challenges we face. It is these connections that in any experience also enhance your personal resilience as a leader – which can often feel like quite a lonely space. Courage is also vital – not in an aggressive or adversarial way, but connecting with our hearts and enabling those often unheard voices in our system to feel listened to, actively participate, and contribute to bringing about meaningful change. Creating a sense of permission and establishing conditions for active participation in our system are crucial leadership traits from my perspective.
Q: What is the role of the NHS in addressing the broader determinants of health and inequalities within local communities?
A: It’s important to recognise that the NHS alone cannot address all the drivers of inequalities experienced by local communities. We must work in partnership with others to tackle the social and economic disparities in our population effectively – that is central to the purpose of integrated care systems. It’s essential to avoid inadvertently disempowering local partners by over-medicalising the challenges people face. We need to rebalance power across communities, ensuring they have the agency and autonomy to address wider determinants of health and inequalities.
Collaborating with organisations like Healthwatch and the voluntary community sector, who have deeper connections to local communities, is vital. We tend to assume that it is our role in the National Health Service to solve all of the problems that exist for our local community. We have to let go of that because otherwise we will fail to appreciate and value the contribution made by our local authorities and public health teams, voluntary sector, and communities themselves. We also risk unintentionally creating dependency on the health and care sector and undermining people’s confidence in managing their own health.
Q: How do you see the role of diversity and inclusion within the health and care system?
A: I’ve come to understand that we will not solve the challenges we face as a health and care system if we do not include a much wider range of voices within our work and decision-making processes. Enhancing the diversity of our workforce is critical if we are going to understand the experience of the population we serve and ensure they trust the services we provide, but it is more than this – it is essential if we are going to truly understand and solve the challenges faced by the health and care system. Including a broader array of voices in decision-making is not only about enabling people to feel heard, but also about leveraging their unique perspectives to develop different, more effective solutions. Actively involving local communities and diverse perspectives in decision-making processes will significantly improve our ability to address problems effectively.
Q: Now you’re off to pastures new in Singapore! Can you tell us more about the role?
A: I’m going to be doing some work with the National Healthcare Group (one of three integrated care systems in Singapore) and the Centre for Healthcare Innovation, to identify opportunities to work across health and social care in a more holistic way – very much as I have been here. I’ll also be working with the University and Medical School to develop a curriculum that reflects the changing nature of healthcare and emphasises population health approaches.
Many of the challenges that Singapore is experiencing are similar to those that we have in south east London. They’ve got an aging population and significant challenges in how they can continue to deliver affordable high-quality care. Equally, they want to look at how they bring about change, particularly in the primary and community sector. That’s something I’ve been really focused on in London, so I hope there will be many opportunities for shared learning.
I’m also hoping to continue my work around innovation and change, but this will be my first time getting involved in the academic side of the work with the university. This is a big move, and at the age of 52 is not without its challenges! But I’m excited for a new adventure.
Q: What are you most proud of in your work in south east London?
A: Everything I’ve done in south east London has been a team effort, and I absolutely can’t take any individual credit. However, what I’m most proud of is the System Leadership Academy. This initiative focuses on creating opportunities for individuals from different organisations to come together, learn, share experiences, connect, develop leadership skills, and understand how to scale innovation within the system. It reflects my understanding of how change occurs within our system and builds capabilities within the healthcare ecosystem. It is lovely that this has now been recognised both regionally and nationally as an exemplar of how we develop the capabilities we need in our integrated care systems to ensure they are fit for the future.
Q: As you leave, what are you most optimistic about for the southeast London integrated care system?
A: I’m most optimistic about the commitment I have seen from senior leaders across our system to shifting power and resources into the voluntary community sector and local communities. This approach to addressing health inequalities and improving the experience and outcomes of care for our population is central to our partnership strategy and is not something I have seen demonstrated as actively in other ICSs. This will form a strong foundation for the future of the south east London integrated care system. I look forward to seeing how this work progresses and very much hope to stay in touch.