People are at the heart of Hertfordshire Community NHS Trust

Elliot Howard-Jones, Chief Executive of Hertfordshire Community NHS Trust, talks to Sarah Dale about why he loves leading a community NHS trust and its successful ‘hospital at home’ programme

‘You are the heart of everything we do’ is the ethos of Hertfordshire Community NHS Trust (HCT), which provides community-based healthcare services to more than 1.2 million people living in Hertfordshire, West Essex and beyond.

From school nursing to specialist dental or speech services, from community nursing rehabilitation to palliative care, HCT, which has 2,800 employees, is an integral part of the health and care system in Herts.

Elliot Howard-Jones, who joined the Trust as CEO in November 2020, says: “There are 53 different services that we run across the Trust. Some parts of the health service are about seeing numbers; I like working for the Trust because we have a much longer-term relationship with the patients and a deeper connection. We fundamentally change people’s lives and improve the life chances of children. I feel really privileged to be able to do that.”

Prior to working at HCT, Elliot had an integral role during the COVID-19 pandemic as Strategic Incident Director for COVID-19 for the East of England under his role as Director of Performance and Improvement in the NHS England East of England regional team. He led the operational response and strategic planning for the pandemic across the region.

“I wanted to join HCT because working with the community is key to supporting people’s health needs in the future,” he says.

“Fifty years ago people would need the health service for accidents or occasional incidents of ill health and they didn’t live as long, but the whole population is changing. There are more people with more long-term conditions. So we have to find a way to provide a service to support those people with long-term conditions.”

One of the key services the Trust has introduced under Elliot’s leadership is a ‘hospital at home’ service. He had the idea of introducing the service on New Year’s Eve 2020 and just over a fortnight later, the new service was up and running on 15 January 2021.

It started small but now can support up to 250 patients at a time, carrying out around 34,000 home visits a month. It has also attracted attention from across the UK and globally in Singapore and Germany.

“They have all come to see what we do,” he adds. “We have set up a world-leading service out of Stevenage!

“We look at what support they need to be able to remain at home rather than going into hospital to be treated. Increasingly, people have multiple conditions and require a needs-led approach.”

Elliot explains that there are three key challenges for HCT: more children and young people seeking neurodiversity and mental health support; an ageing population and people living with long-term conditions; and the general economy which the NHS relies on to grow services.

To tackle the rise in patients seeking diagnosis and support for neurodiversity, Elliot says there needs to be a wider coalition with other agencies to ensure children and young people are “seen within a reasonable time”.

“You are only as happy as your unhappiest child and early diagnosis and support are vital to ensure children don’t fall behind their peer group at school,” he says.

“That’s also a really important thing for other services such as hearing and sight issues – early diagnosis to smooth children’s pathways.

“With the elderly, it’s about supporting people in their last three to five years of life. That is when people access the healthcare service the most in their lifetimes. For example, an 85-year-old patient with an UTI resulting in confusion would likely deteriorate quickly in hospital where they might not move much, consequently suffering a rapid loss of muscle mass. Whereas if we can see them at home, we can pick up that rising temperature and provide oral antibiotics early, so there is no need for a hospital stay. We want to be able to identify and address issues for people before they become unwell and start to need the Hospital at Home service.

“We are looking at a broader coalition – GPs, voluntary sector and hospices across Hertfordshire. We are also looking for Chamber members with expertise in analytics.”

HCT joined Hertfordshire Chamber of Commerce in November 2017.

“The benefit of being a Patron member of the Chamber and being part of the network is the connection to the business community,” says Elliot.

“It is important that the NHS does not become disconnected from the communities which it serves. It is vital we link with businesses in the local area and the Chamber has connected us to other members who are always a source of inspiration.

“My advice to new members is go to everything. Sign up and go to as many events as you can. The more you go, the more people will recognise you and talk to you and remember you. Also, speak to the Chamber team for connections to business products or services you need or are looking to work with. They know the members well and can put you in touch with the right people.”

It is important that the NHS does not become disconnected from the communities which it serves. It is vital we link with businesses in the local area and the Chamber has connected us to other members who are always a source of inspiration.