At the end of July 2019, Julia Clarke, Chief Executive of Bristol Community Health (BCH) and Steve Hughes, Chair of the BCH Board stepped down following the announcement that Bristol Community Health had not been selected as preferred bidder for the Bristol, North Somerset and South Gloucestershire Adults Community Services tender.
Julia was appointed CEO in 2011, ahead of the spin-out of our staff-owned social enterprise, created by and for the NHS to deliver community services for Bristol. Under her leadership the organisation has secured financial sustainability and grown from a turnover of £43 million to £78 million, securing a range of children’s public health nursing and therapy services in Bristol and South Gloucestershire, successfully re-tendering for healthcare in five prisons, and retaining Diabetic Eye Screening services across BNSSG. The Adults’ contract was extended three times from an initial 3 years to a total of 9 years, prior to the recent retender. In 2016 the company was awarded an overall GOOD from CQC, who noted a number of areas of outstanding practice, and commented particularly on the exceptional care for staff demonstrated by the leadership team. Under Julia’s leadership the company has maintained a continual focus on clinical quality, governance and improvement, and the involvement of patients, carers and the public in determining priorities as evidenced by successive published Quality Accounts. Throughout her tenure the company has demonstrated a willingness to innovate and challenge established thinking and has been a strong system partner.
Julia said: “Having had the privilege of being BCH’s Chief Executive for over 8 years, I have decided that this is the right moment to step down from leading the organisation and to leave it in the hands of Board colleagues to determine the right course of action for the future.
In addition to what we have achieved for the people of Bristol and beyond, I’m incredibly proud of BCH for a number of reasons. Firstly, we have really developed as a staff-owned organisation. It has been fantastic to have a wonderful Staff Director in Georgie Davin, and an active Staff Council helping to co-create the company.
Secondly I have had the privilege of working with some amazingly talented people both in the senior team and throughout the organisation – in clinical, front line, management and head office roles. Together we have created a real ‘one team’ ethos with exceptional staff engagement. I recruited and developed a leadership team of outstanding talent and together we have enjoyed the highs and lows of business together as a close-knit team supported by a dedicated Board, enhanced through a ‘Board Diversity’ non-executive director post for which I shared an award from the NHS Leadership Academy for Inclusive Leadership, with the first appointee.
Thirdly we have developed a unique and meaningful partnership with the Voluntary and Community Sector in Bristol. The current level of trust and partnership working is the fruit of years of dedicated hard work on both sides, with the aim of learning each other’s language, developing genuine mutual respect, and understanding each other’s strengths, perspectives and priorities.”
Rhona MacDonald, New Chair said: “On behalf of the Board and Senior Leadership Team, and the patients and communities of Bristol, I would like to thank Julia for 8 amazing years, steering BCH from Provider Arm of a Primary Care Trust to the largest staff owned healthcare provider in the country. Julia’s optimism, her community ethos, generosity of spirit and commitment to help others to grow have been particularly important in making BCH the special place that it is.
In a message to staff Julia Clarke said:
Dear friends and colleagues
You will know by now that our bid for the Adults Community Services contract was not the highest scoring bid and that the CCG are progressing discussions and due diligence with Sirona Care and Health, and that consequently I am standing down as Chief Executive.
I am sure you will be asking yourselves ‘What went wrong?’ I want to assure you that the bid we submitted was comprehensive, detailed and high quality. I am proud of the work done by staff, the bid team and directors from both BCH and NSCP, under the leadership of Michele Narey, on this monumental piece of work. No one could have worked harder over the last 6 months or with more commitment. Our financial submission was acknowledged to be stronger but this did not offset lower scores on many other questions.
We worked hard to offer the CCG the safe transfer they were looking for and our proposed merger with NSCP was part of this strategy. This meant that our partnership already delivers in 5 out of 6 localities and between us we employ 75% of the staff delivering adult community services. We felt this would minimise the cost and risks in bringing together three community providers into one, allowing a phased transfer and involving all staff in naming and building a new organisation for BNSSG.
Our combined financial resources also meant that we could securely fund the entire mobilisation and transformation without recourse to outside borrowing, ensuring that none of the funds were required to pay interest and repayments on loans.
We were also confident about our track record on quality based on our CQC rating, our exceptional quality accounts and our strong clinical governance. And we felt that we had developed a unique understanding and partnership with the Voluntary, Community and Social Enterprise Sector across BNSSG.
We have undertaken a full review of the CCG’s feedback on our bid and we have sought additional information and clarification from the CCG, and taken professional advice. The Board has decided that in the light of this there is no merit in questioning the decision any further and it is now in the best interests of patients, our community and transferring staff to facilitate a smooth and safe transfer of services. At the same time the Board will be considering the right future for our other contracts, our central services staff and how to best deliver on our community purpose as a community interest company in this new situation.
I believe passionately in Staff-Owned Social Enterprise as part of the mix of NHS providers bringing passion, energy, creativity, business acumen, financial discipline and innovation, which is sorely needed, to healthcare. I am disappointed that our Health and Care system and the people and communities we serve will not have the benefit of everything that goes with this and everything we are.
I am hugely proud of what we have achieved together over the past 8 years and those multitude of outstanding moments of care which have touched so many lives will live on in people’s hearts forever. I have never been happier in my job than when talking to staff, hearing about your achievements and what you love about your jobs, observing you performing your day to day duties with such skill, care and compassion, and then trying to make your working lives better.
At the end of the day I know that, regardless of employer, our staff will continue to deliver fantastic care and support and will draw their strength and enthusiasm from the support of close colleagues in their local teams. I wish you all the very best for this next phase
A selection of messages from colleagues, staff and stakeholders received within 48 hours of the announcement of Julia’s departure from Bristol Community Health is given below:
- Julia has been a quite exceptional CEO and will be sorely missed. It is a much misused word but I feel it is entirely accurate to describe her as a inspiration to her staff. Having undertaken some work with BCH, I was struck by the high regard in which her staff held her, and their total belief in her concern for their wellbeing. Such a finding from a group of staff is, in my experience, exceptional.(VCSE organisation)
- The last seven years working with [Julia] have truly been a masterclass in great leadership. I saw how much [your personal and emotional investment in the business} touched your staff on a daily basis, that your passion, investment and dedication to making a difference to the people of our communities, inspired others to achieve great things. You have been unwavering in your passion to ensure that community providers have a proper place within the healthcare landscape and have much to be proud of during your tenure at BCH. (close colleague)
- I really admire [Julia] as a leader, she has been very inspiring. I think the loss of this bid will be a great loss to Bristol, the patients and the staff.
- I am extremely sorry to hear you have decided to step down as CEO but I completely understand why. Your commitment and enthusiasm are contagious and your presence, in whatever form the future holds, will be missed. In short, you are a very impressive CEO and I know that you are well liked and respected around the organisation. In all the 40 years I have worked, 33 of them before joining BCH, I have never met a CEO, or senior leadership team for that matter, that has been so involved with the business and more importantly, its staff. It has been very interesting and a privilege for me to be able to be privy to some discussions, decision making and interviewing via the staff council with the board and every one of you has made me feel involved, listened to and valued. (Staff Councillor)
- I just wanted to say a huge thank you for all your dedication, commitment and inspirational work that I’ve witnessed and been a very small part of. You are an incredible woman who has selflessly worked to create an outstanding community health service and achieved so much. (Colleague)
- No company could have had a better CE who was able to promote the new strategy and set an example. You make people believe and the emphasis on not only making a happier and healthier community but ensuring the team delivering services feel the same. (Colleague Children’s services)
- BCH has lost a fantastic leader. You made a big impact on children services, and the staff have a great affinity with you. You have great integrity and are always honest with staff. When I have met you or seen you give presentations, your passion always came across for patients and the services we provide to them, and also your caring for BCH staff and wanting the best for them too….if you ever need staff in the future I guarantee there will be a very long line of people queuing up to work with you again, me being one of them. (Colleague Children’s services)
- BCH is a truly wonderful organisation in which to work. It has given me the autonomy, support and resources that I need to deliver a continuously improving prison healthcare service that does make a difference to our marginalised patients. (Colleague Prison Healthcare)
- As our leader, she has always exuded warmth, genuine kindness and great sensitivity, someone who actively sought to make each and every individual within BCH valued and welcome, for example, sending cards that were personal and supportive. (Colleague Children’s services)
- Your values have clearly been at the root of so much of what is good about BCH. You are admired and loved by so many within the organisation for your fairness, commitment to the people of Bristol and most of all your humble approachability. I have never received a personal card from a CE before and the fact that you dedicated so much of your time to praising and encouraging everyone at BCH speaks volumes about the kind of leader, and in fact the kind of person, you are. (Colleague)
- You have been a guiding light for our organisation, keeping us united in values and ethos as we have grown and thrived. Looking back on the 6 years I have been in the organisation and reflecting on the changes that have taken place, I can see one common thread through all of it which is a constant desire to do the best we can for our communities, and this has come from you first and foremost. You have inspired and motivated everyone in the organisation through your strong belief and sense of purpose, and even today I still feel proud and amazed to have worked in such a brilliant place. Working under your direction has been exciting and engaging, and I have always felt a strong sense of belonging and community that I have not felt at other organisations. I am very happy that I have had the chance to experience this, and am grateful that you have nurtured such a caring and creative environment, full of wonderful individuals who have taught me so much. (Colleague)
- I remember you arriving as CEx, and you are genuinely one of the main reasons why I have stayed all this time. The personal loyalty so many of us have to you is because you always speak from the heart. Your principles, commitment to all of the people BCH looks after, plus staff and the wider community shines through. You have forged an organisation people are proud to work for. (Colleague)
- I just wanted to say a massive thank you for all that you done and been for BCH. From the moment I joined in 2012, you have been someone who has been visible and demonstrated a leadership style that resonates with me strongly. BCH has been without doubt the best employer I have had, and I have worked within 2 acute trusts and 2 GP surgeries, during my 20yrs as a qualified nurse. I have valued watching and hearing you in your role as CEO and have learnt from you when learning and developing my own leadership style and desire to be the best I can be.(Colleague Adults services)
- You have been a leading light, a visionary, and at the same time an eternally positive and ‘real’ leader. You get ‘it’ and what it means to provide excellence in adult services and importantly for me, community nursing. I have worked in the community for 18 years, BCH is my 5th employer in that time, and BCH has easily been the best. (Colleague Adults services)
- Julia you have been an inspirational female leader. Your passion for patient and staff wellbeing always shines through and I have really enjoyed being part of such an innovative health care organisation. (Staff Councillor)
- Please know that BCH was and is an amazing organisation to be part of. I have worn my BCH badge with a sense of pride over the last 8 years.
- It has been an absolute once in a lifetime privilege to work with you. (Colleague)
- You will be a huge loss to the system. I’m sure I’m not the only one who regards you as very visionary and full of positivity – and from a digital perspective probably the CEX who is most ambitious/full of ideas! You will be missed. (System partner)
- All I can say is that you made the most incredible difference to healthcare to the Bristol community. Look where it started 8 years ago and where it is today. What a fabulous legacy. You were the best CEO ever and influenced so many things and people for the better. Bold, caring, fair and best of all original (Former Board Colleague)