Ruth works as a system leader within Sandwell Place supporting staff, services and people (patients) as they navigate urgent and intermediate care pathways including hospital discharge. This is a hands-on, operational role accountable to both health and social care partners with the remit to improve everything in scope of intermediate care, including flow. Her background in rehabilitation and palliative care exposed her to the value of integration in delivering better patient outcomes and improved job satisfaction for staff. This has led to the development of integrated teams and pathways which have challenged the traditional models of healthcare delivery. One example is the Integrated Care Service (@icares_SWBH) which has been cited as an example of good practice by the Kings Fund (2014), NHSE (2017) and NICE. She brings creativity and a systems psychodynamic approach to problem solving ensuring everyone has a voice and is involved in the co-design of change programmes. She describes her role as being either a container, helicopter or dating agency and sometimes all three at the same time.