I am sure we can all acknowledge and agree, there’s never what you might describe as a quiet time in the NHS, only moments that feel even busier, when the pace and pressure pick up even more than usual.
I think that’s how it feels this week at East Lancashire Hospitals. There’s a lot on and it does feel tough.
Part of this is down to the implementation of our new electronic patient record (EPR) system which I have mentioned many times in this blog over the past couple of years and will, quite literally, transform the way the Trust works by removing any reliance on paper and old fashioned systems, replacing them instead with live and up-to-date digital notes with multiple, seamless access points.
In the past when I have talked about the huge benefits this will deliver to patients, colleagues working across all services and settings and, of course, partners across the health and social care system, the finish line was some way away. So it was easy to wax lyrical and describe a vision of a system which would improve lives and revolutionise care and treatment.
But fast forward what has seemed like no more than a heartbeat and that system will go live next weekend, with just days, hours, minutes and seconds between now and then – and a whole load of hard work still in front of us before it does. It’s tense and pressured.
The project has been well managed, well-resourced and painstakingly delivered, bit by bit, little by little, by a team which has diligently moved through myriad workstreams, testing gateways and interfacing issues. No one could have worked any harder or focused more.
Colleagues at the chalkface – including people from every team and department – have found time in busy days to interact, to train and engage with the system to ensure they are ready for switch on, able to continue supporting patients and their families in the same safe, personal and effective way from day one.
Some people have and continue to work days, nights, weekends and are most likely still making progress on issues in their sleep as the whole behemoth that is the EPR is unrelentingly rolled out.
To everyone who has driven the programme, delivered it and opened themselves up to new ways of working in already challenging and pressured environments – thank you. We’re nearly there and your contribution to this final push is hugely appreciated.
Running alongside this, the Trust is again preparing for industrial action due to be taken by junior doctors over four days next week – starting on Wednesday morning at 7am and ending at the same time on Saturday, in a dispute with the Government over pay.
You will be aware this is the latest period of industrial action that has affected our services this year and I am both grateful and in awe of how we continue to rally together to prepare for and manage it effectively.
I want to say – again as always – that I completely respect the right of individuals to take part in industrial action and recognise that, for most people, taking the decision to do so is never done lightly or with any ease.
But this particular one is going to be a huge challenge above anything we have managed before simply because of its timing in relation to the EPR. Junior doctors are a large and important part of ELHT and they will be sorely missed during this time.
I know colleagues come forward and pick up more shifts in these circumstances to enable as much day to day activity to proceed, but there is no doubt that losing such a vital part of the organisation for any amount of time has huge implications for patient care, safety and experience.
It’s a real balancing act that will take very careful handling indeed to deliver but, as I have said many, many times before, if anyone can do it, ELHT can.
The continued response here at the Trust has been brilliant and thank you so much to everyone who has played their part in trying to minimise disruption for our patients and their families. It is inevitable that some planned appointments and procedures will be cancelled – and this may be at late notice as the team explores every possible way for activity to go ahead. There may also be longer waits to be seen than usual but do check our website www.elht.nhs.uk for a range of other pathways that are available for care.
I am sorry to everyone affected by this, but please know that if you’re treatment is delayed we will get you back in just as soon as we possibly can.
With all of this going on, you’d be forgiven for thinking I would be chained to my desk but I am a Chief Executive who likes to get out and see people, to check in on the ground and see how we’re doing for myself wherever I can.
So this week I have met a number of people on my travels (and on Teams it has to be said) that have perked me up, seem to have welcomed a visit from a friendly face and just helped take a moment to catch up in these very busy times.
The first is the directorate management team in our Surgery and Anaesthetics Service (SAS) who I met to talk about the ongoing challenges facing the Trust and especially as we move further into 2023 and 2024. I won’t share the conversation in full but safe to say I appreciated the candid and open dialogue which included how we could be more productive and more efficient by considering how we are configured clinically. I don’t underestimate this will be another detailed and challenging project to pull off – but if we can we’ll improve things for colleagues, patients and their families wherever possible.
I also called in on the team in ward C18B at Royal Blackburn Teaching Hospital to congratulate them on a Gold Award presented following a recent, unannounced inspection by our internal SPEC (which stands for Safe Personal Effective Care) assessment team. Clearly from the result they were found to be running a tight ship on the ward and received praise for their approach and commitment to standards across a range of areas. It was great to chat to those on duty and, whilst I know you’re so busy, I appreciated the opportunity to catch up. Well done to everyone in the team.
Of course, underlying all of this and never far from our minds, is the financial position for the Trust and the need to reduce costs without impacting on patient safety. I was pleased to chair our Financial Assurance Board yesterday and hear how our plans to reduce waste and duplication, as well as transform and innovate to do more for less, were progressing well. We’ve made a great start towards achieving some tough targets on the budget this year – but there is more to do. Thanks to everyone who is doing anything they can to help – and that includes everything from switching lights and kit off where possible to save energy to collaborating with others across the wider system to do things differently on a much larger footing too.
We don’t have a choice in this – accepting we have to do some things differently and reduce our costs and improve our value for money for the tax payer – but it is a challenge and additional ‘ask’ of people who are flat out and feeling overwhelmed with the size and scale of it on some days already.
To my initial point – and I am talking to colleagues specifically here – I know there is a lot on and it feels like a very tough place to work at the moment but, please, keep going. I have spoken many times about how we ended the year 2022-23 in a very positive place and that was down to you and your hard work. It is appreciated and valued and we couldn’t do it without any single person who is part of this brilliant team.
To our patients, their families, our partners and the community as a whole, know that everything we do we are doing for you. We’re doing our best and no matter how hard it gets we will be here for you as always.
There is going to be some disruption as the EPR is implemented and industrial action continues to impact on our services. Please, be patient and be kind with the team and help us where you can by seeking alternative places for care where safe and possible.
Thanks for listening – and also your lovely feedback on the blog. It is appreciated. I have also heard from lots of people who caught the piece on ITV Granada earlier in the week about our ‘Head of Happiness’ Alfie the therapy dog. If you didn’t see it, you can watch it back here and, if you need a bit of relief, I absolutely recommend that you do.
Martin