As is often the case in life, this week has been something of a mixed bag of experiences and emotions.
On one hand we’ve had some difficult issues to deal with and resolving them will take some time in some cases, but on the other we’ve had positive and uplifting news too.
I have said before that one of the biggest challenges I have as Chief Executive of a large and multi-faceted organisation, spread out over a big and diverse geographical area, is how you get to the bottom of the real and consistent experience for colleagues, patients and families.
This remains something that preoccupies my mind as I hear about issues and triumphs in equal measure. The truth is out there though, as they say, and I am determined to find it and face so we can continually improve areas that matter to local people and to colleagues where needed.
Of course, things are always going to happen that are out of our hands and it’s important we’re able to react and recover without derailing important day to day priorities. When you work in health care tasks and activities involve people and their quality of life and so the day to day grind can also, literally, be life and death.
On Wednesday night the team moved quickly to manage an incident on one of our wards at Royal Blackburn Teaching Hospital, when a fire took hold of one of the bathrooms. I won’t say too much about how it started to respect an ongoing Police investigation, but I am grateful for the swift action of everyone involved to contain and manage it. This includes the ward team and colleagues from across ELHT and One LSC, as well as patients, visitors and officers from Lancashire Police and Fire and Rescue Service who attended very quickly to help.
You can imagine in a bustling hospital with one of the busiest A&E departments in the UK that we’re used to dealing with incidents and evolving issues, but there’s no doubt a ‘phone call about a fire will always bring you to sharp attention. I was beyond pleased to hear that whilst some colleagues were treated for smoke inhalation, the ward was evacuated effectively and everyone very quickly accounted for. Once investigations had concluded the ward was closed for a deep clean but, again, as testament to the spirit of ELHT, it has reopened albeit a new bathroom will be now be required.
A huge and heartfelt thanks to everyone who stepped in and stepped up in this moment and in the hours afterwards to ensure everyone remained safe and cared for. I am always in awe of the machine that kicks in during these moments, run by incredibly able people who have my full confidence and admiration. Thank you to everyone involved.
We have also been dealing with some issues in our pathology labs, which processes hundreds of thousands of samples and tests on clinical specimens every year, not just for the hospital and its services but for the wider primary care network, including local GP practices in East Lancashire.
The team is critical to ensuring clinical colleagues are able to access and obtain information about the health of their patients to aid diagnosis, treatment and prevention of disease – and as with many things in recent years we have seen a huge increase in the number of tests coming through.
This week unfortunately we have had some issues in processing them in the lab and I know this has resulted in some GP surgeries recalling some patients to redo tests again. I want to apologise to everyone who has been in this position and acknowledge the extra work this has created and, not least, the additional time required for both clinical colleagues and patients.
I completely accept also that some patients find having tests really difficult mentally and physically and will already be anxious about their health and the outcome of diagnostic tests. I am sorry if this issue exacerbates that. I will say we picked the issue up quickly following the weekend and immediately launched an investigation into what happened. Our focus now is to recover the position as soon as possible and make sure colleagues are supported over the Bank Holiday weekend. Again, my thanks to everyone who has been looking at this issue and trying to resolve it this week.
Of course, all this creates extra work and inevitably extra cost for everyone at what is the most financially challenging time the Trust has ever experienced.
Regular readers of the blog will know we have an eye-watering deficit for this year, which in plain English means we have to reduce the amount we’re spending by around £61million. This is more than £1million a week or about £230,000 a day over a five-day working week. Keen mathematicians will calculate further that if you do eight hours a day on average that’s a consistent reduction of about £30,000 an hour, every hour of every day of the year.
Adding the cost of a ward closure, a deep clean, a new bathroom following a fire, repeating samples and other additional costs such as covering the recent industrial action taken by resident doctors all increase the amount we spend and subsequently have to save to balance the books too.
But colleagues across the Trust continue to focus on reducing costs whilst maintaining and improving services and I am grateful for the ongoing effort and energy being put into this critical task. At month four, which is July in the financial year running April to March, it is slowly starting to pay off. We are now seeing a consistent reduction in our spending, we are using less temporary workers to cover shifts through our bank and via expensive agencies and we are broadly delivering the huge range of saving schemes as planned.
When I talk about money I am always keen to link it to our performance too, because as important as our budget is, patient safety and high quality care will never be replaced as the top of the priority list so long as I am in the CEO seat.
I mentioned last week the NHS nationally was returning to robust monitoring of key targets and that rankings and ratings were becoming a weekly update into the Trust, including comparisons with similar Trusts so that we can see how we’re doing compared to the best. I won’t repeat the detail but you can read that blog here if you missed it.
What I do want to highlight is that this week we improved on the number of patients we see within four hours of presenting in urgent and emergency care and were one of the top 20 Trusts in the league table. I have mentioned we are one of the busiest A&E departments in England and so to achieve this is really positive indeed.
We also continue to do well on the time it takes from being referred for treatment by a GP to accessing services. The target is 18 weeks and we’re doing that about 60 per cent of the time. Of course we can and would always want to be better and, in particular, we have a lot of work to do on patients who come into A&E and wait more than 12 hours to be admitted to hospital for inpatient care. We are also working hard to reduce the number of patients who have waited over a year for a procedure and will continue to do so for some time to come.
What this information and myriad other data points from many different systems and sources does tell me though, is that operationally we continue to perform well, on the whole, across hundreds of services and settings in East Lancashire.
Of course, for patients I know how good we are will only ever be judged by personal experience of care and we continue to focus on ensuring this is positive for everyone equally. I have said many times we don’t always get it right, so please do provide feedback of your experience whether it is good or otherwise and we will always listen and take action where we can.
As we approach the Bank Holiday weekend and what will be the final days of the summer and school holidays for some, I want to thank each and every member of ELHT for everything they have done and continue to do. This includes the good things and the things that need to be better, that I can confirm we’re focused on every day.
I remain of the mind that whilst we’re not perfect we are making a huge difference and our contribution to our communities is huge. I do hope we all get some downtime over the Bank Holiday but am conscious of everyone who will be in covering a shift too. Thank you for that.
If you’re a local resident or patient, please do be mindful of the continued pressure and demand on services – which clearly translates to pressure and demand on the team. If you need to come in for care we are here, always, but it is always worth checking whether we’re the best place for what you need here and, indeed, you can also check our waiting times across a number of locations here.
If you do find yourself needing our care, please be kind to colleagues who are working hard in very difficult circumstances and absolutely doing their best for you. It’s appreciated.
Martin