As always when we have had a guest blog the previous week, I want to begin today by thanking Megan Dowson for stepping in and providing an update from her perspective as one of our brilliant acute care team.
I have said before I love reading the guest blogs and appreciate the way they always give a completely different insight into life at the Trust.
It was great to get an update on Megan’s work leading our critical Call for Concern programme and the Patient Wellness Questionnaire (PWQ), which is currently being trialled on two of our wards - B14 and B18.
Both of these clinically led initiatives are key in supporting patients and families to share their concerns and experiences with us, so that we can understand, respond and improve. If you haven’t read Megan’s blog, please do catch up with it here.
I want to stick with clinical matters this week so far as possible which, frankly, shouldn’t be an unusual theme for a health care organisation such as ELHT, but I am mindful of the need to also balance the continued focus we need on our financial position.
To this point, I met with some of the local Council Chief Executives on Wednesday to brief them on our position, what we are doing to correct it and what the year ahead may bring. They were hugely interested in how we intend to balance the budget through 2025 and into 2026, but what struck me was their genuine appreciation for the challenges we have now and will face in the future.
There was a clear recognition that we were trying to balance managing the budget with our commitment to provide safe, personal and effective care, equally for all communities, no matter the pressure or demand.
This was unexpected in some ways as I know local government colleagues have been under pressure themselves to manage their own diminishing budgets for many years, without much compassion or understanding from others at times. For that reason, I thought I might encounter at least a little apathy to our issues, but in truth colleagues demonstrated real compassion and the same concern that we prioritise care for residents across East Lancashire.
I was pleased to be able to reiterate that the Trust performs well in so many areas that really matter to communities and that recent research across the region showed that ELHT was more productive than other NHS organisations, doing more often for less cost than our neighbours.
As a group we shared a hope that the ongoing intervention into the Trust and our enrolment into the Recovery Support Programme would be beneficial and help us to improve, but also take on board the wider health challenges of the area and how this has and continues to impact on how much we spend.
Of course, the well known and well documented pressure and demand on urgent and emergency care remains a concern for everyone and, whilst this is an area we are always firmly focused on managing effectively, we are making ever more determined efforts to improve too.
In truth, a focus on improving urgent and emergency care and specifically the A&E department at Royal Blackburn Teaching Hospital requires a whole team effort and I am pleased that throughout March we will be coming together across the Trust in a renewed push to achieve this.
To succeed will take colleagues in UEC, working with wards and inpatient settings, community teams across East Lancashire, partners in health and social care and, indeed, patients themselves. As with so many things worth doing, it won’t be easy but the potential rewards are huge too.
Regular readers of the blog, colleagues across the Trust and patients who have attended for urgent or emergency care will know that, for some years now, we have been facing overwhelming pressure with record breaking numbers of people turning up every day.
Demand has significantly outstripped provision on every front, including the physical footprint of the department and this has and continues to result in a regularly congested waiting room with long delays in being seen and, worst of all, in patients being treated on trollies in corridors whilst we try to find them a bed on a ward.
I know the team are working around the clock on what must seem like a hamster wheel of seeing people, making the decision to admit them but needing to discharge others before they can do so. I want to say people couldn’t be working any harder and it remains a source of huge pride for me that we continue to find the energy and drive to go on and indeed go further every day too.
Of course, we do receive complaints from patients and families who feel their experience could be better and I accept completely that we don’t get everything right even on a good day, but it is heartening to see that this feedback almost always ends with a compliment for or about the team and a recognition that they were doing their best.
I know how incredibly difficult these ongoing circumstances are for everyone in all services and settings, on top of what has been an intensely difficult and challenging few years no doubt. We all joined the NHS to care for others and it is clear for all to see that teams across the Trust take great pride in their work and genuinely care about patients.
I will pause here to say thank you to everyone who continues to operate effectively in these circumstances, whilst also being asked to do more for less every day. We cannot and will not normalise this way of life for colleagues or patients and so a reset and refocus through March is a welcome thing in my book.
If we channel the spirit of ELHT and question what we could do differently to change this experience for everyone, I believe we can continue to move forward and make a difference. An initial plan has already been drawn together and progress will be tracked day to day over the course of the month ahead. We’re going to try new things and where they don’t work we’re going to learn and encircle the problem in a different way until it does.
Our main and unyielding ambition is to reduce the need to care for people on our corridors. In fact, let me be a tad bolder and say we want to eradicate this completely.
To do this we’re going to need to focus on discharging patients who are ready to go home as effectively as possible and there is a part for everyone to play in achieving this. Colleagues, of course, need to be tenacious in identifying who can be discharged and we have promoted a sense of ‘why not home, why not today?’ for some time now. Patients can help by making arrangements to leave promptly when they get the clinical green light and, please, if you get a call to pick someone up, make it a priority in your day.
Of course safety is key here and we don’t want to send people home before they’re ready, but diminishing delays and reducing their stay with us is good for them, for the Trust and for the next person who needs our care.
Improving the experience patients and colleagues, optimising our approach so we can be as productive as possible and making the best use of valuable clinical accommodation are our three goals for the month, albeit with the ever present requirement to do it within our financial means.
Please, get behind this and help where you can. I will keep you posted of progress and am feeling optimistic of the impact this will have.
Lastly, a couple of shout outs for colleagues who are living and breathing the values of the Trust and everything I believe to be true about ELHT.
The first is for one of locum consultant urologists Mr. Haytham Elsakka who has been talking in the media about the use of ketamine and its effect on the urinary system. He was most recently interviewed on BBC Radio 4 to help to raise awareness of the significant risks associated with recreational use of the substance which is an issue in East Lancashire and particularly among young people. The great thing is that Mr Elsakka was recommended to the journalist by a patient who had experienced positive outcomes from their treatment.
Mr Elsakka tells me that the number of patients suffering from ketamine abuse is increasing and its really positive that he is taking the time to enhance awareness in this way - thanks. If you’re interested in finding out more you can read the interview here or catch it on BBC Sounds using this link.
Secondly and very much to prove the point about our performance, we have again achieved the standard to be accredited as a specialist endometriosis centre for the 10th year in a row. I have spoken many times about the work of the team at the Lancashire Women’s and Newborn Centre at Burnley General Teaching hospital, who provide really critical care for local people across services that could not matter more.
So, it is incredible that the evidence this year showed a further increase in the number of surgical procedures for people suffering from endometriosis, which has been bolstered by a number of new specialist clinical colleagues joining the team. Well done to them. I know this condition has devastating impacts for sufferers and it is great to know we are supporting them in this way.
Martin