I will start this week with a quick thank you to guest blogger Lee Barnes, who stepped into the breach last Friday and offered some really important insights and advice about how to cope during what is a difficult and challenging time for everyone at the Trust.
Lots of people continue to tell me how tough it feels across teams at the moment, so inviting Lee to take over and share some of her thoughts personally and professionally as our occupational health and well-being lead, seemed the right thing to do.
If you haven’t read her update yet, you can see it here and I would recommend it to you. It really is worth five minutes of anyone’s time. And if you are a member of ELHT and need some extra help or support, please do reach out and ask for it.
To this point, it has been another difficult week, and I know I won’t be the only one to applaud, finally, the end of January when it comes.
Of course, life won’t miraculously change for the better with the flick of the calendar from one month to another – but at least we are closer to warmer weather and lighter nights. Indeed, I saw somewhere at some point that in another month or so we will be enjoying 7pm sunsets and, for most people, that will mean a journey home in daylight rather than the dark.
These small differences are important. Signs that all things and times will and do pass. That we make progress and move forward, no matter how difficult it feels.
This week has been tough again at times but, to use a sporting analogy, something of a game of two halves for me. As a Middlesbrough fan, I’ll make the obvious joke that both halves are often as bad as each other (particularly it seems when we play Blackburn and Preston) but in the case of the Trust, I’m pleased to say the difficult stuff has been tempered by positive news too.
In the first category, the challenge of correcting our financial challenge remains ever present for everyone at ELHT – and the wider Lancashire and South Cumbria system as a whole – and on Wednesday we met regional and national NHS colleagues at County Hall to stock take progress on the improvements we’ve been asked to make.
In the last few months, as part of a programme of system-level investigation and intervention, followed by a period of official turnaround led by the national NHS team, a range of intensive and additional scrutiny and support has been put in place to help us reduce our costs.
Colleagues have been focused squarely on the challenge at hand and huge amounts of work and effort has been expended – with progress made – but, nevertheless, we remain significantly overspent. There is, no doubt, lots more for us to do.
As a team we are all acutely aware of the need to reduce our costs quickly whilst continuing to provide safe, personal and effective care to our patients. As part of this, it is important to maintain confidence in services and to ensure people who need it still come forward for care.
To this point, let me provide some assurance that the Trust continues to perform well against a number of clinical targets including for urgent and emergency care and elective procedures, despite huge volumes of attendances and demand for our services.
I have referenced many times over the weeks writing this blog the areas of very good practice we have, including one of the best maternity teams in the country and excellent community services which are caring for people in their own homes.
Our challenge now is to do this whilst living within our means and it is going to take the efforts of everyone equally to achieve.
This is where we enter the second half, which I think demonstrates that we’re not short of energy or effort. Indeed, we have some outstanding players on the pitch.
The first thing I will mention is the incredible news that the Trust is first in England for theatre utilisation for ear, nose and throat procedures. Not first in Lancashire or the North West – but better than anyone else in England with a total usage score of 98.2 per cent. That means we are productive and operating almost all of the time, with a smallest amount of downtime.
An incredible achievement which is by no means easy to do, requiring a relentless focus day in day out to schedule patients, get them ready for surgery and to be poised and prepped to add people in where slots come up or cancellations come in. It is great and comes just weeks after the Trust was named first for general theatre utilisation too.
Well done to everyone involved in this amazing achievement which is making a huge different to the lives of our patients and their loved ones.
Talking of people who are making a huge difference, let me mention three nurses: Louise Canovan, Helen Davis and Julia Higginson, who have all received a special award from the Queen’s Nursing Institute (QNI) for their commitment to high standards of patient care, learning and leadership.
The award is only presented to people who can evidence professional practice and positive feedback from colleagues, patients and families. I’m so proud of Louise, Helen and Julia and I am grateful to have them here at the Trust.
I have said before that, in the toughest times, I am always reminded that I am surrounded by brilliant people, across a range of roles and this clearly includes nursing teams both in hospital and in our community.
Here let me acknowledge the team from Reedyford Ward at Pendle Community Hospital, which closed this week. The ward was one of three which provided intermediate care and rehabilitation to patients but, thanks to the way we now provide services, we’re doing this in the community, in people’s own homes, where we know they get better much faster.
As a result we have developed community services in partnership with a range of social care providers, enabling us to close the ward whilst still supporting more patients than ever before.
An enormous amount of work has taken place to support the team and redeploy them into different roles in other wards or community settings, whilst ensuring minimum disruption to patients, who will continue to receive the same high standard of care from our team.
I wanted to take a moment to say thank you to those leaving Reedyford for everything they have done so far and for your professionalism during the recent changes. The team has cared for thousands of patients over the years and received many, many letters of appreciation reflecting their dedication and kindness.
The closure of the ward is in no way a reflection of the fantastic work that has been done by the team. We remain immensely proud of everything you have all achieved and pleased beyond belief you continue to be part of ELHT.
Lastly, it wouldn’t be a blog without mention of the ongoing pressures in our urgent and emergency care pathways, always most noticeable at A&E at Royal Blackburn Teaching Hospital.
This week we have again experienced some very high attendances resulting in some very long waits to be seen. I know people have been cared for on corridors and that the team continue to do their best in very difficult circumstances for those who need support.
I will end with three lovely bits of feedback we received – and then some ‘breaking news’ from earlier today, so stay tuned.
The first message said: “I just wanted to thank all the staff in ED last night after I attended with my daughter. We were seen super quick and transferred to urgent care where all I witnessed was staff being abused. It was awful to see and I wanted to shake some people. I see how hard you work. Thank you to the lovely doctors for their kindness and patience. ELHT really doesn’t get praised enough.”
The second message: “I attended A&E with my daughter and I want to say thank you to all the staff who looked after her. They were attentive, efficient and we were in and out so quickly, despite there being several other patients, which was such a relief. Thank you for all your hard work.”
And the third – entitled ‘A heartfelt thanks’ – was a bit longer, but so compelling I have struggled to edit it: “I felt I should give you feedback on the service we received at the Royal Blackburn Hospital. Unfortunately, my father suffered a massive cardiac arrest at home. My mother who is 81 was comforted by the 999 operative and within minutes a team of paramedics arrived, resuscitated him and blue lighted him to RBH via ambulance.
“Once we arrived at the hospital, everyone was just so caring and constantly checking on us to see if there was anything we needed whilst my dad was in resus. It was the worst 90 minutes of our lives but whole team in Resus, despite being very busy with patients on trolleys, did everything they could to save my Dad and for this I will be forever grateful. When we needed the NHS the care, commitment, dedication and attention we received as a family during a very difficult time was outstanding – a word I never use lightly.
“As if this wasn’t enough, two days later my mother received a call from the breast clinic at Burnley. A very lovely gentleman tried to give every reassurance all would be ok and she was seen again by the most wonderful kind, caring bunch of people. A couple of days later the consultant even sent a very personal letter wishing her well and she hoped that she was coping with the loss of my Father. Just WOW. The whole team at the Breast Clinic at Burnley are awesome – caring for my mum like their own.
“The Bereavement Team have also been amazing – calling me each day to see how we are coping, if there is anything we needed, how was Mum and keeping me updated. A truly professional group who do their job day in day out but make you feel like you are the only person that they are caring for – just again AWESOME.”
“In a nutshell, every single member of staff has been truly amazing. I am sure as a CEO it must be rewarding to have such a great team behind you – without all the ‘knights in shiny uniforms’ this country would be in a much worser place.”
This touching feedback really made a difficult week easier and so it was an additional bonus this morning to hear that a local transport operator has announced it will step in and pick up the shuttle bus route between Blackburn and Burnley hospitals from April 1.
As a Trust we have been clear we couldn’t afford to continue to subsidise the service any longer, but recognised it was valued by everyone who used it and committed to doing everything we could to find an alternative solution. It is absolutely brilliant news that Blackburn company Moving People will provide a similar commercial service when ours ends on March 31 and we will continue to do everything we can to support them, to publicise the route and encourage people to use it.
I speak for everyone at East Lancashire Hospitals now when I say we’re grateful to Moving People and everyone who has worked so hard in the background to make this happen and that includes our local MPs, local authority leaders and local people as a whole.
And so, I end where I began, acknowledging that it has been a difficult week in so many ways and that there is clearly more to do, but it’s clear to me there is no better team than ELHT to do it and we continue to bring energy, determination, kindness, compassion and expertise to everything we do.
Together we know there are improvements we need to make – but we’re getting stuff done and I remain stoic that we should remember and feel proud of that too.
Martin