I have promised over the last few weeks to try and shorten the blog. I’ll start by saying I haven’t achieved it today – but please, bear with me as the story at the end is well worth the wait.
I’ll start with news from yesterday when the Government published its 10 Year Plan for the NHS and, in setting out the vision, the Prime Minister Sir Kier Starmer and Secretary of State Wes Streeting MP were keen to acknowledge that it was shaped with over a million views from people who took part in an engagement process earlier this year.
As part of that, people said they were largely concerned with access to timely care, making healthcare more seamless than it currently is and fixing ‘the basics’ around getting procedures and appointments more easily. This is fair and realistic feedback I recognise from patients, partners, tax payers and colleagues. That the plan is based around improving these key areas is positive and welcome.
It was also pleasing to hear there is an acknowledgement and an aim to enhance the experience of working in the NHS – and regular readers of the blog will recognise my ongoing concern around morale for colleagues now and also our ability to attract and keep great people in the future. It can be a tough and unrelenting environment, no doubt, but it remains my view that colleagues, patients and partners all have a part to play in improving that and only by working together equally will the NHS evolve.
In the main, the plan is set out in three areas which are quickly becoming known as ‘the three shifts’:
- The shift from hospital into communities – This is the bit the Government described as the Neighbourhood Health Service and aims to transform services by locating them together, away from hospitals and closer to home. When asked the Health Secretary described neighbourhood hubs where teams and patients can come together to access a GP, dental care, specialist referrals, prescriptions and round-the-clock mental health support
- The shift from analogue to digital – This is the ambition to use technology better to create a more seamless experience. Electronic patient records, using Artificial Intelligence to enhance services and using the NHS app much more effectively to self-refer, book appointments and see a doctor if clinically appropriate are all priorities
- The shift from sickness to prevention – Focusing more on preventing poor health rather than treating it is key and the plan covers how we can make it easier to make healthy choices through things like eliminating smoking, banning energy drinks for under-16s, promoting healthy eating and recipes in supermarkets, offering weight loss services, home screening kits and providing financial support to low-income families
Over the coming days, weeks and months, it is clear we will hear more about our part in this and what it means for the way we work with patients and partners from other NHS organisations and in the wider health and social care system as a whole.
We will need to understand what the barriers are to delivering the plan – and for colleagues my aim is to use our regular Teams Brief session on Tuesday to discuss, provide feedback and ask questions as a group. I know lots of information will also be published on our internal sites and channels including OLI and the news bulletin – so please do keep you eyes out for updates.
Externally there has been a huge amount of coverage about what this means. Of course, as they say, the proof of the pudding will be in the eating – but I would add that I am supportive of these aims and ambitions and, indeed, they reflect lots of what we’re already doing and planning here at ELHT.
Let me share a few examples where I think our own ambitions already align:
The shift from hospital into communities:
- Community Diagnostics Centres You will remember that only recently the PM visited Rossendale Health Centre as a great example of a building where lot of different services are provided by lots of different organisations in one place. The Trust has used the building as one of two East Lancashire community diagnostic centres which have delivered an additional 300,000 tests over the past three years. These include CT scans, MRI, X-ray, audiology and cardiac testing which are all available in the community with no need to come into any of our hospitals.
- Virtual wards Our virtual wards programme, called Hospital at Home, is caring for more and more people at home, safe in their own beds. Patients are given the necessary equipment and monitored by health professionals where we know they can recover better and faster compared to being in hospital and, of course, this approach also frees up time and space on our wards for patients with more complex needs.
- The Church on the Street Set up in Burnley in 2023 colleagues in voluntary group The Church on the Street have been hugely effective in creating easier access to podiatry services. It started because we looked at the data of people attending A&E because they had not been attending appointments for wound or foot care in health centres. Instead the team took the service into the community, setting up treatment rooms in a neighbourhood facility that was comfortable and familiar to patients. The service has now helped hundreds of people - and was the winner of one of last year's Star Awards.
- Intensive Home Support Team A range of services and initiatives are available to patients in their own home thanks to this team which operates 24/7 and works with local GPs and charity and voluntary sector organisations to provide swift assessments and care in the home rather than hospital. The scale of this is huge and in the last year the team has responded to more than 10,000 urgent patient requests within two hours, undoubtedly reducing the number of people coming into hospital.
The shift from analogue to digital
- Robotic surgery The Trust introduced robot surgery in 2015, initially to support procedures for prostate cancer. It was a huge step forward offering a minimally invasive approach for patients and it continues to grow the number of procedures it is used for. In 2017 we led the way by being the first in the region to use the equipment to carry out colorectal surgery, again offering massive benefits with patients having a shortened stay in hospital, less pain and a quicker recovery.
- Dispensing robots The Trust using dispensing robots in pharmacy, picking items off the shelves to order and allowing pharmacists to spend more time with patients.
- Reducing Traditional Communications Around 30,000 letters are now sent digitally every month, which is a huge shift away from traditional post. In January we launched an app to give patients more control over appointment times. It was piloted in the pain service and is now live in 12 areas including Rheumatology, Haematology, Ophthalmology, Orthodontics and Urology, helping patients to access information, receive text updates and cancel or reschedule appointments themselves. General surgery will be added in the next week.
- Artifical Intelligence We’ve been using AI to support pre-operative assessments and the work is so innovative and successful it was highly commended in the national HSJ Digital Awards in the last week. The technology records the conversation between the clinician and patient and transcribes it into meaningful notes which are then uploaded to the patient’s record. Robust information governance and safety protocols have been followed and the tool has enabled more appointments to be carried out each day, as less time is being spent on administrative tasks. Since the Trust first used the technology, the pre-operative department has gone from seeing 55 patients per day to 63.
- Streaming tool in A&E Our streaming and redirection tool is now well established and helping to reduce waits at Royal Blackburn Teaching Hospital’s Emergency Department and Burnley General’s Urgent Treatment Centre. Patients are triaged on arrival by answering some simple questions on an iPad and those who are eligible – up to 75 per cent of those who attend – are offered an appointment slot, enabling them to go home and return later to be seen, rather than waiting on site.
The shift from treating illness to preventing it
- Sheltered Housing Partnership A new partnership been set up to try and reduce the need for residents in sheltered housing to come to A&E. Community services teams, North West Ambulance Service, pharmacy colleagues and charity Age UK have so far visited 28 schemes and spoken to over 500 residents to raise awareness of community services and provide advice and guidance on things like falls prevention, long term medications, falls lifting and social support. The focus of the work is on prevention, to try and keep people healthier and ensure they know how to access help before the issue escalates into a trip to A&E.
- Befriending service The team behind this newly launched initiative offers emotional support and friendly conversation to vulnerable people. Colleague volunteers check in with patients once a week by phone, video call or in person to see how they are and assess any issues that are causing concern. A good example would be something like damp affecting respiratory health, but there are many, many more. It’s not a clinical or therapeutic service, but simply a way for someone to have someone else to turn to and talk to about issues social conditions that are impacting their health.
It goes without saying that these are just a few examples of how we’re already starting to work on the ‘three shifts’ and it would be remiss of me not to mention our electronic patient record, implemented across the Trust in summer 2023, as a huge part of current and future plans. It replaced all paper records and is designed to be the first step towards seamless services across many settings and organisations. It has certainly changed the way we work forever.
A change of this type is challenging though as it tests every existing process and I know it has been hard for colleagues to conquer at times. New updates of the system promise to give us the opportunity to further some of the Government’s ambitions around using AI and automation to allow clinical colleagues to focus on patients – but it will bring additional challenges too. The biggest one I hear is from clinicians who feel they are looking at screens and clicking boxes rather than looking at their patients and talking to them. This is the kind of stuff that makes the NHS great and no matter how efficient we become we are all human and we need to ensure that personal interaction remains at the heart of everything we do.
Now, as I have already said, I have not achieved it my aim of a shorter blog, but I did think the launch of the 10 Year Plan was important for us all. I was mindful too of colleagues feeling like it is yet another thing to deliver or a further change to what we’re doing and how – so I hope I have demonstrated we’re well on with this agenda. Indeed, we’re leading some of the way.
Before I close let me mention a couple of more local things.
Thanks to everyone who made it to The Grane restaurant at Royal Blackburn Teaching Hospital on Thursday mornin
g for a cup of tea and a biscuit to celebrate the NHS Birthday and as part of the charity event The Big Tea. I say biscuits rather than cake as the queue was so long when I arrived the cake went very quickly and I know many colleagues will have seen only a spinning plate on the table and an odd crumb left tantalisingly nearby. (I am sharing a picture as proof there was one – and it wasn’t small!)
Not withstanding the disappointment, it was great to see so many people taking a break and the chance to say hello. I know not everyone will have been able to join in and that there are colleagues beyond Blackburn too. I always do my best to get out across our sites and see as many people as I can and I will continue to do this as often as possible.
For this reason, let me mention something amazing that happened at Burnley General this week when a patient was the very first person to get the town’s new football kit for the 2025/26 season – thanks to the team on Ward 19.
Carl Sudworth is a long-term inpatient and lifelong Burnley FC season ticket holder who has been going to Turf Moor for the last 76 years. He was seriously injured after being hit by a car following a match and, since then, it’s been a lengthy and challenging recovery. Ward Sister Lucy Morris and the team said they were so inspired by Carl’s unwavering positivity and determination to get better and return to watch the Clarets that they asked the club to arrange an extra special treat – and Carl was presented with the kit before anyone else.
He said: “I am a bit overwhelmed to be honest! It is very good - I am really chuffed. Thank you to everyone for all that you have done.”
I can’t think of a better sentiment to end on. Thank you to everyone for all that you have done. The ask and the ambition continues but I remain confident that there is no better team than ELHT to deliver it.
Martin