I want to start today with a really heartfelt thank you. I know how hard people are working across all services and settings in East Lancashire Hospitals and also in teams across the wider health and social care system and it is hugely appreciated.
That hard work is resulting in some really tangible outcomes for our patients and their families and, whilst there is a lot of focus on our financial challenges, we are an integrated healthcare provider first and foremost and our clinical and operational performance will always be a priority as well as spending public money wisely.
I said last week that balancing the quality of services with cost and the health and wellbeing of colleagues was front and centre in my mind and this week I have been buoyed by some real barometers around the strength of the quality of our services and – more importantly – the strength and quality of our staff.
We are making progress on reducing costs but, critically, the quality of services isn’t suffering even as we continue to see growing demand. It was stark to hear this week that we are now seeing 40 more people through A&E each day compared to this time last year, when we were already smashing records for attendance.
Our operational performance remains strong and this is in line with a national focus from colleagues at NHS England to be as productive and efficient as possible. To this point, this week I was writing a foreword for the Trust’s Annual Report and reviewing our performance at the end of 2024-25. Over the course of the report and accounts you will see a comprehensive range of achievements including:
- All performance and operational standards met
- Waiting lists reduced for elective procedures by almost 17 per cent – with no one waiting more than 65 weeks for care
- Just under 80 per cent of people seen in urgent and emergency within four hours – despite huge and record-breaking numbers of people turning up for care
- Patients handed over from ambulance colleagues in less than 30 minutes on average
- Consistently high standards in cancer pathways
- Consistently strong productivity in operating theatres which are amongst the best in England and often in the top three Trusts nationally
- Continued improvement in already effective maternity services which are recognised as some of the best in the country
On Wednesday the Trust was officially enrolled into the national NHS Recovery Support Programme (RSP). Regular readers of the blog will be well versed with our financial challenges and, in truth, we have been focused on improving our position for some time.
Indeed, we have already benefited from a significant amount of extra support following the announcement in February that we would be downgraded to segment four of the NHS Oversight Framework (NOF4) specifically due to our financial position, not the quality of our services.
If you missed the updates at the time, NOF4 is often also described as being placed in ‘special measures’ and, whilst this term isn’t formally part of the regulatory language used by the NHS, I think it is one way to understand what it means. Certainly, NOF4 is the lowest segment within the framework and the Recovery Support Programme is designed to bring expertise, innovation and learning from other places together to ensure immediate improvements are made.
In the last few months, we have reduced our outgoings thanks to a continued and unwavering focus from all colleagues and we did bring our budget for 2024-25 in on target, an agreed deficit of around £80million, which is a notable improvement from where we thought we might be.
In April – the first month of the financial year – we also continued to reduce costs, with pay, non-pay, overtime payments and bank and agency shifts all down.
Of course, it’s not an easy thing to achieve month on month and it has been a tough and relentless slog for all colleagues, across all services and settings. For this reason, it was really touching to hear colleagues in the Recovery Support Programme share lots of positive feedback about what they have seen, heard and experienced at ELHT so far.
This includes a recognition of the spirit and culture of the organisation as something the team don’t see everywhere they go and that, in facing our challenges, we have been generally open and accepting, rather than defensive or dismissive, which was great to hear.
I am proud of how we have risen to the issues with a determination to improve and quickly started to do things differently to create more sustainable services across our settings.
Of course, I am not saying we are perfect, there is certainly a lot more still to do – but operationally, clinically and culturally our results and standards remain strong. We have clearly also taken lots of action to try and reduce our costs and spend money in the most effective way. As part of this I want to acknowledge there have been some difficult decisions and there are more to come too.
This was especially evident when we had to move out of Accrington Victoria Community Hospital at short notice last year because the fabric of the building was crumbling beyond repair. As part of the closure programme, the Trust made commitments to local people that it would retain clinical services in the town, ensure the rich history of Accy Vic was remembered and celebrated and, when the time came, engage the community in what would happen next to the site.
I am pleased that we have been able to deliver on those promises and are now in the last phase to decide what happens next. I am delighted that Hyndburn Council and the local MP Sarah Smith are working with us to encourage anyone who wants to get involved to come forward with ideas, suggestions and views over the coming weeks and months. As part of an initial engagement plan, a digital survey has been prepared to gauge initial views and ideas. This can be found here. Please do fill it in if you get a minute and let us know your thoughts.
This is difficult and emotive stuff, no doubt, and my commitment to all colleagues, patients and partners in the wider health and social care system is that we will continue to be honest and open. Indeed some of the efficiencies we must deliver will come from joint working with partners, particularly the other provider Trusts that form the Provider Collaboration Board in Lancashire and South Cumbria.
We continue to support you too and recognise your incredible personal resilience in doing more, better and for less, each and every day, for our patients and for every taxpayer that pays into the system expecting high quality services that make a difference to their lives.
It is the right thing to do, but it doesn’t make it easy.
Keep going, you’re doing brilliantly. I hope you enjoy the Bank Holiday weekend when it comes and if you’re working – thank you, but please do get some downtime for yourself when you can too.
Martin