I mentioned a couple of weeks ago that I was prepping for the July meeting of the Trust Board, which took place on Wednesday in the activity room at the new Dovestones Gardens housing complex on the Burnley General Teaching Hospital site.
The facility itself is fantastic – a partnership between the Trust, Burnley Council and social landlord Calico Homes which provides supported living for people over 55 in a neighbourhood setting that includes community and communal space, gardens and a great café.
It’s the first time I have been inside the complex since it opened a couple of months ago and I was hugely impressed with the feel and vibrancy of it. Everyone I saw looked really happy with their new home – I was more than a bit jealous of those enjoying the outdoor space in the sunshine I have to say.
The Board met for a public session in the morning which is open for anyone to attend and a meeting in private in the afternoon. As you would imagine, both agendas were packed with updates, responses to our challenges and reports offering detailed assurances about our work across a range of services and settings.
In addition – and a clear reflection of the times – we were updated on and discussed a number of transformational programmes involving collaboration with a number of other organisations, including plans to configure clinical services differently across a much wider footprint than East Lancashire. These items are complex and require lots of different people to pull together to achieve – but I know those involved continue to keep the improvements and benefits to patients firmly in their sights.
It was positive to see some members of the public at the meeting in the morning and this is one reason we are taking the Trust Board ‘on the road’, to try and encourage more local people to come by making it easier to attend.
I know it can be over-facing to read the papers and follow discussions with people who are living and breathing – and resolving – issues each and every day, but it is important that we bring residents and communities into those discussions wherever we can.
Even so, I accept that there is a huge amount going on in the Trust, within the wider health and social care system in Lancashire and South Cumbria and in the NHS nationally as a whole and it is difficult to bring it all together and triangulate the reality of what is happening on the ground.
This was reflective in my update as Chief Executive at the beginning when I openly acknowledged that there were things I wanted to share which were not within my report because they had evolved or emerged since I filed the paper just a few days ago. This included an overview of a new report published by the Chair of NHS England Penny Dash on improvements to the quality of services in the NHS as a whole. That is just one example that shows just how much is happening – and I was being honest when I told the group that, in all of my years in the NHS, I had never experienced such change at such pace before.
It’s a trick to sum up such vast amounts of information in a way that can be easily understood and interpreted to allow members of the Board, local people, patients, visitors, colleagues and partners to feel assured of our plans and progress.
One way we do this is to ask a patient to give some feedback at the start of each meeting and this month it was the turn of a mum of two children who had both been diagnosed with learning difficulties. In her video update, she talked openly about her journey so far and it struck me, as it often does with patient stories, that providing this insight would have taken time and effort in an already busy day. I’d like to thank her for taking the time to do it, in helping us understand what the challenges are in accessing services from the Trust and to add her voice to ours.
A key thread throughout the meeting and, indeed, writ large in the Government’s newly published 10 year plan for health, is how we bring more patients and their families into the NHS to share their experiences and help us shape services for the future. Certainly, patient stories are an excellent window into the world from many different perspectives, but how we then encourage people to join us in a more formal and organised way is something we want to explore much more in the months and years to come. Let me know if you have any ideas or, indeed, want to come and add your voice to our discussions at any point.
Of course, it would not be a Trust Board meeting without a thorough interrogation of our financial position and our performance across our services and I have talked at great length about the challenge of reducing our costs this year and for some years to come while balancing quality and safety for patients and colleagues.
This will continue to be a significant and increasing pressure on the team to achieve, in addition to the challenge of continued, very high numbers of people coming forward for care. It’s a circle we need to square however difficult it feels.
To colleagues, please know I remain enormously proud of our efforts and the plan we have to reduce spending this year by over £60million. In the next few months one of the biggest challenges we have ever faced will be to deliver it and to do so in line with our assessments which ensure quality and safety hold firm in our minds.
The Board heard and was assured that we are performing well against key metrics despite seeing those record numbers of patients and reiterated again its commitment to high quality, safe services and the need to transform and innovate to do more for less, rather than simply cutting costs.
In the past, we have struggled to deliver some of our saving and waste reduction plans or left it until very late in the year – and this has contributed to our position now. So, colleagues, it is critical to the future of the Trust that we do what we say we are going to do and that this happens as quickly as possible, please. If you have financial commitments, we need you to deliver them without exception and on time.
To this point, let me say again I know how tough it is across all settings and services across the Trust at the moment and how hard colleagues are working. The word ‘relentless’ is often appropriately applied to the NHS environment, but we do also have the secret weapon of the best people, in the best teams, doing their best, each and every day – and that ‘best’ is always good enough.
It is a sad fact though that day to day and as a Board team, we continue to hear too many examples of incivility, violence and aggression towards colleagues from patients and their families, including verbal abuse and physical assaults.
It remains a priority for us to manage and eradicate this and we can clearly articulate that commitment in our response to every incident. We are consistently reporting incidents and referring them to the Police, utilising our zero tolerance policy, issuing ‘red cards’ to patients which effectively bans them from receiving any further care from the Trust unless it’s life threatening and, perhaps most importantly, ensuring those impacted receive support.
Of course, there are times when patients don’t have the mental capacity to understand what they are doing or saying and it is absolutely the case at the moment that we are seeing more people in mental health crisis than ever. This is something we are working with our partners at Lancashire and South Cumbria NHS Foundation Trust, which provides mental health services in this area. I know we’re determined to work together to improve this for patients and colleagues alike.
Of course, at the same time, colleagues across the hospital continue to offer support to patients and their families no matter the circumstances and, in my opinion, never lose sight of what people need. They are doing amazing work in very difficult circumstances and whilst I appreciate that emotions can run high when people are feeling poorly or anxious about their health, please remember we are all doing what we can to help. I know I am grateful for the patience, compassion and kindness from everyone when challenging moments arise.
This will become material when resident doctors take industrial action for five days and nights later this month, starting July 25. These dates were announced after their union the British Medical Association (BMA) shared that a vote among members to strike had been successful. The Trust immediately stood up the process to manage the industrial action and will implement well developed business continuity plans.
As I have said about previous periods of industrial action, the Trust respects the right of colleagues to do this as part of negotiations in the pay dispute with the Government. Our focus will be on ensuring patients continue to receive the care they need and services remain operational wherever possible.
It would be remiss of me not to say that losing this key team of colleagues will, of course, impact on the work we can do and in particular the number of elective procedures we can deliver. We will minimise this wherever possible and if you’re due to come into the Trust for appointments or procedures during those days please continue to plan for it going ahead and we will be in touch if we need to rearrange.
Let me end with some positives and some shout outs for individual colleagues and teams who I think demonstrate the spirit of ELHT as I have described.
The first is our Veteran Support Team Fiona Lamb and Shafiq Sadiq who attended the National Service Awards for Police, Fire, NHS and military services last week and walked away with the prize for the Most Outstanding NHS team for their fantastic work supporting veterans who come into ELHT. Over the years since they have been with us they have literally helped thousands of people, who I know appreciate their support beyond words. Well done Fiona and Sid and thanks for everything you do.
I also want to give a shout out to our fantastic health records team and, indeed, say sorry and offer a correction to a sentiment I included in the blog last week.
Manager Danielle McCourt messaged me with a timely reminder that we do still have some paper records, despite the advent and ongoing development of our electronic patient record system (EPR). She is right and I should have remembered from my own visits to the team that they continue to do brilliant work moving bundles around every day to ensure patients and clinical colleagues have what they need to hand. Thank you to the team, you’re doing a great job.
With that, I will sign off from another week and say this to colleagues and patients equally. Together we can build on all the great things we have created here at ELHT and, indeed, raise and discuss areas where we need to improve too.
It will take all of us to achieve the health care and working environment we want to see and experience and it will take some time to do so too, but if we take each day and do what we say we will in the way we would want to be treated, we won’t go far wrong.
I am proud of everything we are achieving and confident we continue to make progress every day.
Martin