In over 30 years of working in the NHS I can honestly say I have rarely experienced such a difficult time.
On one hand we’re trying to protect and improve where possible our existing high standards and quality of our care – and this is amidst well-documented increased demand for services and enhanced expectations around activity to reduce waiting times.
On the other we are drastically reducing costs and managing a really challenging financial situation that includes shrinking the team without impacting on services where possible. In an ideal world we would maintain what we have, reduce how much we spend on doing it and grow in excellence and productivity at the same time.
It doesn’t seem doable, yet we are making progress.
In the first month of the financial year (you’ll appreciate we haven’t got last month’s figures yet) we brought costs down in almost all key areas including using bank and agency workers, whilst maintaining or improving on clinical and operational targets.
This is an amazing achievement, down entirely to the amazing teams across all settings, all services and all professional groups.
The challenge now is to keep our foot down, maintain reductions and continue to progress until our books are back in balance and our considerable deficit is reduced to nil. That requirement is part of the legal undertakings we were given when we entered the national NHS Recovery Support Programme, which is currently supporting us to return into the financial black.
I have said previously in my blog – and, indeed, elsewhere to colleagues – that this additional pressure is intense.
To everyone in ELHT – in hospital or community teams – who continues to go above and beyond, thank you. It’s important not to underestimate the personal strength and energy it takes to juggle all this with safe and high quality, compassionate care.
Yet we do, in spades, and I am so grateful for that.
As one example, let me share some feedback from a family about the care their father received from the Hyndburn Central District Nursing team at the end of his life. Referring specifically to the Clinical Team Leader Mikey Kempster, it said: “Mikey and his team cared for my dad so very, very well. Nothing was too much and the care, support and compassion was outstanding. Mikey – you should be very proud of your team. Your direct care to dad, right from the first visit to the support and advice you provided me over the telephone, was outstanding.
“Every District Nurse who visited dad’s house, cared for him, supported mum and the wider family and were truly exemplary. Nothing was ever too much trouble. Dad enjoyed chatting with the nurses, had a little laugh and knew he was being cared for so well. At the very end, he needed frequent visits and we must have telephoned four or five times on the final night – yet everyone was so amazing and supportive.
“It was amazing care at such a sad time and the team’s compassion, support and kindness shone, making an unbearable situation bearable with their support, kindness and outstanding care.”
There is that word ‘amazing’ again and I would, of course, add my own thanks and appreciation to Mikey and the whole team who cared for this man and his family with such warmth and skill. Those colleagues who visit patients in their own homes often feel hidden or unseen compared to hospital settings – so it is lovely for them to be recognised in this way.
I also want to mention in the same vein of positive feedback that I visited the paediatric team this morning across the children’s observational and assessment unit (COAU), outpatients and the inpatient unit at Royal Blackburn Teaching Hospital – and it was brilliant.
The compassionate care to children and young people was clear to see but what really struck me was the complex health needs of some of our patients and the dedication and determination to support them to recover. Thanks to the team for making me feel so welcome and taking the time to talk to me and explain the challenges they have – as well as how they’re over coming them each and every day. It was really heartening and cheered me up after a difficult week.
This provides me with a seamless link to our annual colleague recognition event the Star Awards, which is now open for nominations for 2025 across a range of categories, colleagues can nominate via the links on the Intranet. These include awards that are open to colleagues or patient nominations – so if you want to get involved, please do.
The Star Awards are always a highlight in the calendar for me, offering a huge boost of feel good factor and a moment to remember who we are and not just what we do.
This year due to financial constraints we’re not sure how we’re going to physically give the awards out, but we are hopeful of external sponsorship to support a ceremony and some treats for those nominated and the winners themselves.
It goes without saying there are no funds to pay for this from our main budget – but I’m confident we will find a way to do something meaningful and genuine in the months to come and no matter what happens it is often the nominations and sentiment themselves that really count and make such a difference to morale. We all know the power of just saying thanks.
To this point let me conversely highlight a couple of really unpleasant episodes we have experienced this week which have impacted colleagues personally and professionally as they go about their work.
The first was a shocking and overtly racist incident in A&E at Royal Blackburn Teaching Hospital where a patient with full capacity to know what he was doing abused members of the team in a completely unacceptable way. This is under investigation internally and will potentially be passed to the Police as a hate crime. The likely result will be that this patient be banned from using ELHT services in the future and would need to seek care elsewhere.
I make no apology for this having heard the details of the incident and have said many times we will not tolerate violence or aggression against colleagues in any service in any form. If you behave in this way, expect repercussions to come.
Secondly, a similar incident on a ward was also reported with a patient who was struggling with mental health issues and has now moved into a specialist place to receive care. It is different in that he did not have the capacity to manage his emotions or actions, but nevertheless the impact on colleagues remains the same and I know the team suffered both mental and physical abuse which will require them to have support and recover for some time to come.
These are – thankfully – isolated incidents among the thousands and thousands of positive and enjoyable interactions we have had with patients and families this week – but, please, remember to treat our team with the civility you would expect. Ultimately, we are all human, we’re all doing our best and I know colleagues are working hard to help you as quickly and effectively as they can.
Lastly, for those celebrating Eid this weekend or PRIDE month throughout June, let me close today by wishing you peace, happiness and time to enjoy yourself with friends and family without prejudice or discrimination.
Here at ELHT, kindness, compassion and care for others equally will always prevail, no matter how difficult life gets. It costs nothing and is worth an enormous amount.
To those who are grieving the loss of colleagues this week which I know has been very distressing for some teams in particular – I want to send my heartfelt condolences. I don’t want to name them specifically but we are thinking of their families and friends at this difficult time and remembering their contribution to the Trust over many years.
Take care,
Martin