Dedicated to improvement to support patients and colleagues

You know when you take some leave, enjoy it, then return and by lunchtime on the first day back feel like you have never been away? That’s definitely me this week.

I have been to Spain with some friends on a cycling break. It’s an annual thing with people I have known for years and I look forward to it on the whole. In my opinion, being on your bike, pedalling up a mountain, with nothing but your own thoughts, sunshine on your face and beautiful scenery whizzing by is a tonic for the mind and it was great in so many ways.

But one curse of being a Chief Executive is the worry of what you have left ehind, how things are going ‘back at the ranch’ and, especially in the NHS, whether people are OK. This is never far from my mind, no matter where I am, doing what or with who. I personally just find it difficult to shake off the challenges we’re facing and the impact on people, no matter how much I try or believe in the mantra that downtime is essential for everyone’s good health.

As I left the office, the Trust was again struggling with huge demand for services and this always and unequivocally impacts on patients and colleagues in equal measure.

I have said many times how this pressure naturally builds through urgent and emergency care, where on most days now we are seeing more than 700 people coming through the door for help and we keep breaking the record for the busiest day. The latest data shows that was topped again last week when we saw 827 people in a day.

Of course, these are not numbers, but real people who are suffering emotionally and physically and in need of our care and support. They come in and find themselves waiting in a relatively small space that was designed to cope with much less. There are times, not too long ago, that we would never have imagined that many patients in any shift and, yet, here we are. I wonder how and when this might ease, but it doesn’t seem like any time soon.

One difficulty – albeit I am proud of it too – is that no matter how busy or crowded we are the Trust will never turn anyone away. That is the essence of the NHS we all know and love – free health care to everyone at the point of access. It’s an incredible philosophy I, for one, believe we should protect. That we’re here for you every minute of every day, week in, week out, month after month, year after year is exactly why we all joined up and continue to strive to deliver.

But it’s right also to recognise that this commitment is taking its toll on colleagues and, without a doubt, impacts on patients and families and the standard of care we provide. It’s just not something we should normalise, ever.

I’m mindful of those patients and their families who wish for and deserve a better experience when I say I am desperately concerned for the team – not just in urgent and emergency care but across all our sites, wards and community teams who together support this great influx into the hospital every day. We are doing our absolute best in the most difficult circumstances – but it never feels good enough.

I have asked the team this week to circle back on everything and see if we could make any changes – large or small – that would make things better. I know they are working through this amidst everything else I have mentioned and I want to say thank you for that continued dedication to improvement. Sometimes the sense of the wood and the trees can be a factor when you’re dealing with a relentless workload – and we should never stop looking and asking if we can do something differently and get a different result.

As part of this I know we have already moved things around to create more space, added more medical colleagues into pathways to enable hundreds more patients to be supported, asked teams from outside urgent and emergency care to ‘reach in’ for people who need specialist care and created more beds for older people who need a short stay in hospital before being discharged to our fantastic community teams.

There are signs this is creating improvements – but we continue to monitor, review and adapt all the time.

I want to mention here that it is Celebrating Community Services Week nationally – and we’re doing our bit to thank and recognise all colleagues who work across East Lancashire, often in people’s homes.

It’s clear their work – often helping to reduce the need for people to be admitted to hospital – is critical to how we cope with demand and care for patients effectively. Thank you to every single person who is part of our community team – including medical and clinical colleagues but also the amazing, often unsung heroes who are providing support in the background and very much keeping the show on the road. I am beyond proud of our work in this area and the people in the team.

It was good to see an update from the Chief Executive of the NHS nationally, Amanda Pritchard, earlier this week that reflected many of the issues we are seeing here at ELHT and suggesting focus on the areas we’re already focused on. She spoke of the pressures nationally, on all Trusts, in urgent and emergency care and the importance of a team effort including community colleagues.

In addition, national colleagues have been working on a recognition framework which aims to ensure people working in the NHS feel valued and appreciated, especially in such challenging times – and, linked to this and my earlier point, how we support colleagues during these difficult times.

We heard from the Trust’s staff network advocating for mental health at our Exec Team meeting on Tuesday and the presentation could not have been more poignant or moving. We listened to an audio clip from an anonymous colleague reminding us how many people continue to wrestle with the after effects of our response to Covid, now compounded for some by the relentless pressure and demand upon us.

The clip included some emotional and raw feedback on these struggles and I was touched by how determined this person was to stay in work, do her job and support people, but needing support to carry on too. It struck me that whilst we have a Covid recovery plan for patients, there’s no equivalent for colleagues and it’s a gap now we need to address if we have any hope of retaining the amazing people who hold everything together across the Trust like human glue.

At ELHT I believe we do have a positive approach to mental health, with occupational health provision and other complimentary programmes in place. What is clear, however, is we need more and that’s just non-negotiable.

I am always glad to hear from colleagues and I hope this person reads the blog and recognises herself from my description of the clip. It was clearly not something that was easy to do, but I want to say thank you for being so brave – your honesty really moved everyone in the meeting.

On this wider point of sharing experiences, it would be remiss of me not to mention colleagues can still return their staff surveys over the next couple of weeks – and I want to urge anyone who hasn’t done it yet to please find a tiny bit of time – amidst everything I know – to let us know how they are doing and how it feels out there in the Trust.

I would especially like to hear about what is valued and should be protected or even increased, as well as where the gaps are and any issues which are making life harder than it needs to be. Only by telling us can you be assured we truly know and, if you need help in doing this, please shout the Well Team who I know will be happy to help.

Lastly, I want to recognise the impact on all colleagues and communities of the Palestinian Israel conflict and acknowledge that whilst there will be differing opinions on the what and the why, there cannot be a person who isn’t touched by the horrific images in the media.

The Trust - the NHS as a whole – is here to help and care for everyone no matter their heritage, background, race or religion and we stand by and support people in their time of need. No matter your political or personal persuasion, we must remember that people are losing their lives, their families and their children and it isn’t acceptable.

Be kind to each other, we are all human and we are all doing our best.

Take care,

Martin