Published on: 10 May 2024

Next week is May’s Trust Board meeting and so this week I was preparing my usual Chief Executive’s Report which provides an update for colleagues and the public on national, regional and local issues and highlights across the NHS and health and social car more generally.

If you want to read it, you can access the papers here and if you want to attend the part of the Trust Board which is held in public, you can. It is at Burnley Football Club’s Turf Moor ground at 1.30pm on Wednesday, May 15. This is part of a push to get more local people to attend – so if you’re interested you can read more here.

It is always a difficult call as to what to include without it becoming a very long read in what is a busy and tight agenda – and as I sit down to write the blog today, I must admit I feel the same way.

There is just so much going on, it’s a challenge to sometimes edit the week into a bitesize, readable chunk that is of interest to a wide range of people including colleagues within the Trust, our partners in the wider system and patients and their families who make up our community and service users.

I will mention that yesterday colleagues from across Lancashire and South Cumbria NHS organisations met to discuss some issues and agree some actions as to how we can work better together as a group.

This is important because there is no doubt in my mind that the outcome of our focus on collaboration and improvement absolutely impacts everyone. If it doesn’t, we’re doing something wrong in my view.

The system, which spans from Burnley in the east to Blackpool in the west and from the Lake District to Chorley north to south, covers an admittedly vast and varied geography, as well as myriad different areas with very different issues.

As part of this there are huge variance in access to and the way services are provided – and as a group we want to ‘level up’ and provide good services across the board in a more consistent way.

We talked about how we could do this in great detail and also what we think success looks like. To most people the latter is quite simple – that people can access what they need to support their health and well being in a timely manner, across both physical and mental health services.

I was amazed to hear a general statistic that if we pooled resources more efficiently we would have enough capacity to treat everyone without the need for long waits. Of course, this might include reconfiguring where some services are provided and moving them from one area to another to be more effective, but I sense that most people would be willing to travel if it meant being seen quicker.

It is this type of discussion and considering how this might impact on different people differently that adds the complexity thought. If you have a car, for example, or enough money to get a bus, train or taxi, this is good news. If you haven’t, your access to services reduces as you can’t get there easily.

And so it is the how – across hundreds of buildings, with thousands of colleagues and millions of patients – that presents the real challenge and in some cases the way we do things still dates back more than 75 years to when the NHS began and largely operated in its own way from place to place.

I have spoken many times about East Lancashire Hospitals Trust’s determination to provide safe, personal and effective care consistently for everyone – as well as our commitment to continuous improvement and reducing waste and duplication to keep our budget in balance and our spend on the right things for patients.

But how we bring this all together, cohesively with others, is what experts call a ‘wicked problem’ and it’s going to take change and energy on an unprecedented scale to achieve.

It’s right at such times to consider what you can do differently yourself and ask yourself what is within your immediate gift to change too. I can and do work with colleagues to re-engineer processes, pinch good practice from others to adopt for ourselves and ensure that we share information about what has worked for us so that others may learn and improve too.

All this is straight forward and for the greater good.

But an excellent challenge I heard during one of the discussions yesterday questioned how input from others in the community is heard and then plugged into change to make things better from their viewpoint, which is often different to ours.

Predominantly I think this came from the perspective of patients or service users and their families, but we should rightly widen this ear to local businesses, community leaders, faith and voluntary groups… Among many, many others who will have a view too.

Of course, the system can align internally or make improvements to processes and procedures across organisations to ‘level up’ – but the true and real impact falls to local people and their experience and ability to access what they need, so understanding and encouraging input can never be overestimated.

There is nowhere more visible in the Trust to me when it comes to gauging patient experience that our urgent and emergency care pathways – which include the emergency village at Royal Blackburn Teaching Hospital, the urgent care centre at Burnley General Teaching Hospital and the minor injury unit at Accrington Victoria Community Hospital. Together these teams can see more than 800 people in a day, making the facilities among the busiest in the UK.

I know from being in there and talking to people myself, from feedback from colleagues who work there day to day and from patient feedback that it is often a stressful environment for everyone.

I am always touched to read or hear that, on the whole, patients and their families appreciate the efforts of the team and understand they’re doing their best, which is appreciated in return.

If you were in the department at Royal Blackburn yesterday afternoon, you may have seen a large group of people including myself wandering through. This included the Health Minster Helen Whateley with local MPs Kate Hollern (representing Blackburn with Darwen), Sara Britcliffe (representing Hyndburn) and Anthony Higginbottom (representing Burnley) who asked to come and visit and see the pressures for themselves.

I am grateful to them all for their interest in the Trust and the difficulties we are facing with overcrowding and long waits to be seen for those who attend, but I have to admit I was worried about adding to the issue by taking a group of people into the area. The last thing any of us would want to do is further compromise the privacy and dignity of patients waiting or actively being seen, but it is also critically important that those representing our local communities and who have decision making power and influence are able to see for themselves what is happening day to day.

I would like to thank all of the patients and their families in A&E, in the waiting room and within the wider hospital as we moved around the building, causing some congestion at times as we met and spoke to people along the way.

I know the Minister and all MPs present recognised the difficulty but found the experience extremely valuable – and that they will go away and do whatever they can to help.

I also want to thank the team involved who took time out of what is undoubtedly a very busy to provide more information and ask questions – in particular Georgina Robertson, Matt Sutcliffe, Dave Simpson, Sharon Reid, Jane Dean, Jayne Myhill, Claire Hey and Zoe Lewis. Important to mention also Arif Patel, Michelle Montague and Emma Cooke who worked really hard to provide an enormous amount of detailed information in advance.

I often hear compliments along the lines that the Trust does this type of thing really well, but I realise it’s only ever as a result of the constant hard work and innovation demonstrated on a daily basis by colleagues. Many thanks to everyone for your fantastic contributions and also for those of your brilliant teams too.

Listening to democratically elected people with strong links to the community is undoubtedly one way to ensure the voices of patients and services are heard and I am confident together we are focused on finding real, tangible improvements that make a different to people’s lives.

I am always interested in feedback, ideas or suggestions about what the future could and should look like – and if you have any please do get in touch.

Solving the great range of issues the NHS faces, ensuring people have the health care they need and providing equity across communities in Lancashire and South Cumbria is a huge and complex challenge which we will not solve easily or in one week – so I will keep you updated as always.

In the meantime, I will sign off today by saying if you’re off this weekend, enjoy the fabulous sunshine forecast for East Lancashire and stay safe, please.