Let me start today with a quick thank you to Arif Patel for stepping into the blog spot last week as guest author and providing another truly thought provoking update on our work around improving health equity.
If you didn’t see it you can catch up with Arif here and read his blog which includes some highlights of what we are doing to ensure everyone has equal access to health care and support and that involves, first and foremost, recognising that this doesn’t happen at the moment.
I’m really proud of everyone at ELHT for not just owning this complex challenge and working hard to redress some very long standing issues – but for keeping it high on our agenda amongst everything else on the ‘to do’ list (which is considerable). So a huge thank you from me is due on behalf of our communities to Arif and the team for everything done so far and the future plans they have in place.
Now, while I am on with saying thank you and recognising colleagues generally, let me add a few more people to the list. As ever, in doing this I’m aware the risk is not mentioning individuals or teams who are doing great things each and every day across all our services and settings – but I still think it’s important to mention those who are on my radar this week. If you ever want to add something or someone to my list, please get in touch,
I’m always more than happy to do shout outs and celebrate colleagues and I genuinely love hearing what is going on around ELHT.
This week we have again seen incredible numbers of patients coming in for urgent and emergency care in either A&E at Royal Blackburn Teaching Hospital, urgent care at Burnley General Teaching Hospital or our minor injuries units at Accrington Victoria and Rossendale.
On average we are seeing around 100 more people every day than we were a year ago – when we were also talking about record numbers and relentless pressure on services. This means we’re routinely seeing north of 800 people every day across just this part of the Trust. It feels very difficult to see when or how this might reduce to anything we might have previously considered as ‘normal’. The truth is that Royal Blackburn is now one of the busiest A&E departments in England and this pressure shows no sign of slowing down.
For this reason, I want to say thank you to the team in urgent and emergency care across the Trust who are working in this environment every day – and also to our patients and their families who are experiencing a different type of care than they might have expected or experienced previously.
Only through these two groups of people working together and supporting each other can we even hope to be able to get through each day and, even then, it is a constant struggle on a scale we have never seen before.
I have been mindful of the health and wellbeing of colleagues who are working in these conditions day and night for some time and this remains something that regularly keeps me awake at night. The ask is huge, the burden both emotionally and physically is tough to bear and the entire Trust and community is indebted to their determination to carry on and do their best in very difficult circumstances. Thank you for everything you are doing, even when it isn’t what you imagined your life in clinical practice to be. I know you’re doing your best and that is always good enough.
The stress of an overcrowded department, streams of ambulances arriving throughout the day and night, some very poorly patients and anxious families and friends is no doubt a heady mix of issues within a very small space.
This escalates when all cubicles and allocated spaces become full yet people still need treatment, including those in the care of colleagues at North West Ambulance Service when they arrive. At this point, we literally have no option but to use our corridors and at our height this week we had 30 beds on the main hospital corridor full of people who needed medical help. This is something I havent’t experienced in my 15 years at the Trust.
It should go without saying, but let me reiterate anyway, that no one in ELHT wants to work in this way or care for people on corridors. It isn’t the level of safe, personal and effective care we aspire to as an organisation and it isn’t the vision of clincial practice any of the team imagined when they trained for their role.
But the stark reality is there no alternative when people come in and need care – the enduring foundation of the NHS is that it’s free at the point of access and to move away from that simply leaves people suffering and turned away from the help they need with no where else to go. This is an option we’re not prepared to consider here at the Trust and I know most people – even those being cared for in corridors – agree and support us on this.
It’s imporant for me to stress here that whilst patients are waiting for a bed, they are being cared for, reviewed, assessed and supported by colleagues. The team could not be doing any more but I know it’s a situation colleagues, patients and families feel uncomfortable with at best. I want to say thank you to everyone who has found themselves in this position but continued to show compassion to the team. I acknowledge it would be easy to take frustration and anger out on others – but the fact we haven’t seen much of this is truly humbling.
Please be assured that everyone at the Trust is working as hard as possible to reduce waiting times and support people who need it.
This includes colleagues on the wards and in services who are looking after more patients, reaching into A&E to help the team there in any way they can and simply considering every day what more they can do. I know that whilst A&E is high profile and busy – some of this work behind the scenes to keep the hospital moving can feel unseen, so I just want to say how valued these contributions are. Only by working as a true team will we get through what seems impossible to manage.
Another group of colleagues who are working their socks off day in and day out are those in community services. They are doing amazing things in people’s houses, care homes and in treatment and practice rooms across East Lancashire to ensure people are safe and cared for. This often actively prevents the need for people to come into hospital or be admitted onto a ward.
This work which is again often unseen – and especially in the media hype around the pressures on A&E or waiting lists – but it cannot be underestimated and is integral and paramount to the Trust’s ability to function. Thank you to all our amazing community teams – I know the impact you are having on people’s lives and I am so proud to say you’re part of ELHT.
This was writ large in a number of performance meetings we have had this week with colleagues from different divisions around the Trust. In just a couple of hours, teams were able to demonstrate the phenomenal work that is taking place within their area and, personally, I have found them uplifting, not least hearing about how we are looking after patients. Ultimately that’s everything we stand for as an organisation and a tonic compared to some of more difficult meetings in the diary each day.
If you are reading this from outside of the Trust team and want to help us, please know that you can in a number of different ways and each would be very welcome indeed.
Remember when you have an issue with your health (and remind others when you can) that A&E is for urgent and emergency treatment only – only come in if you have medical needs which are life threatening.
It is easy to do a quick check online to see the best course of action for your condition and make the choice to seek the most appropriate pathway for care – this might be NHS 111, your local GP or pharmacist, but there is advice out there.
You can keep up to date with how busy we are, tips for self care and advice and guidance on a range of issues through our own updates on Facebook, LinkedIn, X (formerly Twitter) and more recently local forums such as Next Door.
If you want to give us a follow and keep up to date day by day as well as sharing critical messages to your own followers that is appreciated and does make a difference. We have recently done some films explaining which of our services or pathways might be right for you and also the difference between A&E, urgent care and minor injuries. The feedback has been positive about how helpful they are, so if you want to watch them please click here.
Lastly, taking all of that on board, I am going to end with a quote from Frank Turner which I see daily in the office of the Deputy Chief Executive Sharon Gilligan and feels relevant here and really sums up what I think is key to getting through this difficult time together.
He says simply: “In a world that has decided that it’s going to lose it’s mind, be more kind my friends, try to be more kind.“
I hope this resonates with you too and thanks in advance for your support.
Take care,
Martin