I thought it might be useful to colleagues if I provided an update about the operating status of the Trust – including the context of the NHS as a whole, regionally and within the Lancashire and South Cumbria Integrated Care System.
You will be aware from media reports that the NHS nationally upgraded the response to Covid to a Level 4 Incident in December. This is the highest level now assigned to our relentless response to and management of the pandemic.
The continued challenges we face are being well documented in the media, but include:
· Continued high demand and long waits to be seen in emergency departments and urgent care centres and pathways
· Hospitals running at or close to full capacity
· The continued struggle to discharge people who no longer meet the medical criteria to reside in hospital which is becoming more difficult with increasing outbreaks of Covid in the community
· The basic unsustainable sum of more people being admitted to hospital each day than are being discharged
· A significant increase in Covid infections, which continue to rise
· High numbers of Covid positive patients and those classed as ‘contacts’ in the hospitals
· And lastly, but most importantly, high staff sickness absence and isolation levels of above 10 per cent
The Regional Director of the NHS in the North West Dr Amanda Doyle has also written to all colleagues, setting out the current position and actions that need to be taken to manage the pressures over the coming weeks.
The letter reiterated six areas for immediate action, which were:
1. Maximising discharges across the system and wider health and social care sector
2. Reviewing provision of virtual wards and home oximetry provision to create capacity
3. Creating capacity to manage any additional surge in hospitalisations from Omicron
4. Ensuring effective management of the workforce, including redeployment of non-clinical colleagues
5. Protecting elective recovery plans for high priority procedures
6. Ensuring key messages and information is shared with patients and colleagues, particularly around getting vaccinations and booster or flu jabs and appraising communities of alternative access points for care to A&E
Taking all of that into account, it’s clear that the NHS as a whole continues to face a challenging and complex set of circumstances on top of our usual winter pressures that always come at this time of year.
Let me provide some assurance though that due to the diligence and continued hard work and dedication of colleagues across the Trust and the wider system including yourselves, ELHT is faring as well as can be expected.
We are challenging but continuing to provide safe, personal and effective care – not just to our communities but to our staff too.
You will have seen in the last few weeks our ‘Home for Christmas’ campaign, which resulted in the highest number of discharges ever recorded for Royal Blackburn Teaching Hospital. This continued through the festive period and has provided the best possible start to the year for us. I would like to thank you for your help and support in this achievement.
We have now moved to a message around ‘Why not home? Why not today? and would again ask for your help and support in preventing people from needing to come into hospital through effective care and treatment in the community as well as discharging patients in the most timely and effective way possible across Pennine Lancashire.
Working together will be paramount in sustaining the fine balance between the number of people who need to come into hospital and the safe discharge of patients who no longer have a medical reason to be here.
Considering the six asks as set out by the Regional Director above, it is clear that the Trust had already identified, considered and actioned activity within these themes – and we continue to make progress, especially in protecting elective procedures for those who need them urgently. This is an incredible achievement.
This does not mean the next few weeks will be easy. The modelling of the variant and the huge rise in community prevalence and subsequent hospital admissions is now higher in the North West than anywhere else in the country. It is going to be tough and we’re going to need every bit of resilience we can muster.
We will potentially need to take action to protect our services and ensure patient safety and, again, I would like to assure you all that we will take difficult decisions as and when they arise. This may include postponing some elective procedures – but please know this will always be a last resort and some times might feel like ‘short notice’ but this is because we’re battling to the very last moment to get people in.
We also need to remember to look after each other and ourselves in all of this. We do need key workers across all sectors to be fit and healthy and mentally well to come into work, pick up extra shifts and dig deep into the resilience banks in the next few weeks.
Please be aware we continue to offer vaccinations, flu jabs and Covid boosters for all colleagues.
I know we can and will do it – and I remain so, so proud to be Chief Executive of the Trust and part of the Pennine Lancashire team and wider system across Lancashire and South Cumbria.
Let me know if you have any thoughts or ideas about what we’re missing or could be doing differently or better – if it sounds like a plan, we’ll do it.
Kind regards,
Martin
Martin Hodgson, Interim Chief Executive
East Lancashire Hospitals NHS Trust