With only nine Fridays until Christmas, it feels like winter is at our doorstep. Not so much due to the weather—East Lancashire has seen some spectacularly autumnal days recently—but because the clocks go back this Saturday, adding to the sense that the season is changing. However, what truly underscores this shift is the palpable atmosphere within our hospitals.
Examining the situation reports of our emergency department, I find myself confronted with unparalleled numbers. In my 30-plus years in the NHS, I've never witnessed anything quite like this. While regular readers are familiar with our recent records in emergency department attendances, these records are now being shattered daily.
There is a tremendous amount of effort from colleagues who are doing all they can to attend to our patients, many of whom are in urgent need of care and treatment. As mentioned last week, our emergency department is accommodating far more people than it was ever designed for, and it weighs heavily on my mind that our patients may not be receiving the quality of care we aspire to provide.
This challenging working environment isn't conducive to a great experience for our colleagues either. Since the summer months, daily activity has steadily risen, with September marking our busiest month so far.
To provide context, ELHT ranks among the top five highest attended emergency departments in the northwest region, even surpassing larger Liverpool and Manchester Trusts with multiple emergency departments. Just last week, we recorded over 5,000 attendances and received almost 700 ambulances—we're also in the top five in the northwest for ambulance attendances.
It's clear why the most common question at meetings is "What more can we do?"
Efforts are already underway. We're revising and reviewing our winter plan and exploring good practices to navigate the upcoming months. One area we're maximising is the use of virtual wards and out-of-hospital support, such as Home First and our Intensive Home Support Service. These services are integral to our provision, and we plan to build on them in the coming weeks and months.
Managing hospital services is a delicate balance of quality, safety, and performance against challenging financial constraints. Despite our financial difficulties, I want to stress that decisions affecting patient and staff safety will be made, prioritising safety over cost. However, we simply must ensure we have grip and control on our budgets, ensuring taxpayers money is spent wisely and effectively.
It is incumbent on us all as professionals to come together and do all we can to continue to provide safe, personal and effective care for our patients and their loved ones.
It’s also important that we do all we can as individuals too, and as usual this time of year, cases of both flu and covid are making an appearance. I have had my flu vaccination and will be receiving my covid next week, a very quick and easy process it is too, by our very skilled vaccinators who are working hard to protect as many of you as possible before the season sets in.
The vaccines are the best protection we have – along with good hand hygiene – so I urge you all to top up your immunity as soon as possible to prevent becoming ill from flu or covid and to protect against spreading the viruses on to our patients, family and friends.
It would be remis of me not to mention that we are at the half way point for the National Staff Survey. We have received over 2,500 responses so far, which is slightly behind where we were this time last year. I fully appreciate that this will be down to colleagues prioritising the delivery of good patient care, and that completing the survey is possibly not part of your priorities.
If you have not already done so, I do urge you to try to put 10 minutes aside to fill in the survey and not miss out on your chance to have your say. You’ll find an email from our survey partner Picker in your inbox.
I truly believe it is one of the surest ways of making changes for ourselves and our patients, so it is important that you are provided time to contribute to help shape our future.
As Freedom to Speak Up Month concludes, I’d like to emphasise the importance of speaking up for positive change at ELHT. Breaking barriers was this year’s theme, which hopes to address the concerns of why people remain silent in the NHS, sometimes due to fear or a sense that nothing will change.
At ELHT we are committed to encourage a culture were speaking up is the norm. Colleagues should feel free to actively speak up, aiding the Trust's learning and improvement, while leaders, including myself, should be responsive to listening and acting. I’d like to thank the Freedom to Speak Up team, Jane Butcher and Nicola Bamber, for their sterling efforts in raising the flag – both literally and metaphorically - for speaking up.
Please do continue to speak up, listen up and then follow up, whether that be connecting with colleagues, inviting your Freedom to Speak Up Ambassador to a team meeting, or sharing something getting in the way of you doing a great job.
I'll conclude by sharing two appointments that framed my week. A meeting with the tenth Bishop of Blackburn, the Rt Revd Philip North, focused on empowering and strengthening the community. Collaborating with various sectors, including business, healthcare, education, and politics, we discussed ways to bring about positive change in our local communities.
Support for the community was further highlighted at a celebration event for Step Into ELHT. This successful programme, in partnership with the Department of Work and Pensions, has made a significant impact on individuals' lives, with 129 people completing the programme and 108 securing roles at the Trust through the past nine cohorts.
These endeavours showcase the Trust's commitment to improving health in local communities, not only through healthcare but also by supporting employment, reducing waste, and collaborating with various partners. It's a reminder that our impact extends beyond medical treatment, contributing positively to the social, economic, and environmental well-being of the communities we serve.
Our achievements come down to the many amazing teams and individuals across the organisation. A standout example is Debbie Hardy from B2. I was genuinely touched to receive an email from her this week in response to my blog. What stood out even more were her heartfelt words about the supportive environment on B2, benefiting both colleagues and patients. She also shared how her husband contributes to the team spirit by baking lemon drizzle cakes for everyone, and I was lucky enough to enjoy one yesterday—thank you once again!
With the challenges we're facing, it's easy to feel overwhelmed, so take care of yourselves. Enjoy that extra hour from the clock change this weekend. And to those working, thanks for all you do—try to rest when you can.
Take care
Martin