I have to admit, it’s not often I don’t know where to begin with a blog, but that’s where I find myself today and if you have to write things for work or at home, you might recognise the process.
Start, stop, review, delete. The creation of various introductions and observations, but none quite right. I’ve deleted words and paragraphs, moved them around and returned to an entirely blank page a few times. You’ll recognise that, in that moment, the more you repeat the process, the more difficult it is to nail.
This led me to ponder the cause instead and I have come to the following conclusion: it has been busy, there’s an enormous amount going on and I am tired. Annual leave is calling, my mind needs a break.
Now, I know this isn’t exactly rocket science territory, but I wanted to share it on the basis that if you’re feeling similar, it might provide some morale support.
I have written previously about the importance of recognising when you – or anyone around you – is struggling and needs some time away from work… and whilst it might evoke feelings of guilt over those left holding the fort at busy times, remember it is important for our overall resilience to rest and refresh.
There are multiple reasons for my fatigue, all normal and recognisable to most people I am sure. Life continues every day, every week… through the months and years. We keep going, driving forward, delivering and don’t often stop to ask ourselves if we’re OK.
In the NHS, I think it’s fair to say we continue to recover from the monumental response to Covid and everything that has backed up in its wake. Sometimes I wonder if we truly recognise what we have been through as an organisation, an institution and as people too. Only in years to come will we look back properly and understand the full impact of what we have endured.
Colleagues here at the Trust probably couldn’t mark the end of the pandemic, only when they turned their focus more to reducing the ever-growing waiting lists for treatment and, of course, when face masks and social distancing could be removed.
Since then, we have literally never stopped. The relentless pressure at the front door of the hospital – our urgent and emergency care pathways – which have been breaking all previous records for attendances, with June 2023 being the highest ever experienced at the Trust.
As I have referenced before, this requires a daily effort for every single member of the team on a Herculean scale, no matter what department or professional group. The need to keep flow optimised around the hospital is intense under pressure and cannot be left unsupervised for a second.
This includes everyone in all of our hospital settings and in every single element of our community team too. I know working across the wider health and social care system with equally dedicated colleagues in neighbouring organisations is the only way we can be effective, together as a team, united in support and service of our local communities.
I want to thank everyone who is connected to the Trust, who works in it and with it, for everything you have done and continue to do. I know the proverbial light of the end of the tunnel never seems to close in, but we continue to move forward any way and that ongoing determination is an incredible achievement in itself.
It’s hard though – and not just for the team but for patients and our families too. I know the pressures impact on their experience of the health and care system and sometimes we are managing in ways that wouldn’t be our choice in an ideal world.
I do receive lots of feedback as Chief Executive from patients and their families, including people sharing a positive story and often highlighting individual colleagues who have a done a great job, which is appreciated.
There are others who have more challenging experiences to share too and, truth be told, I appreciate the value of both. On the former I always let teams and individuals know where they have been recognised and say thank you. On the latter, similarly, I will share the insight and be clear we should accept it unequivocally and then use it constructively to improve.
Indeed, this week I received a particularly sobering note from a patient about her experience. I won’t go into detail and share information inappropriately, but safe to say I have taken immediate action on her concerns – and I always will in such circumstances.
If you haven’t had a good experience with the Trust on any level please let us know. Hearing feedback is one of the best ways we can learn, understand and work together to improve. I truly believe we do not shy away from this but instead embrace and use it to help make things better in the future.
To everyone who has endured a long wait in A&E to be seen, found themselves on the list for a bed we struggle to find or is ready to leave hospital and needs elusive support to be in place, I am sorry that we cannot make things happen more quickly for you.
Nonetheless I thank you for your patience and continued kindness to colleagues who are doing their best. Please know, every patient in every setting is being monitored constantly and we’re doing everything we humanly can to help minimise delays.
This will become more difficult as the impact of ongoing industrial action continues to bite. We have more junior doctors out on the picket line today and over the weekend, with further dates announced by a range of medical colleagues over the coming weeks.
The Trust respects the right of colleagues to strike – and the dispute is with the Government rather than ourselves – but, as I have said before, we can’t pretend it doesn’t have an impact on patient care, safety and quality of services and on the already long waits to be seen.
I am mindful also about the resilience of colleagues who are trying to cover and manage something that seemingly has no end in sight. I know the lack of progress is making it difficult to stay positive, but we are grateful to you for your ongoing support.
In amongst all this, ELHT continues to deliver and achieve and I remain eternally proud of the team.
Just this week I heard some statistics that I want to share as evidence of our going commitment to safe personal and effective care:
· Around 75 per cent of people waited less than four hours to be seen in A&E, urgent care or the minor injuries units. With such high numbers attending this is really good
· Of more than 700 ambulances which came in, almost 90 per cent were back on the road in under half an hour. This means they can get to the next emergency as quickly as possible, which is important
· The team in the integrated community hub is taking more than 500 calls from people every day. This helps us to manage the flow of people into hospital better and prevent the need to come in at all in some cases, which helps us across the board
· We are getting to 98 per cent of people in the community who need urgent help in less than two hours. This is way beyond the national target of 70 per cent and great we’re mobilising to people who need us quickly
These are just a tiny fraction of the number of performance indicators we are monitoring every day to make sure we’re putting resources where we need them and helping people. The effort and impact really is immense.
This commitment was borne out in person when I called in to see the pre-operative assessment service earlier this week and it was great to see Toni Bell and her brilliant team working so innovatively to help people in advance of what is often very major surgery.
Not only are they clinically assessing patients to ensure they’re fit and ready to go ahead with treatment but they are using research to work with them before and after surgery, which often leads to improved outcomes both physically and emotionally.
I want to thank the whole team for being so welcoming and open in sharing their passion for providing safe, personal and effective care, but I want mention specifically Elaine Spencer, a Health Care Assistant, who is celebrating a fantastic 43 years’ service in the NHS. An amazing achievement to be truly proud of. Thanks for everything Elaine.
I am on leave now for a couple of Fridays so I have challenged my deputies Sharon Gilligan and Jawad Husain to step into the breach and blog in my absence, so all being well you will hear from them in my absence and I look forward to catching up when I am back.
Martin