I want to talk about ‘system working’ this week – and I have introduced the inverted commas in recognition that whilst some colleagues will be familiar with the term there will be as many, if not more people, including patients and their families, who don’t recognise it at all.
A jargon buster would probably translate it into working together with others in the health and social care system in order to provide more ‘joined up’ services to patients and citizens.
And that might sound straight forward enough but for East Lancashire Hospitals that means collaborating with colleagues in Pennine Lancashire and also Lancashire and South Cumbria as a whole, as well as the North West regionally and right across NHS England.
So it is complex to navigate and involves a lot of people but not as much so, I suspect, as if you’re a patient trying to access services managed and delivered by a myriad of different people in different ways. I don’t underestimate how difficult that can be and, that’s the point really, to work together to make things easier and better for everyone.
As we continue to manage high volumes of people coming into hospital through our urgent and emergency departments and see as many people as possible who are on waiting lists for care, it’s going to be key.
I have said before how proud I am to be Chief Executive of the Trust and I hope my high regard for colleagues across our hospitals and community teams is implicit in everything I do or say.
But no one is an island as the saying goes and I’m equally clear that we won’t recover from the pandemic without working across organisational and service boundaries and, indeed, with everyone in our communities too. Indeed, I now think the size of the challenge is so big and complex that no one organisation can deliver everything on its own.
Last week I linked to a letter from the Chief Executive of NHS England Amanda Pritchard, who you might remember visited Royal Blackburn Hospital just a few weeks ago. It clearly set out national priorities designed to help us transition away from our response to Covid.
Amanda was clear about three things she felt would make a huge difference:
- Effective urgent and emergency care including ensuring people are discharged as soon as they are clinically fit to leave hospital
- Delivering more routine elective procedures to reduce the backlog of those waiting for care
- Improving the experience for our patients and their families
On the first point, you will know that we continue to see huge numbers of people coming into our urgent care and emergency departments at Royal Blackburn, Burnley, Accrington and Rossendale. This has been the case for some time and is reflected across A&E departments across the UK. This month has been extremely busy – almost on a par with the number of people seen in June 2021, which was our busiest month on record here at the Trust.
We are receiving large numbers of ambulances with acutely unwell patients onboard, with colleagues who are also under pressure to hand over patients safely as soon as they’re able in order that they can move onto their next call. I’m pleased to say that we are good at this, using our improvement work as a foundation, and we will continue to prioritise supporting the North West Ambulance Service as much as we possibly can.
To ensure we can take these patients, we need to work with social care colleagues and families to discharge people who no longer need to be in hospital but might not be able to return home without further support. This is very challenging at the moment for everyone involved and a day to day pressure on the wider team, particularly colleagues in our community services who continue to do a great job, but it is absolutely critical to our success.
To the second point of Amanda’s letter, we currently have around 30,000 people waiting for outpatient appointments or inpatient care and whilst we are working through these as quickly and safely as possible, and constantly rejigging plans and schedules to support those with the greatest clinical need, new referrals are also coming in all the time.
Working with GP colleagues and specialist clinicians across Lancashire and South Cumbria we are trying to ensure people are effectively referred and have equitable access to care too, so we reduce this idea of a ‘postcode lottery’ with people waiting longer for the same service because of where they live.
On improving the experience for our patients and our families, I want to assure people that this is a real priority for the Trust and is clearly demonstrated in our long-standing commitment to providing safe, personal and effective care. I am pleased that this was recognised by colleagues in the recent Staff Survey.
Just this week our senior leadership group heard from one of our improvement programmes that set out to ensure we were sensitively and appropriately caring for people at the end of their lives. Talking – and more importantly listening – to patients and their families about their experience and seeking feedback during such a difficult time has prompted many changes. I know these are already having a positive impact and I’d like to thank everyone who has been involved.
This brings me to the health and well being of all colleagues working in health and social care and I want to recognise again how much has been contributed, particularly over the past two years. The team is tired, continues to work relentlessly and is being asked to do more all of the time. We can only make progress because great people are bringing their expertise and energy each and every day. No matter what, we must remember to check in to see if they’re OK, responding with support where needed.
These are just a small number of examples which make it clear that ‘system working’ is very important indeed.
It’s helpful that this approach has developed significantly during the pandemic such that we are now not only working together more effectively across the health and care system but are actively seeking out opportunities to collaborate and improve as a group more and more. For this reason, the provider Trusts in Lancashire and South Cumbria, which includes ELHT, have come together to form a ‘Provider Collaborative’ including all five Chief Executives to agree joint priorities and how to best deliver them across the patch.
In addition, there is a specialist collaborative group working on Mental Health, Learning Disability and Autism services, led by Lancashire and South Cumbria NHS Foundation Trust and including colleagues in health, social care and the voluntary, community, faith and social enterprise sectors. This is going to be a really key group, coming together to focus on increasingly pressured but incredibly important services in the area.
I believe the collaborative groups will improve quality and experience by sharing and standardising best practice and reducing variation and duplication along geographical boundaries. It’s right patients have equal access to the same high-quality care wherever they live and colleagues should have the same high-quality experience wherever they work.
It’s important to say for those with deeper insight into how the system is governed that this is about strengthened partnership working and not organisational change. Each Trust will remain a statutory body and each Chair and Chief Executive will remain accountable for their own organisation.
But it’s an exciting start that promises to deliver real improvement and support the recovery of the NHS, as well as improved health for our communities.
If you’re a colleague interested to find out more about the collaborative please do register for some online sessions in June and July where you’ll also be able to ask questions and make comments or share ideas. Details about this are in our news bulletins. You can also find out more here www.lscprovidercollaborative.nhs.uk
As always if you have any thoughts or comments you wish to make, I’m happy to hear them on any subject. I enjoy your feedback and welcome your input.
Finally, two quick points that are hot off the press.
The first is a thank you to everyone from a variety of teams who helped to create a very special space to remember at Clitheroe Community Hospital, in memory of colleagues who lost their lives during the pandemic. ELHT&Me funded a bench and a cherry tree in the grounds which was unveiled to families at a ceremony yesterday. The bench was beautifully hand crafted by colleagues in the estates and facilities team, a very touching service was delivered by Clitheroe’s Chaplain Andrew Froud and refreshments afterwards expertly made by the catering team there, including the legend Dulcie and her amazing team. The event was very clearly appreciated by everyone who attended and, as ever, we did ELHT proud.
Lastly – but definitely not least – I want to give a special mention to the team in urgent and emergency care at Royal Blackburn Hospital , who started today with a very low number of patients waiting to be seen and no-one being cared for on the corridors. I am conscious we are quick to send updates and emails with urgent actions for colleagues when things are difficult and so it is only right we acknowledge and recognise when things are going well. I know it is the result of an incredible amount of hard work from the team and wider colleagues across the hospital sites and community settings. This is going to be key over the next few days as we approach a double Bank Holiday weekend.
Thank you so much for everything you are doing it is valued and appreciated – and when I say I am proud, I truly mean it.
Take care,
Martin