Monthly archives: March 2019

Chief Executive’s Message – Friday 1 March

Happy St David’s Day! That means there is just one more month to go on the mandatory training countdown that you will appreciate the Trust has been on for a little while. As in 2014 when we began to make having an annual appraisal comprehensive, we are now intent to delivering each year the full statutory obligation for required training. With your payslip in January you will have received your own personal scorecard. Even if you think the data is wrong, that data is the information we hold about your status. It is your responsibility to both complete your training and ensure the data held centrally is accurate. We have a whole team in learning and development who are there to help, and this year we moved most of the training onto e-systems that can be accessed at work, at home, and on the move.  So, if you are one of the 4,000 people we employ who is already 100% compliant, thank you for your efforts and organisation. If, like me, you have some work yet to do to be compliant please ensure that you make arrangements over the coming week to schedule that training or undertake it on-line. If you are paid through Agenda for Change you will not pass through your increment if you are not 100% compliant on our central database. If you are applying for consultant clinical excellence awards, the same obligation applies. And to be rated at a performance level of 3 or 4 in your Aspiring to Excellence 2018-19 PDR, which will take place in the next twelve weeks, you must have undertaken all of your mandatory training.

This week we held our regular monthly TeamTalk team brief. My short film feeding back on TeamTalk is out in staff comms, and you should have a face to face team meeting in the next four weeks that gives you the opportunity to talk, listen and engage with local and organisation wide issues.  If you do not have access to, or do not know how to, attend such a session, do get in touch with either your group director of operations or with Ruth Wilkin or myself. MyConnect is great, Heartbeat is terrific, email comms is ok, but we know that face to face conversation matters most.  As part of the work we are doing to support individuals and teams, it is so important to have that time. Last week I had the opportunity to talk with a fascinating group of frontline team leaders on our apprentice programme:  It was very clear from their feedback that messages get lost or unintentionally distorted, and we need to do more to talk – only that face to face time helps answer the why questions that people have, as well as the what, how and when discussions that can dominate.

From next Friday we will issue a regular weekly update on Brexit preparedness within the Trust.  Whatever is happening nationally, we need to make sure that it is understood internally, and explained to patients and visitors. The issue of medicines and equipment availability continues to dominate much discussion. Our Chief Pharmacist, Pun Sharma, and others have done a sterling job making sure we are well connected to the central purchasing arrangements. I am reassured that both getting medicines into the UK, and holding sufficient stock, is well planned.  If you do have concerns on any aspect of Brexit readiness feel free to get in touch with me. Across our project team, which covers information governance, research trials, professional registration, fuel and energy purchasing and such like, we are confident we are well prepared, but it is always possible we have missed a local nuance. So, as ever, do speak up.

15 March is our next Quality Improvement Half Day. That date is important for a couple of reasons.  All QIHD teams are required to submit and have accredited their efforts by the end of March. That was the shared learning topic in November and the countdown is on for around fifty teams who have not yet put in their application. If that is you do get in touch with Allison Binns and the governance team. The next QIHD will also see the formal launch of our arrangements for smoke free, which by now you surely know is 5 July. With that launch will come a comprehensive set of Frequently Asked Questions, and our answers, building on what you will have read in this month’s Heartbeat. As a Trust we are pro vaping, pro nicotine replacement and pro quitting smoking altogether. I mentioned a £3,000 saving last week that giving up could save you, and I know that dozens of colleagues in our Trust have taken the impending ban as a stimulus to try again to cut down, switch to vaping, or quit altogether. That is fantastic and we want to keep up that momentum as we move towards entirely smoke free sites, with shelters removed, and both wardens and cameras tracking our sites to make sure that no-one is smoking on our land.

A big thank you to everyone involved in our continued work on sepsis.  80% of patients who should have been screened last week, were screened, along with over 95% of patients who should have had a VTE assessment. Sepsis remains our top quality priority as we work to tackle avoidable harm and amenable mortality.  Next week’s Board meeting will see a detailed presentation from David Carruthers of the improvements being made and the work being done. Infections, including sepsis, remain our biggest opportunity to make a difference, although it is also the case that better identification of patients who are expected to die will help our comparative data. After improvements in recent years, that identification gap is especially true at weekends. It is also at weekends when we sometimes struggle with rapid release arrangements, which is a key issue for many in our local community whose faith or culture obliges certain timescales for burial. Later in March, we will issue revised guidance to address this small but important gap in the way that we work.

Finally, we continue to make decent progress with recruitment. We have a team out in Australia now sourcing more recruits (often Brits returning). And this week we are adding to our paediatric consultant team. The year ahead will see exciting changes at the Trust in children’s services, as we get ready for Midland Met and respond to our forthcoming CQC report. We are determined to make sure that children presenting as emergencies get the very best care from our A&E and paediatric teams, and that specialist surgery is undertaken by teams who are typically experienced in the care of children. We are just a month too from taking over the school nursing contract and Cheryl Newton joins us shortly as the new Group Director of Nursing for paediatrics.  With a £1.5m investment in new neonatal facilities, I am heartened by the progress we are making and hope you are too. In the long term, however, it will be childhood obesity that defines the health status of our local population and there is more yet to plan to do, let alone deliver, before we can be confident about our outcomes in 2030.

Attached are this week’s IT stats: IT Performance Stats 1 March 2019

#hellomynameisToby

Heartbeat: Colleagues united in Unity

Our recent Unity engagement events gave colleagues much reassurance about our new electronic patient record.

We’ve received encouraging feedback with 71 per cent of attendees agreeing learning points were well made, 93 per cent of attendees found the content relevant and 97 per cent of attendees would recommend the event to fellow colleagues.

The two engagement events took place at Sandwell’s Education Centre in January with the aim of giving colleagues more information about the ‘pain and gain’ of implementing an electronic patient record.

The engagement sessions were kicked off by Roger Stedman, Consultant Anaesthetics and Critical Care Medicine who is certain that Unity will aid drug prescription. He said: “When Unity goes live our prescribing of drugs will be done in an entirely electronic fashion. We know that incomplete prescriptions will fall from approximately 62 per cent to 0 per cent, inappropriate doses will fall to almost 0 per cent, legibility and signing prescriptions will rise to 100 per cent and the recording of allergies will rise to 100 per cent.”

Leong Lee, Clinical Safety Officer and Consultant Cardiologist echoes these thoughts and said: “Unity will make things more consistent, it will improve communication between different members of staff and it will improve clarity. No longer will you have to look at a bit of writing in the medical notes and wonder what the words say because of illegibility. You won’t have to look at drug charts and wonder about prescriptions because of the handwriting or wonder who has actually prescribed it.”

Attendees heard from Dr Alistair Morris (Bradford Teaching Hospitals NHS Foundation Trust and Calderdale and Huddersfield NHS Foundation Trust) and Helen Beck, Executive Chief Operating Officer (West Suffolk NHS Foundation Trust), who talked about how the implementation of their own electronic patient records has benefitted their organisations.

Both covered initial teething problems and how it took a short period of time for staff to learn how to use the system. However, once they became comfortable with it, the majority of them went on to become efficient users. In fact the majority of staff in both organisations have said they would not go back to using a paper based system.

Colleagues also had the opportunity to see Unity in action as they took a patient on their Unity journey through their care pathway. There was also a chance to quiz senior clinical and operational leaders on how Unity will change the way we perform our daily duties.

Here’s what colleagues had to say about the event:

“At first I thought ‘oh no another IT system’ but I now understand the ways and wherefores. I envisage problems with some colleagues coming to terms with this but if we adopt the listening and helping strategy they will come round. Bring on go-live.”

“Much more reassuring to hear from other Trusts who have gone live. My concern is that some things they raise, we don’t seem to have learned from e.g. need for training that is not in silos, need for more devices etc.”

“Very informative, glad I came! Really useful to hear from those that have lived and breathed the journey, I don’t feel as scared for go-live now.”

“Good to see how other trusts kept the staff engaged. Relieved some anxiety how the system takes a long period of time to settle in. Ward staff would benefit form attending.”

Root cause analysis training – limited places still available: 21 March

Are you interested in investigating incidents in a recognised systematic way? Root cause analysis (RCA) is the recognised method for investigating.

We have some places left on a RCA training day on Thursday 21 March at the Postgraduate Centre, City Hospital, 9am-5pm.

Note: If you are interested in attending, you need to be able to undertake investigations on behalf of your directorate, into areas outside of your specialty. You may also be called upon to assist with a serious incident investigation.

If you’re interested in attending or would like more information, please contact allison.binns@nhs.net.

Heartbeat: Full dress rehearsal increases confidence in Unity

Our sites were turned into shades of green as we took on the full dress rehearsal (FDR) of Unity from Monday 11 February.

A survey of colleagues who participated in FDR revealed:

• 72 per cent of colleagues agreed with the statement, “Having participated in FDR, I feel more confident in using Unity
• 72 per cent said there was enough communication in preparation for FDR
• 69 per cent felt they were prepared and able to deliver what was expected of them
• 89 per cent reported they had enough support with issues raised.

There were some issues flagged up such as printing, with 50 per cent of users.

saying they were unable to do so when needed, whilst others reported that barcode machines weren’t working as they should. We should note, though, that most issues were resolved quickly.

Katie Gray, Deputy Chief Operating Officer and Head of Unity Implementation said: “We’ve had some marvellous feedback from FDR. We have gained a tremendous amount of knowledge and learned so much, even from smaller clinics, such as the clinical nurse specialist clinic in respiratory medicine.

“There were issues with printing some labels and documents and there were some problems with barcode scanners that will require further investigation.”

Katie added: “A number of debrief sessions to gather feedback on how FDR went have been taking place. The aim is to create a good foundation on which to build the go-live support. If colleagues have not been able to take part in the feedback sessions I would encourage them to contact the team and give their views directly.”

How was it for you? Dress rehearsal participants share their views:

“It’s our first FDR and we have been admitting patients, allocating them beds or chairs and it’s gone really well. It’s been quite straight forward. There’s been a couple of little issues but those will get sorted out. This has been a great experience before going live. It gives you the chance to ask questions if you’re not certain about something.” Dorothy Lord, Ward Clerk, Medical Infusion Suite

“I just wanted to say how proud I was to be part of the BMEC ED FDR today – I work with the best team ever! It was wonderful to work with people who were so intent on making the FDR work today – your enthusiasm, drive to find solutions, passion for sharing your knowledge with others was awe inspiring. There was a complete ‘we can do this’ mentality which was fantastic. Thank you to everyone, without the staff running the ED as normal we would not have been able to test the systems as thoroughly as we did – literally everyone has played a vital part of today’s success.” Laura Young, Directorate Lead Nurse, Ophthalmology

“Initially, it has been challenging. The first time I looked at the Unity system on screen, it was quite scary. However, after working my way through it, I saw my second or third patient and I found it was getting easier. I think the system will make a real difference to everybody.” Anne Rutland, Skin Cancer Clinical Nurse Specialist

“Things have gone smoothly today. We have been transcribing and it has made us feel more confident in the system before it is launched.” Mark Zimmerman, Alex Hollis and Dan Worthington FY2 Doctors

“I feel like it’s (the dress rehearsal) worked quite well today. I initially felt worried because I hadn’t done the training for a while. But it all came back. We raised a few issues, but these were resolved with support from colleagues”. Oneka Berry, Nurse Associate, Lyndon Ground

“It’s been a great day of FDR we’ve done fabulous episodes of meeting with different colleagues and dealing with their problems one by one. Eventually we will have better ways of identifying problems which will be resolved and become part of our implementation. “Alan Scott, EPR trainer

If you would like to give your feedback on FDR please contact the project team at unity.cutover@nhs.net.