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Chief Executive’s Message – Friday 5 April

April 5, 2019

The first message of the new public sector year! A year in which we expect our incoming funds to grow by 10 per cent, the number of people we look after to rise by 100,000, cut our waiting lists by just under 20 per cent, and make quantified strides to dropping mortality (rate vs. expected) in our care below 100 – in other words better than to be expected adjusting for deprivation and morbidity.  I am not making a prediction on vacancy rates but you know by now, I would hope, that we are targeting a figure around 2 per cent.  So, a year of huge ambition and dramatic change and that’s before we start our Unity countdown.

Alongside that quantified change, all of us will want to make sure that we play our part in improving quality.  The last few days have seen some hard and good work to tackle norovirus at Sandwell, in our local community as well as on the fourth floor of the hospital. We all know what we need to do to treat infection seriously. But quality gains also lie in making sure that we have good relationships and civility, that we manage the human factors within our teams well. Introducing each shift or theatre list, each meeting, by making sure everyone knows everyone else, and has the opportunity to ask questions or raise issues. Last week I listened to a terrific group of registrars and others in our emergency departments discuss how they learn what is going on in their department, how they can act to change it, and how to address issues of concern. Like any such discussion, workload and staffing will feature, but so do policies or practices developed over months or years that might need to change. It ought to be as easy at night to get access to equipment, medicines or kit, as it is on the day shift. Easy means plenty, but it also means neat, tidy, available, stocked. That was the point of the new resuscitation trolleys we installed in February, responding to one of the fairer criticisms in the CQC report from last year, which was published today.

Whether you work in paediatrics or in the corporate leadership, there are some difficult ideas in the report. Our well-led rating is one that has gone down this time, even as critical care has stepped up to join the rank of outstanding rated teams. There is no point pretending I agree with every conclusion in the report, and I know there is brilliant work being done that is not remotely mentioned or considered. But the views expressed by the CQC are ones that the Board, including me, will take seriously and commit to improve upon. What I sense in the well-led report, and what I see in the weconnect survey data, is a yearning for a juster and fairer culture in our Trust. There is a belief, sometimes well grounded, that not every decision made about promotion, about flexible working, about change, operates transparently or reasonably. Individuals feel their voices might not get heard, or that in some way speaking up is not going to lead to change or is going to lead to retribution or disregard. Sometimes the examples cited are from many years ago, sometimes recent.  Either way, to build the Trust we all want to be part of we have to address the big and small issues, through team discussion and local action, and through making changes corporately to help. The managers’ code of conduct which we will launch in early June is part of that, and we will consider this autumn where our values and promises fit into the decade ahead, and whether it is time to work together to refresh those words and the actions that have to sit behind them.

Heartbeat this month included details of our Period Poverty campaign. You can support that in many ways, one of which is to contribute to the fundraising effort around it. At the same time, we have many, many staff involved in fundraising for our Your Trust Charity, and for health causes close to their hearts. Ramandeep ‘Raj’ Kaur was a staff nurse on D17 when she first qualified. Raj had a life threatening asthma attack and unfortunately passed away on 26 February 2012. This year she should be celebrating her 30th birthday with her twin sister Amandeep ‘Amzy’, who works for us. So the family have come together to knit little coloured chicks with creme/oreo/caramel eggs in them. They are £1.50 and all proceeds will be donated to Asthma UK, to help raise awareness. Please join us by buying your own little chick. They will be around on D25/D27 at City where Amzy will be selling them. They featured yesterday in our Trust Board meeting, as we look to support research into how to address respiratory disorders.

In the deep background, our work to improve IT in our Trust continues. Last weekend we moved all of the storage for imaging onto different servers. The aim is to reduce fragmentation and to improve response times. That same aim sits behind our N3 changes over the next fortnight. And the new synchronising time source we are installing to make sure that every IT system in our Trust runs to the same clock. This was not an issue when the hour went forward last Sunday, but this year we will be ready for it going back, and the annual disruption that brings. While I am writing about disruption, we are nearly there with installing our uninterrupted power supply in the BTC and therefore cancelling the downtime that comes with generator testing.

I truly do hope you feel that you can raise centrally, with any member of the executive, and Board, or with me anything that you wish to – and that leaders at group and Board level are visible, even at 4am.  From October we will re-start something called First Friday, which we tried for a while in 2014 and 2015. This is dedicated time for visiting all parts of the Trust to see what really happens and to hear what works well and anything that doesn’t. We don’t want to over-structure something that should be pretty organic, but do get in touch with your group director of operations if you want to be visited as part of the first six months of that programme. The Board does undertake site visits after each meeting, yesterday we went to the new colposcopy suite at Sandwell as well as to our paediatrics wards, gynaecology outpatients, and the fantastic new clinical research facility which we will formally open on 22 May.

During April you will probably see some publicity about Midland Met. If you read the Chairman’s page 2 column in Heartbeat you will have a strong sense already of the progress being made. By the end of spring the Winter Garden will be in place. May’s Trust Board meeting will consider the final business case for the completion contractor, with a view to Whitehall re-approval before the summer Parliamentary recess. On the other hand, we do need to make sure that what we are building will work well in the integrated care system across primary care and the new hospital. That is why we are concerned by political moves to separate Birmingham from Sandwell, which sits badly alongside a population that spans such borders. Our view is that services should fit round natural communities, and that the location of your GP practice should not be the defining factor. You may live in one borough and have your healthcare in another. We know that when new hospitals opened in Peterborough, Bristol and Wakefield in the last few years, a failure to grip this issue of ‘planning blight’ was a key factor in the challenges they faced on opening. So we intend to be very direct with local residents and partners about the risks, and of course, if we can make Midland Met a day one success, the rewards for patients, visitors and staff. The natural geography of Sandwell, Ladywood and Perry Barr has brought Midland Met to the point of completion. We want to see that success completed.

Attached are this weeks IT stats:IT Performance Stats 5 April 2019

This week’s Brexit Bulletin: SWB Brexit Bulletin 5 April 2019

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