Chief Executive’s Message – Friday 2 August

August 2, 2019

The Board yesterday focused most of our time on the future of acute care services in our Trust. There is a lot going on before we get to Midland Met in 2022. And there should be, because many of you are providing emergency services 24/7, and because it is the one area of Trust services where the CQC does not yet rate us as Good or Outstanding. Plans to bring together paediatric A&E and D19 at City are well advanced and will go into operation as soon as the fracture clinic relocates from the spine into the Birmingham Treatment Centre – work should be done on paediatrics by February 2020. Meanwhile, outline approval to refocus respiratory inpatient services this winter to City has been agreed. The Medicine and Emergency Care Group have organised staff meetings in early September to talk those proposals through and shape them further. The changes have implications for other specialties, like haematology and gastroenterology. Our goal is not simply to have sufficient service capacity to manage this winter, but also to be to offer clarity to people working in those services about ward locations, service design and future career options all the way through to Midland Met.

Five months into the public sector year we continue to improve imaging waiting times. You will remember that we set a goal to have maximum wait times for reports to be issued, not simply for scans and investigations to be done. Over 85% of such scans are now cleared inside four weeks, and we are working to ensure that urgent scans are completed inside a week – something currently done two thirds of the time. That same regime of setting core professional standards is now taking place across other disciplines and specialties. Tertiary or additional opinions will be part of that regime, and of course Unity changes how such requests will be communicated to specialties. It also gives us good data on what actually happens for patients. With Heartbeat in August we will launch those standards, and I really hope that doing so empowers ward managers, ward clinical leads and others to know that we are organising around our patients and that patterns of service reflect that rather than history or logistics. Obviously, working across two sites will introduce some inhibitions and challenges – the case for one acute site is more evident day by day!

Part of the focus on acute care, is a complementary analysis of how community services that we run, and indeed primary care, is wrapped around patients in such a way as to anticipate and act to prevent unwarranted use of complex hospital care. Our performance and insight team, led by Matthew Maguire, have been working through this analysis, and Tammy Davies presented data to the Board on the ‘overlap’ between clients of our community teams and A&E attendances. We know from work done by iCares and others over the last year that many more inpatients would benefit from continuity of care in our community teams than are currently referred, either by GPs or by hospital teams. Some of that gap is about awareness across our Trust of the community services that we run, and an even deeper need for education about services offered through the voluntary sector in each patch. As our population ages, and having seen a 10% rise in emergency admissions since March, there is some urgency to putting into larger scale operation a meaningfully joined up connection between what we offer at home and how we care for people in ED and in our wards.

Thank you to everyone who has completed their PDR under aspiring for excellence. You will remember that the deadline was June 30^th. I am pleased to say that almost everyone has now completed their aspiring to excellence assessment of 2018-19 performance and long term potential. 2 is, as you know, the routine score, but I am sure many colleagues will have rated as a 3 or 4. If you have rated as 1 we will work to support you, and if you have not been rated as at today’s deadline then your registered rating will be 1. It is worth checking that your line manager has got your PDR details onto the system on connect. Moderation will now kick off to check that across the Trust scores have been applied fairly, regardless of profession, band, line manager, or directorate. So your final PDR rating is not confirmed until that process is concluded. The outcome of moderation will not be confirmed until later in September. I am keen that everyone understands this cycle, for all sorts of reasons, as PDRs are important, but also because in 2020-21 the Board has agreed to introduce a modest pay related aspect to our PDR system, and so it is important that this year we learn the habits that make that exciting change easier to implement.

Four paragraphs in, and I am only just mentioning Unity: Here goes…..yesterday CapMan training was launched. If you need CapMan training please undertake it by e-learning in August. To be clear this is the system by which patients are moved and registered, and so if you work in a ward area, regardless of your seniority, it will be important that you complete the training. Likewise, we need everyone to have completed their individual competencies and had that validated. Yesterday was our target date to be at 100% and we are 26% short. Those folk will be contacted next week to make sure that competency support can be provided. Your line manager should by now be talking to you about UniTeam. This is the short series of simulation activities we need to do before Go Live to test key parts of how we work with Unity – moments like handover or board rounds need to be tested in teams, not so much to test the technology as to make sure that individuals who have learnt that system individually, can use the system collectively. Later in August we will be auditing that team simulation, and that is the biggest measure by far in our final Board Go/No Go decision on September 6^th. Thanks to everyone who has worked hard with our second FDR in recent weeks, and with what is called trial load. We will examine the outcomes from that exercise, and I know, for example, that in Neonates we have a lot of work to do to get the product right for you.

With lots of new colleagues joining us, including our doctors in training this week and next, I wanted to offer a gentle but unambiguous reminder on some key aspects of Trust-life. Car parking changes continue, and one of those is a determination to enforce the car park rules that we have. That means that if you park where the lines say you should not you will indeed be subject to a fine, and if you were fined after April 2018 it will be need to be paid. But it definitely means that marked disabled spaces are marked disabled spaces. If you work for instance in our MRI services at City or Sandwell, adjacency does not mean that you can park in the nearby disabled spaces, unless your car is marked with a blue badge. Likewise, of course, our neighbours are entitled to their driveways and access, and so I would ask again that you park sensibly if you are street parking. With the changes made last month we now do have sufficient spaces for our needs, the challenge is using them collectively well! The new car parks should be with us late in 2020. Our bike stores are being upgraded too.

Thank you to everyone working to sustain our SmokeFree status. There’s always more to do but it is really encouraging to hear stories, or read them in Heartbeat, of colleagues who have managed to quit or switch, and I know that even some staff who shared their scepticism about the ban with me beforehand are recognising your success. The change from sunshine to rain does bring forward our winter challenge of moving people off site if they must smoke – and of course that applies to the maternity building at city too where new cameras and other enforcements aids are being installed. It’s about a two a half minute gentle walk to dudley road from the unit, so let’s encourage families, or colleagues, to make that walk if quitting smoking is truly not an option.

Finally, in October or November, we will moving both payslips and Heartbeat across to an electronic only version. That means that you need to get your access to a computer, or to sign up to get Connect and ESR on your phone. It’s really easy to do that and many, many colleagues have. August really is the month that WiFi will be reliable – even at Leasowes. So follow the links below and join in…

Download myConnect by searching for SWBH myConnect on your phone or from the following links: Apple Appstore, Google Playstore

Attached are this week’s IT stats: IT Performance Stats 2 August 2019

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