Chief Executive’s Message – Friday 15 November
November 15, 2019
Nick Makwana is best known to many of us as an allergy specialist leading a multi-professional specialist tertiary service at the Trust. In his spare time he is also group director for our Women and Child Health Group, working hard to get a clean sweep of ‘Goods’ or ‘Outstandings’ across their core services in next year’s CQC review. I understand to relax from whichever of those two things is more stressful; Nick also dances, a little. Today he has been dancing a lot in the entrance to Sandwell General Hospital. If you wanted to show your support, amusement, or admiration his efforts can be sponsored via https://uk.virginmoneygiving.com/NickMakwana – thank you Nick.
On 29 November, Your Trust Charity are holding a major conference for those colleagues who lead charitable fund budgets, as we introduce the revised role of fund ambassador. Email trustcharity@nhs.net if you want to attend.
This week has been, and still is, Living Wage Week, complete with the announcement that rates will rise to £9.30 an hour. This Trust is proudly at the forefront of trying to tackle poverty pay. We see this as a health related issue, as poor pay compounds issues like fuel poverty, poor nutrition, ad-hoc child care and poor school attendance. Next year, we will be joining others to try and get Birmingham accredited as the country’s first Living Wage city, and in the meantime, we are working to see whether all partners within our STP can join us in abolishing band 1 or much of band 2 wage rates. You will appreciate that, as a Trust, we offer debt advisors as a workplace benefit, and also fund some benefits advice services for patients. Projects that directly tackle poverty are always of interest for funding, both within our NHS service and from Your Trust Charity too, so if you have ideas or projects do put them forward to your directorate or group management teams.
This week’s QIHD topic was needle stick injuries, and other sharps. This is always an area where we can do more and better and safe disposal is typically something that the CQC find fault with our practice. The films issued for the topic provided, I thought, were a powerful reminder of the impact and anxiety that can come from being injured. I understand that within the films some colleagues felt that comments could stigmatise going to a GUM, or sexual health, clinic. We run a fine such service, and are the lead provider in Sandwell collaborating with many third sector groups, to try and address rates of treatable sexually related diseases like chlamydia. All of us should feel comfortable using those services and asking for advice. At the same time our understanding of HIV, living well with HIV, and being treated for it, is one of the great public health and scientific advances of the last two decades, and I would hope all of us now can carry a positive message about the options for someone with an HIV diagnosis.
I had the privilege during QIHD of listening to our pain service talk about their work, research options, educational ambitions, and future plans working alongside community pharmacists and GPs. Pain is one of the very commonest reasons to consult a GP, is a very common underlying issue or secondary condition for hospital consultation, and is something that we want to make sure we provide a comprehensive offer for in both western Birmingham and in Sandwell. The hub of our service is in new accommodation on the third floor of Sheldon at City, with spokes at Sandwell and in various GP settings – as well as treatment programme run from the Park Inn by the M5! The service is doing a fantastic job with often complex patients. I am clear that to be an integrated care organisation or system, we have to have an outstanding offer to patients in pain, and it follows from that that investment in these services will be a priority over the coming two years.
We know that, whilst educational attainment among our medical students and trainees is typically the best in the city, we could do better in all sorts of ways to improve the work/life experience of these colleagues, from sleep and rest, through to how we learn together and improve services. For the last few years we have employed a Chief Resident, paying one of our registrars to take on this part time management fellowship. Thank you to Alison Eastaugh in older peoples’ medicine, for stepping forward to the role this year. We both, I think, very much hope that in 2020 we can draw closer together our senior and middle managers, with our registrars and SAS doctors in particular, to make sure that such an important workforce is able to really have a voice in the Trust, at local directorate, and at corporate level.
There are lots of exciting changes being made right now in our emergency departments. Changes at City to get our new 2020 paediatric A&E services right-sized and better-shaped, changes in renal colic pathways to avoid patients waiting in ED cubicles, a planned investment to support us to tackle gang violence and risks, and new batched pathology order sets for triage, are just some obvious examples. I want to thank the nursing, management, and medical leaders taking those projects forward, alongside key partners like portering, pharmacy, AHPs, and transport. The national media scrum will rightly elaborate on the nationwide challenges, especially of complex frail elder people whose numbers rise, and where we all want to offer the very best service. Despite all the challenges, I continue to believe that being able to look after most attending people inside four hours is the right model, and so we will continue to strive to that end. As I wrote here a few weeks ago, the evidence is mounting that long lengths of stay do have a relationship with outcome and we have it within our collective grasp to be able to offer nine out of ten patients a short wait experience of our front-door services.
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