Chief Executive’s Message – Friday 4 May
May 4, 2018
There are lots of things to be proud of in our Trust. This week saw Paul Hooton and Debbie Talbot lead the team presenting our safety work to a national awards panel. And last weekend we began another important initiative, in our regional Sickle Cell and Thalassaemia centre. This is a patient led project, funded initially by Your Trust Charity, to support young people transitioning from care at the children’s hospital in Birmingham into our adult service based at City. You will recognise that we are providing lifelong care and support through this service to people who will on occasion experience acute pain and attend A&E. Working on patient experience, care for carers including parents, and the transition of teenagers are all issues with application beyond the service itself. I would hope that, as part of our Learning From Excellence drive we have, in future months, something worth sharing beyond just this service. This project, like a number of others right now, are benefitting greatly from the support of our SWB Volunteer Service, bringing both extra people and energy but also community connection into our services.
Yesterday our Trust Board met at Rowley Regis. The meeting focused on learning the 21 serious incidents that we have experienced over the last twelve months. You may know that since December there has been a concerted drive to ensure that amber incidents are not simply investigated but reported, closed and action taken. I want to thank everyone involved in that work. Looking forward the 21-day target to report on every incident will be managed rigorously, as we look to make sure that we spot trends and concerns before they escalate. I think it should be a source of pride that this Trust has a high incident reporting rate, and reports too in anonymised surveys high levels of confidence in the incident system. Of course those are means to an end, and the end is to improve outcomes for patients and working conditions for colleagues. There is definitely more to be done in the next twelve months to evidence the gains from people raising concerns, but I can see simply from my own working week this week, that we have made changes in ENT based on feedback from junior doctors, and are following through on the investments we made in the level one unit for surgery at Sandwell and the NIV service to make sure that we learn from the errors and issues that gave rise to those new teams being created. We invest too in quality improvement, and I am extremely excited to share with the gains being made by our Alcohol Liaison service. A patient story from that service opened our Board meeting yesterday and we heard from Sally and Arlene too. Our first public health plan to 2017 delivered much, but we know that we did not succeed in changing the pattern of care for patients admitted with alcohol misuse, and now in 2018 we are trying again to make real changes happen. The early results in terms of connecting hospital service users to community support are very encouraging, and I know too that colleagues in many departments are benefitting from access to the expertise of our new team.
Midland Met and Unity continue to dominate quite a lot of discussions across the Clinical Leadership Executive. It is a tale of two halves really. Midland Met still does not have a solution on how we will finish, and therefore when. Midland Met assuredly will be finished but you will have seen from the media that options range from 2020 now to 2022. If it is the latter date we will reach conclusions this summer about interim service reconfiguration for 2019. I very much hope, given the distraction, disruption and expense, that we can find a way to avoid that. Unity, on the other hand, is moving forward at pace. We are 107 days away from the likely Go-Live, or cutover. Yesterday the Board received our first outline training on the system, including the HIE which will give us and GP partners great access to data we each hold separately at present. The safety prompts in the system, the potential to reduce duplicate data entry, and the way in which Unity will help us with key aims like Making Every Contact Count, VTE assessment and the Sepsis Six bundle was extremely clear. That does not mean we wait for September before looking to up our game in those areas – there have been massive strides on sepsis screening and action in our emergency departments since this year started, and there is work to do on our wards to catch up. That is the essence of our action plan, highlighted in March. If we are to reduce avoidable deaths in our care addressing the weaknesses in our sepsis identification and timely management is the big step we need to take.
Earlier this week TUPE consultation started formally for all staff across the Black Country Pathology network, including our teams. The consultation and engagement has started now even though the new service model will not start before 2019. I recognise how unsettling this process is, and there is work to do over the next two months to resolve outstanding questions. After six months getting ready for BCP the remaining questions are the tricky ones and so, across four partners, it will take some time to settle that. There is good visibility of the issues among our pathology management team, and at executive level, and I am confident we will reach settlement on the issues that face us. Pathology services at our Trust are a tremendous asset and we want to build future service models which retain staff, whilst improving the service further. Jonathan Walters is taking the key role in ensuring that voices are heard but also that solutions are found.
Attached to this message is something called the corporate calendar. It sets out the dates, times and venues of key decision making meetings in our Trust. It also includes a simple one page diagram of those meetings. Whilst I think much of what it includes is known, it is worth a quick look to familiarise yourself with the two dozen or so monthly meetings by which issues are, I hope, resolved and service quality developed. If you want to know more do get in touch with Clare Dooley in HQ.
#hellomynameis….Toby