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Chief Executive’s Message – Friday 6 July

July 6, 2018

A huge thank you to Unison, and to our communication and charity teams for their work getting 70th birthday celebration events in place for yesterday.  The sun came out, people fell safely off a bucking bronco, and there was chance to have fun and reminisce.  At Sandwell the old photograph exhibition began its tour, and some of our nurses were part of a before/after photo in front of Headquarters, which I am sure will make its way into Heartbeat.  I hope you had chance to take part.  I spent time delivering birthday cards to some of our patients, and saw first hand the challenges to keeping patients hydrated and cool in the current heatwave.  Of course a modern hospital might make that easier!

We are expecting in November to see a new NHS plan come forward, on the back of the funding settlement Theresa May announced a few days ago.  We know that the pay award will be funded and should be in pay packets this July.  Beyond that the content of the plan are uncertain.  However, my sense is that there will be considerable continuity of vision.  By that I mean a continued drive to help organisations to work together.  And a continued push to connect primary care, mental health services and hospital care.  I would expect to see a big acceleration in efforts to replace traditional face to face in situ outpatient models.  And I hope we will see some real action on long term care for older people.  We know we can only succeed with care home partners, and with local authority partners, and alongside third sector.  I guess my point is that our 2020 vision, and what comes next working as a system across western Birmingham and Sandwell is very likely to be exactly what the national process demands of the NHS as a whole.

The future of the NHS is not in doubt as an institution.  But as look forward to our 100th birthday we do need to be thoughtful about what we do, what we might do less of, and particularly how doing more work preventatively could tackle the underlying causes of ill health.  That has to start with the very youngest children.  And needs a particular and thoughtful response to frailty and to patients at the end of their life.  In some local partnership right now we are seeing the emergence of emphasis on the first 1,000 days of life, and perhaps on the last thousand too.  The biggest single public health challenge locally remains obesity, especially in younger children. We have work to do to see our place in a joined up plan for that.

Where we do have a plan of course is around alcohol.  I was delighted that Arlene Copland from our liaison team was one of our colleagues going to the NHS 70th celebrations in York Minster, whilst Caroline Rennalls and Nuhu Usman led our delegation to Westminster Abbey.  Arlene and Sally Bradberry have been doing great work to join up our services for patients with alcohol problems.  Meanwhile we continue to work with the council to see if we can find a route to minimum unit pricing for alcohol locally – we know it works, even if it is unpopular!

Talking of efficacy and popularity, yesterday I wrote to everyone in the Trust about the birthday news on smoking. From 5 July 2019, all SWBH sites will go smoke free – after yesterday’s Trust Board meeting at the Yemeni community centre in West Bromwich. The shelters will be removed and we will be encouraging vaping in our grounds, but not in our doorways. Patients will be offered nicotine replacement therapy and other interventions on arrival.  But visitors, patients or colleagues who smoke on our grounds will be subject to a fine. We have twelve months to be ready. I would ask for your ideas and your support. There is no point going smoke free to sound well meaning.  Even at 70 years old quitting smoking helps. And we intend to be properly smoke free. It’s a big change and we have come to it after several years of putting it off. Please work with us.

The NHS, and the Trust, has a future to look forward to and celebrate. But to be doing that for a long time, and handing on this institution to others in decades ahead, we have to move more quickly to address harms that drive disease. When we get Unity in, we will be focusing hard on Making Every Contact Count. While we plan for that, do think through what information, help or ideas you need to develop the public health and health advisory nature of your service – seeing contact with one specialty or team as an opportunity to look at the wider health needs, physical or psychological, of the patients and communities we serve.