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Chief Executive’s Message – Friday 7 April

April 7, 2023

I was delighted to see the new Medical Same Day Emergency Care facility (SDEC) open to patients this week at Sandwell General Hospital. This is an important development for us and aims to enable clinical teams to see and treat patients on the same day, avoiding the need for an unnecessary hospital admission. Congratulations to all the teams involved in getting this facility open and the clinical pathways in place to make it a success.

The SDEC model is a core part of our future Trust plans and forms an essential component of the care model needed for Midland Met. Due to the importance of the new hospital development, one in three of my Friday messages now focuses on key aspects of the Midland Met programme.

This week, the executive team and Midland Met Programme Company leaders met together as part of the programme’s monthly governance cycle. One of the topics for discussion was assurance over our plans to avoid preventable hospital admissions (which we know can cause patients unnecessary harm) and subsequently enable the right “fit” within the new building. As we all know, our inpatient beds – acute and community – come under pressure throughout the year, usually peaking over the winter months. We need to make sure that the Midland Met inpatient beds are sufficient to meet the needs of our population.

Detailed work has taken place to model the beds required. There are some significant schemes in place that are enabling us to reduce the number of days patients need to spend in hospital (Length of Stay or LOS) or avoid a stay altogether. We are seeing this work pay off in Sandwell. Looking at the data is showing us that there are six key schemes that will make the most difference:

  • Frailty Intervention Team
  • Acute and Community Heart failure Services
  • Same Day Emergency Care (SDEC)
  • Care Homes Support
  • Frailty Virtual Ward
  • Respiratory Virtual Ward

Some of this work is already in place with great results such as the additional support provided to care homes in Sandwell which has resulted in a reduction in admissions from over 20 per month before the service started to consistently less than 10 and zero in January. Some services need expanding such as the virtual wards which we believe can avoid admissions , reduce length of stay and reduce approximately 23 acute beds. Other schemes need to be replicated across Birmingham which has different complexities in terms of community pathways so that patients have equitable services no matter what their residential postcode.

What we need to do to as we embed or expand these schemes is ensure that we are able to safely reduce the number of acute beds . This is no easy task and relies on us all to be focused on discharging patients at the right time, or supporting patients better in their own homes. It is also not something we can fix on our own and we are relying on partner organisations across the Birmingham & Solihull and Black Country systems to act on their bit of the pathway. Helpfully, we have good engagement and support for this work which is mutually beneficial and will also demonstrate better outcomes and experiences for patients and their carers. This is also a key part of our winter planning. With these schemes developing throughout 2023 we expect to be in a much better position going into the winter months.

As we head into another period of industrial action, our focus this week has been very similar to the focus needed as we prepare for Midland Met. We have asked which of the patients in a hospital bed can be safely discharged home with the right support in place that will support safe services next week. Sandwell SDEC is key milestone along this journey and it is great to see it operational.

Have a Happy Easter.

Richard