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Chief Executive’s Message – Friday 17 August

August 17, 2018

This short film explains what happens next over Midland Met following yesterday’s landmark announcement of central Government investment in finishing the build.

You might anticipate that all of my message this week would be about the Midland Metropolitan Hospital.  I cover that subject – and others – towards the bottom of my message, but to start I want again to write about information technology (IT).  More problems this week, more frustration. Last week I confirmed £3m of new investment, and the creation of a dedicated Board level committee to oversee turnaround. This week I want to outline the key parts of the plan for improvement. Maybe not my most scintillating write up, but important nonetheless.

  1. WiFi reliability:  A number of our clinical systems depend on WiFi, and in both our hospitals and community settings we need to have dependability. Right now a team are installing replacement equipment across our retained estate. This should all be in by the end of the first week in September. A process will follow for our interim estate (those parts of City Hospital we had planned to leave next year).  At the same time we have mapped responsibility for technology, including WiFi, across our community bases. After installation of the new equipment we will be able to monitor performance and publish data, and will also spend September walking the floor trouble shooting problems, which sometimes are labelled as WiFi, but have a different route. This is a big start to the changes we need to make, and coming soon.
  2. Our network and infrastructure: We have had external experts on site working hand in hand with our team. Their recommendations for action were agreed by the executive and Board in recent days. Next week we have a final planning meeting to work out how we will install the changes we need to make during September and October. None of the changes are surprising to us, but they will give us a clearer route for traffic around our IT system, and better data on how our system is performing. Because some of our problems have regrettably been failures of foresight or action, this data is especially important and an anticipatory governance model will be put to the Board by Mark Reynolds in ten days’ time.
  3. Hardware:Most of the new computers that we need to install Unity are now in place, and likewise our connected medical devices. We have a new order of 600+ computers arriving shortly and over 100 laptops, most of which will go straight to our midwives and health visitors. The revised budget provides for purchase of around a thousand PCs this year.  Crucially this kit needs to be pre-loaded with the right packages and software, and we are exploring whether that is best done for us by a third party. The next batch of computers will come on that basis. Deployment will take place in coming months, and at the same time we will implement changes to our print function and printers during October, November and December. You will be aware that printing now is an issue, that Unity creates some printer issues, and that we have a bewildering variety of printers in our Trust. The programme of change is designed to address all three issues.
  4. Applications and systems:This is the one area where the Board is not yet satisfied by the plan. On the face of it we have a clear work list of around fifty systems that need change this year or before 2020. The approach to the other 150+ systems is being re-tested over coming weeks, together with a review of how we might address the first fifty. I would expect to confirm our approach in mid-September.

I know that many people reading this will believe change when you see it, and may consider the above belated. We nonetheless have to work from where we are and we now have the broad outline of a plan that responds both to our recurrent problems, and to our future technology needs at least in the short term. The Board will consider at our October meeting the right shape for the future of the IT function given growing demands and needs from the service, and also the technical complexity that comes with IT today. The very best expertise needs to be available to us, and we have to move to an increasingly 24/7 model of IT support. I again share with you the latest performance data from the team (Informatics Data 17 August 2018), and in doing so recognise we have much to do to improve in the coming three months. In particular the critical alerts need to be resolved, in part through the second item of the plan I have described above.

Last week I wrote about our upcoming QIHD Poster Competition.  This will culminate in November and more detail will launch with Team Talk in ten days’ time.  Around £5,000 of prizes will be made available to teams whose entries are judged as the very best.  We are looking to see improvement projects and programmes written up and evaluated, described and celebrated. The aim is both to recognise the work being done in various parts of the Trust, and to encourage the sharing of ideas and innovation. welearn is part a concerted programme of work to make sure that it is easy to share knowledge inside our organisation as we look to build on the 70% of our services rated as good, and on the increasingly research rich nature of what we do. Learning from excellence and from error has to be a hallmark of the Trust if we are to meet our aims; and I know that there remains much we could do to spread great practice across our organisation.

In 2022 we will move into Midland Met. We will find a final contractor in coming months and select the interim “winter” contractor this September. You would expect media focus on the finance of that and the technical detail of the build. All of that demands the attention of senior colleagues and I can promise that there is no intent nor scope to reduce the quality of the building or alter the excellence of its design. But the link between that, and our technology, and our learning culture, must be that to deliver the clinical promise of Midland Met we have teams to build. Recruitment is part of that, so is leadership. But using data well and creating knowledge from what we do will matter too. Whether it is new IT systems or new hospitals the lessons learned process usually concludes that more could have been done to build the human systems and teamwork to make a real success of change. Irritating as the last eight months have at times been, and frustrating as an opening date push back is, we now have time to use to get this right. With the certainty provided yesterday, let’s seize that chance. Government has put great confidence in us, in you and me. I think they sense the potential of this organisation and the people in it. I think we should share some of that confidence.

#hellomynameis….Toby