Chief Executive’s Message – Friday 10 April

April 10, 2020

Mary Seacole was voted the greatest ever Black Briton in 2004.  Awarded the Jamaican Order of Merit in 1991.   Mary was an exemplary nurse who worked to tend to the sick in the Crimean War.  As a role model to nurses she has pride of place in this the International Year of the Nurse and the Midwife.  Her statue stands opposite the House of Commons, beside St Thomas’ Hospital where the Prime Minister is, we hope, recovering from COVID-19.  This Trust is engaged in a huge mass mobilisation of effort and kindness both inside and outside our hospitals.  Our field hospital spans every ward and converts theatres into critical care units.  We are having to adapt best practice to circumstance, demonstrate extraordinary resilience, speak truth to power, and challenge assumptions night after night.  Given the scale of our operation we have chosen Mary as our figurehead in fighting this pandemic, conscious of the many colleagues on our staff drawn from different traditions, faiths, and communities.  Mindful that COVID-19 is disproportionately affecting some local people.  Mary’s bravery is part of her legacy to the profession.

It is perhaps important that everything we say and do is not about COVID.  Or put differently everything is about COVID.  To clarify – parents not taking their kids to ED is a COVID issue, delays in eye saving care are a COVID issue, isolation from hearing loss without access to a hearing aid likewise, making sure we tackle domestic violence is an issue that includes COVID, getting building work restarted on our sites is too.  So everything is changed by COVID, and we need to talk about those things that get less of a mention.  We have focused this week on reorganising Cancer Services to make sure we can still provide the most curative treatments for tumours that march to their own time.  In the next two weeks the Board will oversee construction of our post COVID Recovery Plan; starting to think not just about how we scale up to meet the need backlogged in our diagnostic and outpatient services, but also how we proactively search out disease and risk in people who have not been to see one of our GPs, or whose mental wellbeing has been rent by the tragedies of the current pandemic.  I know it is too early to implement that plan, but it is definitely not too early to be preparing for it.

I continue to be overwhelmed by the incredible determination I see in teams across our organisation.  This bank holiday weekend will never be repeated.  Colleagues in driving shuttle buses on normal service.  Estate staff in testing and retesting oxygen supply.  Portering team leaders pulling extra night shifts.  Senior managers manning the control centre, or even better doing the ‘management’ by walking about, that was my Heartbeat appeal.  Nurses cancelling leave to help us properly staff wards or open critical care.  So thank you to all involved in the Nightingale but let me be very clear.  We are the first responders.  This pandemic simply would overwhelm Perry Barr, Ladywood and Sandwell, if it was not for you and your efforts.

Sometimes though, as I have tried to convey in this week’s COVID Updates @SWBHnhs, the situation can feel overwhelming.  Scale and effort, compassion and kindness, need to be matched by skill, innovation and precision.  There’s a picture above of a constructed FIT testing mask, created by parts from a local supplier, made and validated overnight to help us keep testing.  Don’t think bin bags – we are not having to make up kit that is unsafe.  We are finding safe if unusual routes of supply.  Or remember Lawrence Barker and his team (and we will in the Star Awards in October) finding solutions to link ventilators from abroad to UK standard oxygen supply.  I am not a clinician so you must never take clinical practice advice from me, but I attach the Proning Guidance now being used Trust-wide.  Read it carefully and consider its applicability in your ward as well as across Intensive Care.  There are things individuals are doing, and things that can be done across our Trust which could make a difference not to coping, but to outcome.  This is the week where to me it feels like we are moving from quantity to a discussion on quality – how do we best reduce mortality in our communities.

The rest of the NHS is catching up with Morecambe Bay, Northampton and us on swabbing.  That is fantastic.  If you are still waiting from a result from your Boots test email swbh.occyhealthcovid19@nhs.net.  This week we have expanded our swab operations to include local care workers, from both the councils and care homes.  The heartbreaking events in Luton remind us that now, and certainly during the second surge this summer, the focus of effort will be outside hospital.  In mid March we set up extra support teams to work alongside care homes.  From the get-go we have been issuing PPE at discharge to support care workers taking care of COVID-19 positive patients sent home from this Trust.  It is incredibly important that we are alive to both the care needs and the incidence data from nodes of demand outside the walls of a hospital.  Matthew Maguire’s team have built a model of where our patients are coming from so we can begin now serious and well structured discussions about community hotspots and build the potential for tracing.

This week’s Star of the Week is Leanne Devlin.  She works in our Heath Street GP Centre (the one near Lidl, or city fryer, depending on how long you have worked for us…).  All our GP practices are stepping up to work to tackle COVID-19.  Our Lyndon Practice relocated to create the Hot Centre.  Heath Street are working to make sure every patient with a long term condition receives the right support.  Leanne is part of that effort but her work as a HCA over the last 8 months clinched her nomination.  She has been active in our staff engagement work through weconnect, and has done some fantastic work on the practice’s QOF programme, which focuses on making sure disease registers are accurate and effective.  It was great to hear how Leanne feels like coming together as part of SWB has helped her colleagues with their clinical practice, but also to understand the way our volunteer teams have made a difference in Summerfield.

There are some tough weeks ahead.  Thank you in advance to the 117 colleagues coming out of isolation and back to work this week.  Thank you too to those self isolating but still taking part in the GIM using our telemedicine solution from home.  Thanks to everyone who has volunteered, first up or more recently, for our Brigades.  This is a marathon and we need to structure now the endurance to see it through.  So we are taking actions not just to address this week’s challenges but to anticipate May and be ready.  If we succeed we flatten the curve.  That makes it lower but longer.  We will get tired, we will feel weary.  That is why the team work we see and the smart solutions we are creating give us the best chance to succeed.  I wrote in Update 11 all about TRiM and our resilience support.  Both the NHS wide offer and mental health Trust neighbours are supporting our trauma response, and we are going beyond that with our extended offer.  I would urge you now, before exhaustion takes absolute root, to make sure you know how to get help, or better still to take some help on board.  We will make sure our offers are available to your loved ones too.  They are part of this fight back.  Perhaps especially if right now you are in a hotel.

Do get in touch if you have concerns or suggestions.  Do get in touch if you need to be redeployed and have not heard from us by Easter Monday.  Do get in touch if you know the answer to my 7 COVID quiz questions in Heartbeat (there may be a tie breaker so make sure you read the whole magazine and wipe it afterwards).  Do get in touch if you can see what we are missing.  Like Unity, but more so, this is a whole Trust, whole community effort.  And you are playing your part.  Stay two metres apart (our medical director is 2m tall) and stay well.

#hellomynameisToby