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Chief Executive’s Message – Friday 10 February

February 10, 2023

We know that as an organisation we have a long way to go in achieving the levels of patient satisfaction, staff satisfaction, quality and efficiency that would enable us to be rated as ‘Good or Outstanding’ by our patients, staff, partners and the Care Quality Commission (CQC).

Highly successful organisations have developed an approach to continuously improving their organisations that involves all staff at all levels, every day being equipped and empowered to eliminate waste and improve experience and outcomes.  ‘Waste’ is typically defined by any action that does not add value to the service user. This approach originated in the 1940s at Toyota but in the last 20 years it has been successfully adapted and adopted in healthcare, too.

In the United States of America, the Virginia Mason Institute in Seattle and ThedaCare in Wisconsin have become world renowned leaders in healthcare improvement and the deployment of improvement systems to help their teams deliver their strategies.  In the UK, NHS Trusts such as the University Hospitals Sussex and Surrey and Sussex Healthcare NHS Trust have been recognised as leading Trusts in this field.  Others, like Maidstone & Tunbridge Wells NHS Trust, are not far behind. They have all created a culture of local ownership of issues and a culture of self-determined improvement in their front-line teams.

In the last 5 years NHS England have supported the adoption of Continuous Improvement systems in NHS Trusts.  The CQC assess how ‘well led’ an organisation is partly by the existence of an improvement system. Whilst neither organisation sets out how they expect NHS Trusts to implement or fund these improvement systems, nevertheless, guidance is coming imminently that will, in effect, mandate it.

At Sandwell and West Birmingham, we recognised the importance of having a Trust wide approach to improvement when developing our 2022-27 strategy and signalled this by including Continuous Quality Improvement as an enabler to the delivery of this strategy. This is all available on Connect and on our website. As a result, in September 2022, the Trust Board agreed for a project to go ahead to determine what SWB’s improvement approach should be and how it could be rolled out across the Trust.

Since September 2022,  the project group and senior leaders from across the Trust have explored what ‘Great looks like’ by researching published literature and speaking to and visiting experts in this area, including:

    • Trusts who have successfully developed their own approach
    • Partner organisations who can help Trusts develop their own approach

We now know that this desired approach is an improvement system that we would develop and brand, to make our own, that supports all staff to deliver improvement in an increasingly complex and opaque environment, with increased service pressures and ‘flat cash’ funding.

Our improvement system would help us to:

  • Put the patient at the heart of everything that we do and deliver the Fundamentals of Care
  • Align the whole organisation around what the most important priorities are each year
  • Have a standard approach to the improvement work we do throughout the organisation
  • Enable everyone to make change in their area or to work with colleagues to make broader change without referring to more senior leaders for permission or approval.

Last week the Trust Board spent a session learning more about the type of improvement system that we want to implement and our role in ensuring that it lives within the organisation forever.  They were excited by the opportunity that an improvement system would offer the organisation. Building on the session last week, a series of options will be presented to Trust Board in March, after which we can move on to planning our approach to delivery and procuring any external support we need to help us to implement our improvement system well.

What’s the ask of me?, I hear you say

  • I ask that you are curious to learn and that you remain passionate about improving the care that we provide to our patients
  • I ask that you make every effort to attend or listen in to any events about our improvement system, if you can
  • I ask that you think about how proficient you would like to become at understanding our system and implementing improvements in our organisation and working with partners across our system.

Done right, I anticipate that knowing and living this system will be right at the heart of who we are and how we care for our patients, our people and our population. I believe that it will be weaved into our appraisal process and become a key skill requirement when seeking promotion into senior roles. As the Chief Executive of the Trust, I have now committed to the implementation of this system being one of my top priorities. I fundamentally believe we will not be able to meaningfully deliver our Fundamentals of Care, our financial recovery, our People Plan or our population health ambitions, without it.

Have a good week.