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Chief Executive’s Message – Friday 10 September

September 10, 2021

Dear colleagues

You may have by now seen our Chair, Sir David’s announcement confirming my appointment as the substantive Chief Executive of Sandwell & West Birmingham NHS Trust.

As you can imagine, I am personally delighted at this news. Leading our organisation over the last 6 months has been an enormous privilege. The Trust has so many qualities that make this prospect an exciting and challenging one in equal measure.  The economy of scale we have in our clinical services, the high quality clinical leadership and general management I see and work with every day, the service innovation in our specialist and community services, the welcoming and friendly vibe of the Trust and the opportunities afforded to us by the Midland Metropolitan University Hospital development, are all things on which we can build together. There are many other strengths besides. It will be an honour to lead the Trust and to build on the work led by my predecessor, Toby Lewis, with all of you.

I will be organising some sessions, both in person and virtually, to give anyone who wants to participate, the opportunity to hear about our emerging new strategy for the Trust and the immediate priorities I want to work on with you all, over the next 12-18 months. Of course, at these sessions, there will be plenty of opportunity for you to ask questions about those things and challenge my thinking if need be. Everyone needs to have a voice on how we tackle the immediate and long term local challenges in health and care over the coming years. Do look out for these sessions and come along if you can. As a reminder, our emerging new strategic objectives are:

  • To be good or outstanding in our delivery of patient care and use of resources
  • To cultivate happy, productive and engaged staff
  • To work seamlessly with partners outside of the Trust, to improve life chances and health outcomes.

All of this is good, grand stuff. However, I am all too aware of the current overload we have on our urgent care services and the elective care backlogs we face.  This is putting incredible pressure on you all.  Moreover, I am also aware that against that backdrop, we have a tendency to ask too much of you, to state that everything is a priority. To that end, there are four, practical things that we need to prioritise together over the rest of this year and in 2022:

  • To deliver the Midland Met, including the new care models and new clinical roles which will drive its success
  • To recruit assertively into areas with chronic vacancy problems and agree a new way of doing things round here, encapsulated in new Trust Values which we will hold ourselves accountable for living and breathing
  • To improve on the delivery of the “fundamentals of care”
  • To develop and start to deliver, out of hospital service changes with other organisations in Sandwell and Ladywood/Perry Barr, to begin reversing the trend of deteriorating life expectancy locally.

Before I conclude this week’s message, just a few words on the urgent care pressures we are facing. It is little consolation, I am sure, to hear from me that every other Trust and local system in the Black Country and Birmingham is under the same strain. This week alone, we have seen:

  • Over 110 patients in each of our EDs at any one time – this is dangerous overcrowding
  • Patients requiring admission waiting at times, over 15 hours in ED following decision to admit
  • Ambulance services with an unanswered call “stack” of over 600 at any one time
  • Category 2 ambulance response times of many, many hours
  • 111 services critically overloaded
  • GP services critically overloaded

For every hour a patient who needs admitting waits in an ED, their chances of subsequent death increase by 0.75%. This is the situation we face and it is not yet even winter. We are stepping up our wider, system response to this including things like spot purchasing of care home beds with NHS money, increasing GP urgent care slots at each practice etc. However, there are things we can still do better as a Trust. One of those is the so called “simple and timely” discharges. We always deliver a decent number of discharges but it’s the timing of them that can improve. When the MDT Board rounds take place, do please have at the forefront of your minds how creative you can be about bringing forward the time of a discharge. As the figures above show, every hour counts. Every hour gained saves lives.

Have a good week

Richard