Chief Executive’s Message – Friday 12 July
July 12, 2019
#smokingkills
If you have worn a red T-shirt this week a massive thank you for your work to help reduce smoking in our community; more T shirts are on order. The same thank you goes to security colleagues who have stepped into A&E and made “public service announcements”, to our partners from Safety Net who have had countless chats with visitors and patients, and to ward clerks, ward service officers, HCAs, pharmacists, nurses and doctors who have approached inpatients and offered alternatives to smoking. We are just over a week on from our July 5th ban on on-site smoking in our GP surgeries, community and all hospital sites. The clean-up of the old discarded cigarette butts is in full swing. I met earlier today with our grounds and gardens team to discuss their work and the new equipment that is coming to help with that, as well as the 200+ new signs that are being installed next week to support the smoke free policy here. I hope that by this time next week the sites will look and feel even cleaner than today.
More and more people are asking about quitting smoking. And yes, a 30 per cent discount for you, applies in our vaping shops, which are based in Sandwell outpatients and on the City main spine. Vaping is the quit-model advocated by Public Health England, and it is 95 per cent less harmful than smoking. No-one would sensibly take it up from scratch, and we are clear that children and young people should not vape. But as a route away from expensive and damaging nicotine dependency, vaping is a choice you can consider. If the evidence changes on vaping, we will change our policy. While the peer reviewed evidence is as it is, we will proudly sell that evidence, endorsed by the Board, by our public health committee and by countless professional advisory bodies nationally. Let’s not let the perfect be the enemy of the good.
I know some colleagues remain frustrated by the sight of individuals smoking on the street or on a wall. As the rain comes I am sure that that will decrease. We will be removing some shelters and canopies so that when the weather worsens we do not see a return of smoke to our site doorways. I want to encourage everyone to challenge, talk and support those still smoking. There is every reason to try alternatives: Many colleagues have taken up the offer of paid smoking cessation clinic time, and I must ask line managers to make every conceivable effort to support this.
Learning from excellence
Other things are happening in our Trust! Thanks too to everyone who nominated someone for our Star Awards. The shortlisting process is happening now. Our Star of the Week competition is starting too, as well as our weLearn Poster contest. This week and next week we are adjudicating QIHD accreditation and I can be sure we have more silver award winners than right now and maybe even a gold or two. It is really important that quality improvement time is purposive and drives both successful and failed improvement projects where we experiment to make a positive difference.
You have five more days to get your PDR done. 17 July is the adjusted deadline that replaced 30 June. That deadline gives us a chance to start moderation in August. August’s Trust Board will consider the rewards scheme that will support Aspiring to Excellence 2019-20, with decisions next summer: It is categorically worth being part of this programme. High performers in our system will not only have support but will see salary benefit from high achievement. At the same time, the current pensions crisis will be met by a local Trust scheme for doctors, from 1 August, that tries to help manage the issues that you will have seen cited in the national media this last week.
Getting It Right First Time (GIRFT)/who refers to whom?
On Monday we re-launch clear clinical guidance from our medical director and chief nurse for how specialties work to support patients arriving in our emergency departments. Colleagues in those areas have a reasonable expectation that all of us will support patients with diagnostic attention and specialist opinions. Our EDs are well staffed. But they are not staffed as a ward, or a corridor ambulatory area, and nor can they easily manage 15 per cent more patients arriving than expected – as they did on Monday this week. We are expecting good specialty support to ED, and where trainee teams are not able to attend, consultant colleagues will be directly contacted. 17 patients on Monday waited over eight hours to be admitted or discharged. None of us would choose to be among that group.
On Wednesday we will meet with external teams to explore the progress we have made in tackling emergency waits. Projects like our Single Point of Access stand out. This Trust has the best ambulance handover times in the West Midlands, and has seen the second largest fall in long stay inpatients in the region. Parts of our urgent care transformation are succeeding. We need to complete the triangle by tackling long waits to be seen, admitted or discharged.
Recruitment and retention
Yet again our Trust won awards at the regional apprenticeship ceremony last week. Our apprenticeship team scooped the Birmingham Apprenticeship Training Provider of the Year award. Today I was delighted to attend the Stepping Up ceremony to celebrate the journeys of the BME colleagues who have undertaken a development programme hosted by the NHS Leadership Academy. We were the first region to host the Stepping Up programme, and colleagues from across the Black Country worked together to develop their confidence and skills, many already receiving promotions in the NHS.
Of our almost 1,000 funded longstanding vacancies, we now have 307 people offers accepted with start dates by new joiners, and another 565 people who are completing their paperwork and awaiting start dates. This is good progress as we continue to advertise, recruit and work to bring in new colleagues. It is really important that those new joiners are welcomed and supported. There are interesting ideas like the coloured dots on name badges used in medicine and emergency care to signify tenure and experience, and maybe help point the way to someone who may be less familiar with how we work.
Unity – including annual leave
Almost half of those who need to have now completed self-assessments of Unity competency. But our readiness criteria need us to cover everyone, and have those assessments counter-signed by line managers. In August many frontline staff will need to do three hours e-training on the CapMan module which is essential for those moving, admitting or discharging patients. And as we launched in this week’s QIHD there are a series of team readiness and competency tests to do. The latter will be externally audited. This package is part of making sure that we are ready to use the new system safely. I want to emphasise that most of the risks associated with go-live are now about us, as staff, and our familiarity with the system, rather than with the system or our IT itself. We need to ready ourselves with the precise skills to use the system well.
Part of go-live is the identification of teams that are most central to that safe use – so – called gold and silver teams. The list is attached and if you are not a member of one of those teams the temporary bar in having annual and study leave agreed is duly lifted. Within gold and silver teams we are agreeing staffing levels for the go-live period, and will confirm leave restriction reductions next week. I do appreciate that it is taking longer than hoped to sort this out and I apologise for any inconvenience caused.
Thanks Nick
Dr Nick Harding OBE is shortly stepping down as clinical chair to the local CCG. Nick, and his family, have a long and distinguished association with the Trust. Nick remains in clinical practice locally and will, I know be keeping an eye on our slow march towards Midland Met, and supporting the work that we are doing to better co-ordinate care and work alongside local GPs. Ian Sykes, who works within our partner organisation, Your Health Partnership, has taken over the CCG chair role. You may be aware that the four CCGs that cover West Birmingham and the Black Country are merging, but in truth they will remain distinct until 2021. Ian will work with us to try and adapt commissioning, as we move away locally from a PBR model or one where someone sends us a specification, towards a model focused on experiment and innovation to deliver outcomes.
Attached are this week’s IT stats: IT Performance Stats 12 July 2019
#hellomynameisToby