Chief Executive’s Message – Friday 17 April
April 17, 2020
I am going to start not obviously on COVID-19, but as I wrote last week everything sort of is – with worryingly low levels of presentation for other symptoms and conditions, and people waiting at home and asking for help late. Our Safety Plan is an important part of checking our quality of care once someone does come into an acute setting. I can see renewed improvement back to our August 2018 peak in compliance with our 24 hour assessment checks. Thank you to colleagues who have really focused on this in recent days, and I recognise that with new wards and new teams, it will take a few days next week to get our habits clear. At a time when COVID-19 could distract from other concerns, it is even more important that we get this right.
Safety Plan LT As at 12th April 2020
Earlier today I met our outpatient respiratory physiology expert team, or rather some of them. They are now working on D15 and D17, our respiratory hub that you will remember we created late last year as part of the steps towards our new hospital. I was on the ward to present the whole team with the Star of the Week prize for this week. Amina Mohammed humbly accepted on behalf of her colleagues this well-deserved recognition – strongly supported by nursing and medical nominations. This is a team who have turned upside down what they do every day to share their expertise with new colleagues in new settings. This week I emphasised in my update the need for us to focus on novel or new approaches to the care of COVID-19 patients, the better to perhaps tackle the mortality rate. Evidence evolves about the role of oxygen therapies and NIV, and the Trust is part of several such trials. Respiratory medicine, as you might expect, are central to our efforts to tackle avoidable harm.
Last Friday we code-named our work to tackle COVID-19 as Operation Mary Seacole. That reflected not just her qualities as a nursing role model, but our acknowledgement that much data was showing disproportionate incidence and harm in certain ethnic groups, as well as differences by gender and by age. In truth all of those things may be markers of underlying differences in health conditions associated with poverty and exclusion. This week, especially at City, we have been involved in some difficult discussions with individual families worried by national and local media narratives, by the real data as they read it, and by incendiary comment, some of it viral and untrue. At the same time, it is clear that deaths among staff from Black and Minority Ethnic backgrounds are elevated and a national enquiry has rightly been launched. I want to emphasise to you my confidence that our care is good and that in particular allegations of racism in how we choose patients for specific wards are false and indeed scurrilous. But I also believe that we need to face honestly, and based on the data, the real concern that we have, and that many in the community will share. To that end I am pleased that the local health and well-being board for Birmingham are bringing experts together next week to ensure that we share our data and our insights to date.
We went into Easter weekend opening beds and services. This week ends with a larger critical care unit and some general beds closing. It ends too with a Nightingale launched to the east and with a concerted effort nationally to support care homes. Locally that has been our focus from the start. From the start we have offered PPE at discharge and worked with partners to make sure that discharge happens safely. Those efforts continue. We do not know where in the Surge cycle we now are. Our best guess is lower and slower, demanding the endurance I mentioned in my bulletin. With that in mind thank you to our clinical re-deployees, and to those who have now started in our Brigades. Blue porters yesterday, yellow PPE wardens, and our green clean team. That last one is the team I will be doing shifts in, and I want to express my gratitude to those doing the same. Next week we will get mobilised with our red and purple teams, which will include those working from home or shielding.
On Wednesday we organised our very own clap. Three dozen colleagues joined us outside the BTC to thank those businesses who have stood with us so far. I know from the messages I have seen since from firms how truly moved many were by your appreciation for what they are doing. I have mentioned poverty already in this message, and the financial impact of lockdown and of COVID-19 is emerging as we wait. To have strong relationships with local and regional businesses can only help our work on employment, good housing, and health. I ended today in discussions with local authorities, the combined authority, and others about regeneration at City Hospital after Midland Met opens, and in the canal corridor up to Rolfe Street. The Trust intends as you know to play a central role in bringing partners together to develop our area and to tackle exclusion. Wealth we see as intrinsic to good health. Strong communities in Winson Green and Smethwick are part of where we draw staff from, this and next generation, as well as those we serve.
Work does carry on at Midland Met: Equipping choices, design clarifications, some construction programmes. However, consistent with our absolute determination to push the scope and pace of testing, we have handed the car park site off Cranford Street over for a test centre. Right now that is run by the private sector, and we are working to see how a public/private partnership might enhance its agility and effectiveness. It is important that hot spots like the prison environment, and priority groups like local bus drivers, have ready access now to testing, as we move towards a potential tracing phase. Surge is followed by exit, and exit by recovery. That is why moving our cancer services and some maternity services off site has been a key step for us. Haematology has gone to Halesowen!
Let’s end with a hint of normality – car parking. A staple of my Friday messages. In April in your payslip you won’t be charged. But just as significantly this last week both councils, Birmingham and Sandwell gave planning consent for the new car parks we are building. Current estimate would see opening in 2021 as we strive to provide enough spaces for use, whilst encouraging alternative travel now and in the future. Electric vehicle points are at the heart of those changes, just as we plan for our fleet to go green this year. Well done to Jim and Chris for dragging this, thus far. I know that car parking and IT are always near the top of your list – we managed a whole QIHD on WebEx. Pinch yourself.