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Chief Executive’s Message – Friday 19 July

July 19, 2024

Dear colleagues,

In my Friday message this week, I want to focus on three things – in fact – these three things will be the focus of everyone at SWB for the next few months.

They are:

  • Ensuring we are ready to move to Midland Met later this year
  • Our financial improvement programme
  • Workforce control

Other things, not related to this, or patient safety, simply must wait – and I am giving you all permission to say no. Sometimes it feels like a difficult word to say – but I would not expect my executive team to ask any of you to undertake any work that is not feeding into the achievement of the above things – and we must all take this stance. The pressures that you have all been working under for the last few months are unsustainable, especially if we are to successfully open Midland Met in October and deliver our financial improvement target – it’s time to really focus on what we simply must deliver this year.

This message might come across a little bit frank, but when you are continuing to navigate through ever evolving challenges and striving to deliver exceptional healthcare services, clear prioritisation is more critical than ever.  By prioritising, we can ensure that our resources, be that financial, people or technology, are allocated to where they can have the most significant impact.

Midland Met

Someone told me this week that we have just over 11 weeks until we are planning to move our first patient from Sandwell to Midland Met.

11 weeks – just let that sink in for a second.

After the school summer holidays are finished – there will be just over five weeks – that is not long at all is it.

It is vital that you continue to work towards completing your operational readiness checklists, engage with testing of our critical patient flows, do your online general induction when it’s available next week and continue to engage well with the programme. From August, we will be starting a programme of senior leader walkabouts, to come and talk to you about Midland Met and understand any concerns, or areas where we need to make sure we can offer more support.

If you have heard our Managing Director for the Midland Met Programme, Rachel Barlow speak – you will have heard her use the phrase, ‘this is a team sport,’ and we need one big team focus and effort on our ‘Get Set for Midland Met’ work please.

Financial improvement programme

As I said in my message last week, although the change in government is positive for the NHS, it doesn’t take away the fact that as an organisation, we have a £40m deficit plan that we must deliver against. If we don’t start to deliver it ourselves, we will be in the unwanted position of it being overseen by NHS England – this is not where we want to be at all. We want to do it our way, so please engage in the financial improvement programme – if you are asked for ideas, please put them forward. This isn’t a problem that is going to be solved by the finance team – this is all of our problem – and we all have a part to play in improving it.

We are now into the second quarter of the year, and we still have to deliver £40.6m of savings – hopefully, you are now starting to understand why we have to be so focussed.

We have identified £33.3m – a lot of which has come from your ideas and your hard work – and remember – it’s not just about cuts – for example – the clinical coding team have improved working practices, which we think will generate circa £6m.

The latest figures are below.

If you have questions, concerns, or suggestions – please contact swbh.recoverypmo@nhs.net.

FIP Target £44.1m

FIP Identified £33.3m*

FIP Delivered £ 3.5m

*of which £4m has passed financial validation

Left To be identified £10.9m (24.7%)

Left To be delivered £40.6m (92.1%)

Workforce control

As part of the system wide financial improvement, there is an ask of each Trust to reduce their workforce by approximately 5 per cent. Now I appreciate that this could sound worrying – and I don’t want to cause any level of alarm – but I also don’t want to hide away from the reality of the situation that the system and we as a Trust are facing. However, let me make one thing clear – we are not talking about making redundancies here – but we must reduce our establishment, be that via not recruiting to some of our current vacancies, or reducing our reliance on bank and agency.

We must control our workforce, but we must also ensure that we recruit to the positions we need to successfully open Midland Met.

So, what does this mean in reality?

After accounting for the positions we need for MMUH, we need to reduce our establishment by 158 full time equivalents (FTE) – that’s approximately by 2 per cent.

If I can give you some perspective, we currently have over 1,000 more FTE people than we did a few years ago – however, we have not increased the amount of activity that we are doing – so effectively, we have more people, but are doing less work. Now I know it doesn’t feel that way, when we are all working incredibly hard – but that’s the reality that people outside of the organisation are seeing.

We have put a number of plans in place to achieve the reduction, including being tighter around our recruitment – you will have seen information about things such as vacancy control panels for example, and reducing our reliance on bank and agency.

Right now, these plans are not working quite how we need them to – in June we said we would have 8,080 full time equivalents – we had 8,258 – putting us 177 full-time equivalents over our plan.

This week, the executive team has made the decision to effectively pause recruitment until the end of July. This is whilst the clinical groups are doing some work to look at their current establishments and how these fit within our workforce plan.

You can go ahead and complete paperwork for posts, but these will not be processed until this pause is lifted. Where interviews are already booked, these can go ahead, however, if candidates are not yet booked – these should be paused. There are a couple of exceptions to this for critical positions – such as hard to recruit posts or those essential to Midland Met – these will be reviewed and approved on a case-by-case basis.

As I said at the beginning of my message – I appreciate it’s a bit doom and gloom – but I must be open and honest with you about where we are at. I will of course bring you regular updates on our feedback, and if you have any questions or concerns – any member of the executive team or your senior leadership team will be able to help.

Have a good weekend.

Richard