Chief Executive’s Message – Friday 22 May
May 22, 2020
Our star of the week this week, Dr Rebecca Edwards, is again someone recognised for their role in the compassionate care of people who are dying. Last week I highlighted the role of Leasowes in operation Mary Seacole. Rebecca’s selection reflected the tone and decency of conversations she was able to have with families. Time and again, we find that seemingly incidental details of how we speak, or what we say, make so very much difference to someone.
Improving the delivery of the choice of where someone dies remains on the key priorities of the Trust’s Quality Plan – before COVID-19, right now, and in the future. At the same time we are thinking through how the increased awareness for some people and their families about the need to make plans, including advanced care plans, can help us in the future to offer a more respectful and joined up approach across all health sectors and the care and residential sector too. The subject is the special focus for the June 4th Board meeting, and I notice that professional guidance on end of life conversations during the pandemic has been issued to the NHS across the Midlands – encouragingly that guidance seems to reflect our practice since mid-March.
Earlier this week, we saw changes made by government to their policy on charging care workers from overseas and their families for use of the NHS. In a Trust with people drawn from all over the world, this is welcome and overdue at the same time. The Trust, through projects like Health Overseas Professionals (HOP), is going the very extra mile to make sure that talented people who have fled persecution, or disease, are able to enter the workforce in primary or secondary care. And of course we continue to recruit overseas and have future plans to undertake more of those activities. Clearly economic circumstance will drive labour markets for some time to come, as the region and country brace for a deep recession. There is an opportunity amid that difficulty for us to succeed at recruitment as almost never before, and we need to make sure that this summer we are diligent in pursuing opportunities to have more people join us. We started April with about a 7% vacancy rate and that continues to fall, after we halved vacancies during 2019. We need to tell people what working here is like and why joining us on our journey to better preventative care and to a research-led University Hospital meets their hopes and dreams.
COVID-19 plans continue to evolve. Antibody testing remains part of that work during June, although like tracing, there are many details yet to define and locally apply. In June and July we are encouraging you to take time away from work where you can, and later in July we will take a longer term view of annual leave plans, funding, and arrangements for 2021. Most work is continuing now in two broad areas:
Firstly resetting our lilac, blue and red wards to make sure they are right-sized for where we are now in the pandemic. Remember that tracing when it restarts will come with both patient and staff quarantine arrangements, and so lilac spaces may have a different role. On both acute sites we are moving to a smaller number of designated red wards with some specialty bays in stroke, cardiac medicine and respiratory, after carefully assessing that option against simply using side rooms across our sites. The Trust has done a great deal of work on rates of cross infection since March, and whilst there are examples of nodes of spread in specific wards in specific weeks, the overall data shows comparatively low rates against expected regional norms. What this means is that there is precisely no room for any let-up or complacency. Social distancing and handwashing remain the two chief approaches we need to take, and reinforcing that view among ourselves, and with patients, could not be more important.
At the same time, or secondly, we continue our Recovery work – #greenshoots as we chose to label it – whereby some diagnostic work, some video enabled clinics, and some operations are taking place, especially at Rowley Regis and in our Birmingham Treatment Centre. The clarity of that transition will step up over the coming fortnight, and we should by the end of May (next week) be able to be definitive about redeployment end-dates and moves to alter rotas and rosters. That is one of the reasons we need a little forward planning on leave, as we categorically must avoid inviting someone who has waited in pain at home to come for care, only to lose that service to short notice absence.
Today I met, alongside David Carruthers, with twenty five senior clinicians from many disciplines, to discuss risks associated with NHS work as someone from a black or minority ethnic community. The outcome of those really engaging and positive discussions will be announced at the end of next week, but I took from our conversations two things in particular. The first was gratitude to teams like our PPE squad, and procurement teams, and others, who have worked tirelessly to give comparatively good supplies and a can-do attitude. But secondly that in less-red, more-blue areas of work there remains concern about exposure and about practice. The revised risk assessment tool that we are finalising, synthesising lots of national tools, but making sense of our own local circumstance, will lead to defined choices about who works where, and whether enhanced PPE is available for higher risk employees. This personalisation of PPE will need to be led by data and evidence, but it is our direction of travel as we look to make sure that we keep people safe and manage the understandable fear that many have at this time. As before, if you are dissatisfied with the risk assessment guiding your work or PPE you can contact your line manager, extension 3116, or me.
This weekend marks the end of a very unique Ramadan. I want to wish colleagues Eid Mubarak and hope that the very different arrangements have nonetheless offered fellowship and devotion as you would wish. None of us have certainty on how the coming month will develop, but all of us I hope can take some comfort from the work we are doing to look after one another and our communities.
Please be assured that the Trust, consistent with our values, is campaigning hard to see the NHS at the forefront of a regeneration response to the recession. That response should include making our Real Living Wage something that is taken up more widely across our local STP. Poverty remains a health issue – and it is staggeringly sad that a once in a century virus has had to reinforce the price of inequality and the cost of inaction.
#hellomynameisToby