Chief Executive’s Message – Friday 28 June
June 28, 2019
This week we had the Clinical Leadership Executive (CLE). You will remember each month this meeting brings together our clinical group directors, group directors of nursing, and group directors of operations, alongside the executive team and our staff-side convenor. Two subjects dominated discussions, and neither of them were smokefree (of which more below).
Every single amber or red rated risk in our Trust was reviewed for the accuracy of the risk statement and accuracy of the risk score. We did that so that the Board next week can have an overview of the key risks faced by you in your work and our patients in their care. The monthly Risk Management Committee, on which you have a representative, will now take that work and make sure that it is reflected on Safe-Guard. Over the rest of this year, we will be working across the Trust to manage risk, and so there will be a focus on the actions to be taken to reduce risk scores. Directorates and groups will be held to account for their risk management, including the velocity with which risks are resolved. This is clearly good practice. The focus comes from a perception, the accuracy of which will vary, that we are better at registering risks than mitigating them. You will know that earlier this year every single red rated estate risk was addressed, as part of our recovery plan from the Carillion issues, and I am pleased to note that by August we expect to have stabilised the water systems in the Birmingham Treatment Centre sufficient to remove the longstanding monitoring devices.
One of the big risks we face, and the second topic CLE discussed in detail was violence and aggression, and both staff and other patients fears that come with that. A new taskforce to address these issues is being chaired by Rachel Barlow. Among its tasks will be to implement our commitment of body-worn cameras as a deterrent in some instances and places. At the same time Paula Gardner, our chief nurse, is championing the work done recently on so-called “purple patients”. These are patients whose needs and/or behaviour are most disruptive and distressing to others. The ‘Triple D’ team and senior nurses are available 7 days a week to support local staff in techniques to manage the very individual nature of each of these patients. For other patients, categorised by our nurse leaders as “red patients” additional focused care support should be available. Fill rates vary for these responsibilities, and across the Trust we will now, and immediately, adopt the practice used successfully in our community wards. Patients needing focused care will get support from substantive ward staff, with bank cover being provided for other duties and patients within the ward. Our “red patients” are complex and have multiple needs and so it is right that our established experienced staff are there to support them.
Of course the launch next Friday – at 7am – of our Trust-wide, all sites, all people ban on smoking is the source of much discussion everywhere. A quite quiet majority of people agree with the ban. A number of colleagues disagree, or believe that our support for vaping is ill-judged. In supporting vaping we are following the clinical advice of Public Health England, and have had that reviewed by our own clinical leaders under the direction of our Medical Director, David Carruthers. It is really important that if you are reading this and need support to manage patients and visitors once the ban starts that you speak up. There are written guides and simulation videos available. Crucially we need to talk to patients on arrival and on admission about their alternatives to smoking – inhalators, nicotine replacement and access to vaping. We should try and avoid a first discussion when someone seeks to light up. That said, from Monday fining will start in dummy form, and go live from Friday 5th. This gives us chance to test our cameras and make sure we can spot places where people may try and hide to float the ban. I met earlier today with our security staff to talk through their role in helping to enforce the ban. They will work alongside all of us, plus our wardens and the private specialist company who are on our sites now helping us to make this stick.
For a guide to the ban, please see the attached guidance: Smokefree Guidance
There are a couple of other deadlines that I thought it would be helpful to highlight. Star Awards nominations close very soon. Please can I encourage you to get yours in? We have so much good practice that it would be a real shame to miss out on your suggestions for our very best. In the same vein, PDRs are due to be completed this weekend. There are a number of colleagues outstanding their PDR and we have work to do to close that issue out so that we can start our moderation programme. Remember a 2 is the standard score we would expect, with high performing individuals against their written objectives achieving a 3, and outstanding delivery of those objectives rating a 4. It is really important to be clear that a PDR score is not a ‘face fits’ measure, nor a judgment of your doing of the job per se. The rating is focused on your objectives – which have been completed and how. We are ahead of the wider NHS in how we do this and many of our ideas now feature in the national People Plan. With a 40 per cent growth in training budget and a commitment to grow that further over the next two years, it is really important that your PDR is a good discussion on the present and the future.
Finally, as a Trust that provides general practice, we had a vote in the recent CCG decision about whether to keep Sandwell and West Birmingham together in one commissioning function. We had been vocal and committed as a Board to that option, because we believe that it works best for care integration for our population, many of whom will use Midland Met when it opens in 2022. I am pleased to report that 71 per cent of those voting supported that option, and so I very much expect that the CCG Governing Body on Wednesday next will confirm the NHS England that that is the future shape we will be working alongside. We have a common vision to move away from commissioning, whereby money comes to us based on how many times we talk to a patient or how long they stay with us. We want to use funds locally to bias investments towards outcomes and effectiveness, and the vote gives us a platform from which to begin next year to make those changes, changes that, once again, we might expect the wider NHS will adopt in time.
Attached are this week’s IT stats: IT Performance Stats 28 June 2019
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