Chief Executive’s Message – Friday 3 April

April 3, 2020

I write this message on the day our local healthcare system lost Areema Nasreen. Areema died today on ITU at Walsall Manor. It is clear, from many colleagues here who knew her, what a contribution she made in her career moving from a housekeeper role to a registered nurse post in the last two years. National data on people dying in our country is announced daily but no amount of data can convey the individual tragedy this situation brings. Our COVID-19 bulletin today reconfirms the grief and bereavement offer being made available in the Trust, alongside the wider psychological support offer we explained on Wednesday. My thoughts today are not simply with Areema’s loved ones but with many colleagues across our Trust currently being treated with COVID-19 or worrying for someone who is being.

Lots of our colleagues are currently being trained or re-trained to work in different roles in the days and weeks ahead: Theatre colleagues from BMEC who will be working in intensive care, community nurses joining acute wards, doctors from radiology returning to general medicine. Our staffing models are based on 30 per cent absence. That figure combines sickness, isolation, and any leave that can still happen, consistent with our emphasis on wellbeing. Where we are, as nationally we are being urged to do by both professional clinical bodies and NHS England, lessening staffing ratios for registered roles, we are seeking to increase HCA ratios. One of the risks of that situation is that changed ratios expose staff and patients when short notice sickness arises, and Paula and Liam are working through how we best manage that at site level.

In today’s bulletin we launch our drive to make sure roles such as portering, ward service officers, distribution teams, and catering are sustained in the weeks ahead. Those roles too are seeing shortages from absence with isolation. And our need is growing as we work to try and keep frontline clinicians in patient-facing roles and try and reduce movement in and out of red areas where we can. As far as we can, we will be looking first for people to volunteer to temporarily move across into those roles. The process to volunteer is via volunteerbrigade.swbh@nhs.net – it remains possible that later next week we will need to move to a more insistent approach, formally redeploying staff from roles that will not be so needed in the next couple of months.

This message is heavily focused on how we manage our workforce and support everyone else’s wellbeing. In that context, I am delighted that Frieza Mahmood has been selected at this week’s Star of the Week. Frieza, our deputy director of people and organisation development, working along her HR colleagues, have been at the heart of organising our support for people at home and people re-deploying. Returns to work from isolation have risen from 25 per cent ten days ago to nearer 75 per cent. That is a huge tribute to those coming back to help and to care, and to the organisation that has gone into supporting individuals and line managers.

I know full well that despite incredible efforts neither Personal Protective Equipment (PPE) nor workforce antigen testing are yet working as I would want, or as you would want. PPE is boosted by the delivery this week of over 8,000 Alpha FFP3 masks, and by our improved supply and decision to expand surgical face mask use into blue areas. From Monday the main model of PPE supply will be department ‘drop off’. There will be no need to come to a central store other than where a ward’s use changes markedly. All of our efforts rely on you using the right equipment in the right way at the right time. Dr Mark Anderson has produced a genuinely helpful film that reminds us how to do that, not just what to wear but how to put it on and take it off to minimise risk.

I want to remind you here again that alongside handwashing, social distancing is crucial. I am pleased that I have seen examples this week of challenging of close association, people asking others “not to stand so close to me”, and things like our Trust’s Board on Thursday going WebEx for the first time. I want to also remind you that hand sanitiser bottles can be re-filled and re-used. Shout out to Dr Kanari who has been very active, alongside others in promoting the importance of getting this right. Social media is full of good examples of this, albeit it has got some examples of photographs of patient care and of harm that can only serve to scare the people that we serve. Please make sure your use of Facebook, Instagram or Twitter is consistent with our employee guidance on client confidentiality and the confidentiality of your colleagues. I hope you feel we are being direct and honest with you about the massive challenges we face. Please do continue to voice your concerns and examples with me. t does make a difference.

This time next week, on Good Friday, I will be in work knowing that we will be in the middle of the surge. Over the next seven days we are gearing up. Equipment is due with us tomorrow. Many of you are in this weekend getting trained. Hotels are available. Material to learn from and new colleagues to meet. This will not be the only surge. If we succeed, and we can, the curve will be flatter but will reoccur. The development of a step down general medicine hospital at the NEC will give some extra capacity in the middle of April and I want to thank colleagues who are going to volunteer to move across to support those services, on site or working from here and providing care remotely. More about that next week in our daily COVID-19 Bulletin.

The absolute focus of all my efforts and I hope of much of yours is on ensuring that our “plan A” is in place, staffed and ready. If we keep discharges moving from our sites, both community and hospital, then we will be best able to care for those arriving, needing your expertise. I do not underestimate how different providing care in full PPE at 1m distance is. Relatives involved, only by phone or video. This is a genuinely confusing situation, both in terms of information overload and psychologically. All of us are working to try and get this right, with resilience, compassion and precision. Things we would not have done before, like purple wristbands for patients with evidenced DNA CPR, or staffing models we will not keep after COVID-19, are now part of the months ahead. Everyone working in our Trust has the Board’s absolute admiration and support. It is clear that the country is with us. What we have to do is not what we trained for. But we are the best people now to do this. And we will prove that in the nights ahead, as we have the weeks gone by.