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Chief Executive’s Message – Friday 6 April

April 6, 2018

Although media reports of yesterday’s Trust Board may feature Midland Met our discussions were in practice dominated by three things.

We sought to agree a budget for the year ahead.  We are not there in balancing the books.  We have a variety of ideas to make income match expenditure, whilst funding new investments in things we all value.  Over the next few weeks you will see proposals for new car parks to ease the pressure on us, investments in midwifery staffing, as well as restrictions on some expenditures that we can live without – we have plenty of spare furniture and will be looking to up-cycle not buy more.  The big changes as ever though will come from three changes:

  1. Revised staffing numbers in some specific parts of the Trust, recommended by clinical leaders and tracked for safety and unintended consequences .
  2. Changes to the goods, medicines and services that we buy to standardise products Trust-wide, and where possible doing the same across primary care too.
  3. Changes in how many patients we treat on some theatre lists to reduce waiting times and safely increase our income.

Everyone appreciates the huge effort that has gone into preparing a balanced financial plan for the year ahead, to enable to us to spend more on what matters most.  Over the next three months we aim to reduce our expenditure by £3m, and this will demand changes in approach in a variety of areas.  This does not mean money is suddenly more important than safety or quality.  It does though mean that we need to take due care of our finances in order to be able to invest in safety and quality.

Secondly, we spent a great deal of time discussing how to improve quality further in our organisation.  I wrote last week here about the success we are having in medicine and among community teams in improving discharge safety and experience.  The focus this time of Board discussion was avoidable, or potentially avoidable, deaths.  In March we focused on Sepsis awareness and treatment.  Next month David Carruthers, our medical director, will make further specific proposals to the Board on how we move from having slightly more deaths in our care than we expect, to having fewer than we would expect, through action over the next two years.  Of course most deaths in our care are expected, and our outstanding end of life care service is all about the quality of the last few years and weeks of someone’s life and what we can do to meet need.  But we have work to do to match the very best services in the NHS, who face the same pressures and challenges we do, in ensuring that consistently we offer care that is best practice.  Look out for more detail on that in the next three months, but I know David would value your ideas and suggestions.

And finally, in no small part down to the advocacy of Elaine Newell, at her final Board meeting, we met Nicole and Misty.  Misty is an assistance dog, and our organisation now has a very clear approach and policy around pets in clinical environments.  This supersedes prior practice and is something I hope that you will welcome.

You will have seen publicity over the last ten days for the government’s proposed pay deal for many, though not all, NHS staff.  The trade union consultation on this continues until later this spring and we will know then whether it is to proceed.  By that time too it will be possible to understand how the promised extra funding will come our way.  There are some impacts for us specifically from the deal.  One is that the minimum wage we set two years ago will be matched nationally.  A second is that the pay escalator that was our Heartbeat front page story in March will also need to be adapted, as the NHS as a whole will adopt something closer to our approach.  This is all good news but as we aim to maintain our stunning recruitment success over the last year, we want to continue to find ways to differentiate working here, from choosing to work somewhere else.  Part of that story remains our investment in training and development.  Over 5,000 colleagues now have their PDR booked to complete before June 30th, and over the fortnight all employees and line managers need to get themselves booked in.  This intense period of objective setting will provide a springboard to both showing how each of us can contribute to quality, but also confirming what is needed in terms of development and training.  Our training budget remains ring-fenced.

Back to Midland Met – after the considerable frustration of not being able to yet sign off an interim contractor, we are continuing to work to select the best option for the rapid completion of the new hospital.  We are now working through the clinical implications we would face if indecision continues and we cannot get the new build open by 2020.  There is though a definite route to do just that and we continue to meet with funders and officials with that aim in mind.  Without boring anyone with the twists and turns I hope you feel that you are being given an indication of progress as we go.  Midland Met is a vital part of our future and our future plans, and is of course, an investment in quality, made possible by sensible financial management over the last decade.

#hellomynameis….Toby