An important message from Richard

October 31, 2024

An important message from Richard Beeken, Chief Executive

“Colleagues,

This week, you are bombarded with two Friday Messages – one from Lesley, our Deputy Chair and one from me.  I insisted on keeping my slot this week because I want to talk about one thing and one thing only this week.  That thing is the single biggest factor on urgent care patient safety in our Trust – the issue of service responsiveness to our emergency departments, enshrined in our new set of “Quality Standards”.

I had a positive visit this week to MMUH ED and met the leadership team as well as other staff, for example the nurse in charge for that shift.  Our main topic of conversation was their concern that when it comes to “housing” clinical risk in the Trust, this still, all to often, feels like that risk is expected to be held in ED and ED alone.  They are concerned that we have transferred our old habits to managing this risk, into a new building and little has changed.  The knock-on effect of “warehousing” in ED, acutely unwell patients requiring acute assessment by an admitting speciality, or a direct admission, is to overcrowd the ED and this leads to poor response times for offloading ambulances and at worst, significantly enhances the risk of causing harm to patients because no cubicles are available for assessment.  Many of these patients will have been referred by GPs, for the attention of medical or surgical specialities, and do not require ED clinician input.

To tackle this issue, we have launched a set of “quality standards”, which are standards for responsiveness by admitting specialities to ED, standards for “pulling” patients up who have been referred to an admitting speciality and standards on clarity of speciality responsibility for such referred patients.  These standards have been developed over a long period of time, are consistent with good practice in other organisations and critically, will not be reinterpreted, watered down, or forgotten about.  These standards set out how we expect every service to take responsibility for urgent care patients and they play a huge part in ensuring that we start at MMUH as we mean to go on – dropping the approaches of the past which palpably do not work for acutely unwell patients.

Please can you read and familiarise yourself with these standards and socialise them in your teams?  I expect a consistent response from everyone to them and I want to see a downward trend in some of the incidents we have had, in which admitting specialities refuse to take ownership of patients and acutely unwell service users end up in a tug of war between services.  This is unacceptable – we are here to serve our patients, and we can collectively take better action to improve the experience of patients in our urgent care pathways.

Thanks, in advance, for your cooperation.

Have a good week.

Richard”