April 2015

A lot has happened in our organisation over the last month; a month on from the CQC inspection being made public, and as the country debates our NHS in the run up to the general election.  Most excitingly, over 1000 of our staff took part in the first of our monthly Quality Improvement Half Days.  This a terrific start to something we have been planning for over a year.  The half days, they happen all to be afternoons, are a chance for teams to talk, to learn and to focus on local or Trust wide changes.  Whilst half a day in a typical 20 day working month is a commitment, it is also a vital chance for people who are often members of many teams to talk with their peers.  It gives us a real locus for change, an ability to create momentum, and to openly address safety and quality issues as they arise.

Our last Board meeting saw us approve up to £28m for new IT.  This is a big, and long planned step for the Trust.  If we look back over the last, say, five years, it feels as if we have under invested in technology.  Over the last couple of years we have begun to address that, and our new Chief Informatics Officer, Alison Dailly, supported by a clinical leader, diabetologist Pete Davies, is leading the charge.  In 2016 we will select our suppliers, and by 2017 we expect to see a raft of new technology across our sites and services.  Vitally, we need that investment to be mobile, and to support patient access to what is their (your) data and information.

The next Board will consider the latest stage of Midland Met.  We are invited to once again send our case to Whitehall, one day after the general election, for approval.  The case would go with a compliant bid, submitted at the start of April.  It feels now, as we count down in weeks not years towards October 2018, as if the reality of creating a single acute centre for local people is dawning across our system.  Millions have been spent to get to this point, and it is overwhelmingly important that we neither delay nor stall.  The new hospital is unequivocally not about new facilities for aesthetic reasons – we need to get emergency care (not just A&E, but critical care, older people’s physicians, children’s services) onto a seven day multi specialty basis and the only route to that safety and quality change is a single site.  The support of CCGs, NHS England, the Trust Development Authority, Treasury and Department of Health has been important in the last two years and, as we enter this final few weeks and months of consideration, we can rely on scrutiny proportionate to what are doing (a massive 35 year infrastructure investment) and what is at stake (a much delayed reform of emergency services) that, bluntly, should have happened several years ago.

These are big decisions, but little things matter greatly too.  Our Improvement Plan is full of seemingly small changes we need to make consistently – whether it is better note security, or making sure our medicines cabinets are locked, separating materials in our ward kitchens, or ensuring that we always write to patients after clinic not just to someone’s GP.  We are busy implementing the plan, which takes us through to late October this year, but of course it is the culture of safety that we need to reinforce, both through individuals speaking up, and through the concerted collective implementation our half days can support.  We are already a Trust where incidents get reported on a large scale.  Based on staff feedback we have now tweaked those systems to make it easier to do so, and to allow anyone who works in the Trust to interrogate incident reporting for trends and risks.  We have sought to make our risk registers similarly visible, and it is certainly the case that our Board’s agenda is now driven by that risk register.  That is important as the registers connect the frontline of our organisation to the senior team.  Whether it is entries around the national shortage of BCG vaccine, or very local issues about lift reliability in maternity, we need to be sighted on the challenges and find solutions.

At the start of April, we set a budget for the year ahead.  For the first time our training budget, after significant increases in each of the last two years, is now above £1million.  At a time when we are, rightly, focusing on some difficult workforce issues, with major redeployment, and potential redundancy consultations ongoing, it is even more important than ever, that we look to retain and develop staff in our Trust.  Of course we can invest in training and see little change, or we can make sure that we both harness potential, and reinforce core skills.  So, with a big investment, comes a responsibility to make sure that it gets to individuals and really makes a difference to care.  We are determined that it will in the year ahead.