June 2013

Toby-Lewis-014-682x1024-250x250June is the start of my third month as the Trust’s Chief Executive.  I have had a tremendously exciting first few weeks.  I have of course visited all of our sites – Rowley Regis, Leasowes and Halcyon, City Hospital, Birmingham and Midland Eye Centre, Sandwell  General Hospital, our Learning Works team, and the Lyng – and spent time in our hospitals overnight as well as during the day.  So far I have probably met around a thousand of the seven thousand colleagues that we employ.  And of course I have taken the chance to meet some of our local general practices, local authority and school partners, and to listen to patients, visitors, and faith leaders.

What I hear from those visits is strikingly consistent.  The work of the Trust is valued greatly.  We have a fine tradition of education and of partnership.  At our best we deliver high quality compassionate care, with low infection rates.  Our mortality data shows generally good performance and our process of mortality reviews give us the chance to learn how to improve further, as does our incident reporting system, which is now electronic and Trust-wide.  The confidence local communities have in our candour and integrity has allowed us to work with others to reconfigure services, such as paediatrics, maternity and stroke care.

But I also hear some consistent appeals for improvement.  Many of our strengths are sometimes true, some parts of the week, in some teams.  They are not always systematic but rely perhaps too heavily on exceptional effort and goodwill.  Though teamwork at a local level is good,we have room to improve how we operate as a single organisation, providing community healthcare and acute, specialist services across multiple locations. If we develop more far reaching leadership capability and information technology we could pick up the pace of change, to the benefit of colleagues and patients.

Emergency care is a huge part of what any Trust does.  This is not just A and E services.  We deliver acute care in gynaecology and maternity, in our paediatric assessment units and fracture clinics, through our outreach and rapid response teams.  But we also run two of theWest Midland’s busiest Emergency Departments.  This last winter, the difficulties of noro virus put huge pressure on our beds and on our staffing, and many patients waited too long.  The experience of care was not what we aspire to at all.

That is why we are working so hard now as a clinical leadership community to try and get the right systems in place this summer, not least to be ready for next winter.  We have schemes on both sites to redirect patients as appropriate to GP services.  We are working to improve mental health and alcohol liaison services at A&E, as well as to provide rapid care to frail older people and to refugee and homeless populations in our city.  We are changing how we structure our wards in order to be better able to cope with the demands of acutely ill patients and those with long termconditions including dementia.  None of this will deliver the kind of model of care we think is necessary unless our discharge from hospital is well planned, is in daylight hours, happens at weekends, and is well supported at home, both by our nursing and therapy teams, by volunteer support teams like the Soho and Victoria Friends and Neighbours’ Service (for more details please click here), and by social service teams from Sandwell and from Birmingham.  I am optimistic that we can do better than we have in the recent past.  A big part of my confidence is the determination I see and hear from my colleagues inside the Trust to make things better.

Part of my role is to help leaders to manage today.  But a larger part is to work with the Board of Directors to make sure that we prepare well for the future.  For a long time the strategy here has been to create a single acute care site, supported by outpatient and intermediate care in other locations.  We continue to evaluate and to prepare for the Midland Metropolitan Hospital on Grove  Lane in Smethwick.  All of the various authorising bodies have undertaken to seek to conclude their deliberations during this financial year.  If we do proceed then, by 2019, we would have an exemplary clinical centre and an opportunity to regenerate part of our local neighbourhood through what we build and how we spend your money locally.

Of course, important as new buildings could be to what we do, healthcare, education and research are about people.  So we are also working hard to make sure that we retain and recruit skilled people for our future clinical service models.  That means helping to develop new roles and to find new ways to bring people into the health service, especially from the local community.  That is why I am excited to be joining the board of the Sandwell University Technical College (UTC), as we provide the opportunities for more young people to choose a career in healthcare sciences, by offering them a real insight into what careers are available.

In the next few weeks we will place before our Board proposals to define our future role in tackling health inequalities and amenable mortality.  This is a huge agenda nationally and of course locally.  No one part of the economy can work alone to change behaviours and enhance opportunity but as a large employer, with experts in the field, and important opportunities to make every patient contact count, we see ourselves playing a very important role in tackling smoking, alcohol misuse and physical inactivity which together to do so much to damage the health of the people we serve.

Thank you for taking the time to read my first monthly blog for our website.  I hope it gives you an insight into the priorities the leadership of this Trust is focusing time and attention upon.  Do feel free to contact me directly if you have questions that you would like us to try and answer – tobylewis@nhs.net

Toby Lewis – Chief Executive

Sandwell and West Birmingham NHS Trust