October 2015

I could easily fill my monthly blog with tales of the best of our best at #SWBHAwards15.   I won’t but let’s start there!  The gala at Villa Park was sponsored by our partners, and supported by primary care partners, as befits our mission statement.  But it was graced by not just our 20 award winners, but those shortlisted in all our categories, their families, and work colleagues.  In other words, last Friday’s ceremony was a fabulous chance to say thank you to lots of our teams and volunteers and to look ahead towards our 2020 Vision as well.  For the first time we had awards for equality and diversity, for research, and for integrated care.  Not only did we have our annual award nominated by patients, but this year one put forward by local GPs.  And Chairman, Richard Samuda, gave his personal award to Caroline Rennalls for the amazing work she has done to try and integrate social and health care locally, driving our work to cut delayed transfers of care, and to work fairly with families where someone has to move to a care or residential home.  She is an inspirational figure across our Trust, and I am delighted she was our first recipient.

Four awards faced a staff vote, in X-Factor, or Strictly, style.  Our employee of the year is Joanne Peasley, an assistant practitioner within the Occupational Therapy team, working largely in palliative care.  Meanwhile, our ward service officers – this time through the out of hours domestics team at Sandwell – won again.  Cardiology, now very definitely a cross-Trust service, having launched heart failure services in West Birmingham, got cardiac MRI off the ground, expanded cardiac CT at Sandwell, and relocated interventional services, were our adult clinical team of the year.  And they made sure things went well at the party by bringing their house band, the Ectopics, to jazz up our meal.  The very first Trust Children’s Team of the Year, are our beacon award-winning Children’s Therapy Team.  All 16 shortlisted teams in these categories did magnificently, but someone has to come first and so these are our stars from the 12 months just gone!

October has seen us have another “push” to address unplanned readmissions, so it was fitting that the national pilot at Sandwell for Frailsafe also won an award.  The plan to tackle unplanned readmissions is born of the aggregate of lots of small changes.  The internationally researched LACE algorithm underpins an alert on our bed management system for people in our care at high risk of readmission.  We then aim to mobilise support at home, and give even more advice on how to get our help quickly at home.  Many people readmitted come back a little while later, after packages of support in the community have fallen short.  From what we can discern this is not truly a funding issue, more one of focus and organisation.  It is not just our job to tackle this, and so our work is with GPs and the third sector.  I am sure we will find a role in there for Agewell, our longstanding partner, who take up residence on site next to the outpatient service in January, showcasing all the valuable work they do across the borough.

End of life patients sadly form a significant number of patients readmitted.  We focused the majority of our annual consultant staff conference on palliative care this year.  That is indicative of the importance the Board places on improvement, as we try and move from good (see our CQC report for example) to great.  Partners like Crossroads, Murray Hall, St Mary’s Hospice and John Taylor in Erdington, are vital to that work.  We need to make sure patients, families, and our staff know the services available.  But we also need to make sure that our staff recognise the underlying need in someone in the last year of their life.  It is that that drives the readmissions, as we recognise belatedly the true situation we need to support.  Again, the “we” in that sentence is not just the Trust, but our GP partners as well.  Now we have a clear DNA-CPR and Advanced Life Plan flag on our computer systems, it would be quite wrong for that not to accompany a patient home, where many, but not all, would prefer to die peacefully.  Building the very best end of life care locally will take time, but I am convinced we have in place the right ingredients to excel.

I am pleased to see continued local media interest in the Trust.  Two issues dominate:  The excitement of the new hospital in Smethwick, due to be open in 2018; and our work to improve recruitment and cut sickness.  The latter is the biggest issue we face as a Trust in the six months ahead.  It has the full focus of the board and senior team.  Sickness rates here have been high for many years, and have risen as those across the NHS have risen.  With an award-winning occupational health service, and expanded mental health support for staff, we should be well placed to address long term sickness.  For short term sickness we know what works, and need to see it consistently implemented.  We know that every instance of a day or two off is reasonable, but our policy, and best practice provides for us to tackle patterns.  Patterns which ultimately set back the whole team, as well as continuity of patient care.  Midland Met will doubtless help with our recruitment, but we need to get smarter and better sooner than that.  With a big and expanded training budget, all the forthcoming IT investment, and some committed colleagues, the Trust is an attractive offer for local NHS staff.  If we can match that offer with slick recruitment, we ought to be able to tackle some of our gaps.  Some of our teams have made huge headway in recent months on this, and we need to learn what has worked from them.

Finally, a word on transport options, always a popular issue in Local Authority committees and in my post-bag too.  The new hospital will be served by an on-site terminus (which we have right now at Rowley Regis), and a major stop too on Grove Lane.  Centro continue to work with us on getting good route access.  Meanwhile, we have good pedestrian access, direct from Dudley Road as well, and cycle access and storage.  For those who do come by car, the site will be run by us, not Hospital Co, and all of the parking is underground and accesses the hospital via a lift.  For the next three years we will continue to work with our transport constraints.  Rowley is having more car parking built, we are doing urgent work on the lighting and security at City, and at Sandwell spaces can be tight sometimes.  We have done pretty much everything we can to create spaces and remove “carve out”: We abolished a consultants car park in 2013 so all staff could use it.  On pricing, we continue to adjust our prices.  Long stay rates are among the cheapest locally, and we have moved beyond 2014’s delay rebate, to now offer 2015 carer’s discounts for selected situations.  It is inevitable that this cost, on top of national insurance and tax, will always be seen by some as unfair.  My sense is that we have worked constructively to get this right.  I am reluctant to top slice services to change the existing arrangements, but every year the Board does review the position both for staff and visitors.

It was great to hear at our last Trust Board the work that is going on with volunteers in the Trust.  The Trust will operate our own team (miTime) shortly and I hope as we move through 2016 to see volunteers much more widely used in our Trust, with the little extras that can make a real difference.  If you are able to give just a little time to us, do find details on our website, or get in touch with me and I will have someone contact you.  As a Trust we are working to give our own time to local communities (more about that on a future blog) and there is lots of scope for both work experience and the giving of experience back to our NHS.  Having spoken recently with the Sandwell League of Friends, and attended their AGM, I know it is vital to keep a connection in place between those who have served the Trust in the past and those now working for us.  All of these connections are part of what makes the NHS such a valued local service, providing not just care but employment, and not just employment but a strong sense of community cohesion.  As the Trust looks to launch our 2020 Vision in November, that spirit provides a basis for all that we are doing.