Adapt, improvise, overcome

On Tuesday afternoon I met a remarkable group of women.

Each of them has lived with type 1 diabetes for decades, and during the pandemic volunteered to take part in an NHS England pilot study to trial innovative hybrid closed loop technology to manage their diabetes differently.

This system continually monitors blood glucose and automatically adjusts the amount of insulin given through a pump, eliminating both the need for uncomfortable finger prick tests to measure blood glucose and also taking away their regular injections.

I heard how this technology has changed their lives – enabling them to have more control over their health and seeing dramatic improvements in their HbA1c (a measure of how well their blood sugar is controlled).

Importantly, they also wanted to say how much more confident and ‘free’ to live their lives they felt because of this technology. The benefits to them and to their families was huge and some had already begun to forget the inconveniences that were part of their lives before.

We reflected on how far diabetes treatments have come during their lifetimes – as recently as the mid 1980’s some had used glass syringes for their insulin injections, and they recalled the ‘horrendous’ complications from diabetes that they expected to face and the smaller, everyday discomfort of multiple finger pricks.

Nowadays the pumps they use are updated and developed within a matter of a few short weeks to keep up with the latest technology and software.

The other key factor they talked about was the gratitude and admiration they had for the team who supported them. They felt that they were ‘part of the team’ in managing their care and had huge confidence in the skill and expertise of the specialist nurses they had come to know so well.

Their participation in this study has informed the NICE technology appraisal for hybrid closed loop systems for diabetes and will have a substantial impact – enabling access to this technology for many people.

It was a fantastic example of the kind of innovation, excellence and genuine care that I have seen so much of during my time at Newcastle Hospitals, and I was very proud to see the achievements of this team (more of which is included later).

It’s now four years since I joined Newcastle Hospitals as Chief Executive, and on each anniversary, I’ve taken the opportunity to look back and reflect on my experiences and the achievements we have made together.

When I first joined the trust, I had a good understanding of the strength of the organisation and the high standards of care that have always been so much a part of our reputation. I knew that the job I had to do here was very different from previous CEO roles. Looking back on the last 20 years as a CEO, every role is different, contexts change, and priorities are constantly being reviewed. However, I don’t think any of us could have envisaged the last two years’ experience during the pandemic.

I arrived in Newcastle knowing that over the course of my career I had successfully taken organisations through many challenging situations always learning and adapting. I have used the lessons I’ve learned here in Newcastle to support our expert staff. As a lifelong learner, one of the challenges and the joys I find is in adapting to new circumstances and continuing to learn and grow. Newcastle is a large and complex organisation providing care and services in the community, through to the other end of the care spectrum – highly specialised regional and national services. As a regional centre we hold responsibility for education and training as well as for innovation and research.

I began my journey here by focussing on two areas that help to give us the ‘true North’ on our compass – our trust strategy where we set out our clear and consistent ambitions and direction of travel, underpinned by our shared values; and alongside that – and very importantly for me – the need to focus on staff and becoming the kind of organisation which supports every member of staff to fulfil their potential – which I call our flourish framework.

As I’ve said many times before, that framework is about developing good governance, aligned leadership, quality improvement and supporting different communities of interest to make a difference, as well as meeting the basic needs of staff effectively.

Throughout my time here, including through the pandemic, defining our strategy, agreeing our values and focussing on our people have, I think, served us well.

At the weekend, I saw a tweet from our chaplaincy team highlighting that they faced a new challenge over the weekend and describing how their approach (like the US Marines) was ‘adapt, improvise and overcome’. When I saw this phrase, it reminded me of what I have seen from our teams in Newcastle, as well as from colleagues across the wider NHS.

Our trust strategy is now at the midway point and the graphic roadmap that we have produced reminds us how far we have come. Our achievements cover all five areas of our focus (our 5 p’s Patients, People, Partnerships, Pioneers and Performance) and have involved every area of our organisation. We have extended our impact in our communities, nationally and internationally as we have progressed through the pandemic.

I’m very proud of how far we have come, and the achievements we have made, and I’m excited to be continuing this journey.

Our leadership offer

As I’ve been reflecting on my leadership journey, I’ve thought about the importance of ‘Sharpening the Saw’ The 7 Habits of Highly Effective People®: Habit 7 – one of Stephen Covey’s 7 habits. The importance of taking time out to renew and refresh is one of the vital practices that good leaders exhibit.

Leadership is a lifelong journey of experiences, learning and personal development – which is why we provide leaders at every level of the organisation with a range of training and resources.

One particularly popular programme is Developing our Talent (previously named the Matrons Development Programme). This is designed to help leaders and managers maintain their own mental wellbeing and resilience while supporting teams and delivering results for the organisation. It equips leaders with some of the key management and leadership skills to grow professionally and teach them to embrace the challenges facing the NHS.

Another example is our LEO (Leading an Empowered Organisation) programme which provides leadership development to all of our nurses, midwives and allied health professionals. The three-day course aims to support leaders in developing an empowering approach when leading and managing teams, and I was reminded of the importance of these opportunities when I received some feedback about the programmes. One candidate said: “A game changer in many respects, giving frameworks to engage and plan difficult conversations. Great for self-reflection. Really motivated me to go back and implement for myself and team.”

“The LEO programme not only empowered me, but it has also changed the way I lead and helped me to articulate expectations for clarity of goals. The programme taught me how important it is to build healthy relationships that are built on trust, respect, open communication and supporting others whilst negating unhealthy behaviours to promote interdependence.”

If you’d like more information on these or any other support we provide for our leaders, please email [email protected]

I also want to invite everyone to comment and contribute to our discussion on the kind of positive leadership behaviours we want to promote and embed in the way we work.

The proposed behaviours in the infographic below have been developed using feedback provided as part of the What Matters to You programme and we are keen to co-create them with colleagues across Newcastle.

These aim to set out the behaviours we want all of our leaders, at every level, to show towards us as individuals and colleagues. Developing our leaders to build healthier and stronger teams is at the heart of our Flourish framework. It is so important to get these right because we know that well led, supported and engaged people deliver better outcomes for patients.

If you would like to comment on the behaviours in the infographic below, please email
[email protected]

Improvements in catering arrangements

I know that it has been a really challenging few years for colleagues, and the economic situation in the UK as the cost-of-living crisis bites will not help this. I understand the frustration that staff feel when small things make life harder, and you can be assured that everyone is working hard to make improvements.

I know that top of the list is catering facilities at the RVI, and this has been a really challenging issue to tackle because of the longstanding PFI arrangements. However, we are well into the recruitment of staff and the completion of works at Leazes Wing which will give us 24-hour trust catering.

I know this is long overdue and I want to say an enormous thank you to all of our catering teams who support our staff and patients so well. We also have other support available including:

• Financial wellbeing workshops
• Helping hands service which provides staff with free and easy access to impartial information and confidential advice from Citizens Advice Gateshead. Staff can email the team at [email protected] or ring 0191 8144215.
• Subsidised public transport until September

QI case study

Our latest QI case study this week looks at how the nutrition and dietetics, nursing and catering teams joined together to explore the possibility of electronic food ordering for patients. It is interesting to learn about how this concept has been tested and really demonstrates how good ideas can be explored, for the benefit of staff and patients. Find out more here.

Thanks also to everyone who attended the latest Learning and Sharing event last week – which included our maternity team who shared their journey using the ‘What Matters to You’ framework to increase personal and professional satisfaction for staff through improved team working. There was also information on the role of Newcastle Improvement. If you did miss the event you can still view the recording here.

Visit to the Newcastle Diabetes Services

As mentioned, I had an inspiring visit to the diabetes centre at the Centre for Ageing and Vitality on Tuesday (26 April) where I met members of the multi-disciplinary team, including the admin staff who work behind the scenes to ensure the smooth running of this service.

We talked about the pressures the team and their patients have faced through covid, and the developments they are progressing to support people with type 1 and type 2 diabetes.

The team are working with each of the 32 GP practices in the city to build up the confidence and skills of primary care teams, and this has paid dividends.

I also met the patients participating in the dafne group who were undertaking their week long face-to-face training which helps adults with type 1 diabetes lead as healthy a life as possible to minimise the side effects of their condition.

Finally, I was delighted to meet members of the podiatry team who told me about their work with the vascular team and the benefits of recent quality improvement work to put a virtual vascular MDT in place to support their patients – especially those living in care homes.

Thank you to everyone in the team for their hard work and genuine enthusiasm

Council of Governors update

In October 2021, the Council of Governors welcomed Pam Yanez OBE as their new lead governor. Pam is in her second term of office as a trust governor after a successful career in the trust starting in 1974 in various posts including senior transplant co-ordinator and directorate manager.

The ‘lead governor’ is a statutory position set out in guidance and has the specific role to act as a point of contact for NHS Improvement should the regulator wish to contact the Council of Governors.

In Newcastle, our lead governor also carries out a number of additional roles including working closely with the chairman and trust secretary to ensure that governor meetings and working groups are well planned and that there is effective communication between the Council of Governors and the Trust Board.

The lead governor can also chair parts of meetings of the Council of Governors which cannot be chaired by the trust chair, deputy chair or senior independent director due to a conflict of interest in relation to the business being discussed and is available to all governors and members should they wish to discuss any issues.

We are fortunate to have Pam’s commitment, energy and competence. You can contact Pam and the Governors by emailing [email protected].

Awards, achievements and other news

Putting patients first

An innovative rehabilitation programme delivered across Newcastle and Gateshead, is estimated to save the health and social care sector around £100k in the coming 2.5 years, along with significant mental and physical health benefits to patients.

The ESCAPE-pain programme for osteoarthritis of the hips and knees is run by the Tyneside Integrated Musculoskeletal Service (TIMS), of which we’re a partner, with the initiative supported by the Academic Health Science Network for the North East and North Cumbria (AHSN NENC). Patients can self-refer into ESCAPE-pain programme through the TIMS website at: https://www.tims.nhs.uk/escape-pain/ or call the service on
0191 445 6319.

Major grant for antibiotic research into sepsis

A £1.9million grant will contribute to research that aims to improve how antibiotics are used in critically ill patients and has the potential to fundamentally change the management of patients with sepsis.

Dr Tom Hellyer has been awarded the funding to determine whether antibiotic exposure in critically ill patients with sepsis can be safely reduced by shortening the duration of the initial course.

Tom is an honorary intensive care consultant at the trust and part of the Newcastle University Translational and Clinical Research Institute. Awarded as part of the Health Technology Assessment (HTA) grant from the National Institute for Health and Care Research (NIHR), the funding will deliver a large trial recruiting over 2,000 patients from 50 critical care units in the UK.

Times Higher Impact rankings – Newcastle University

Finally, congratulations to Newcastle University which this week was ranked first in the UK – and 8^th in the world – out of more than 1,400 universities globally in the 2022 Times Higher Education Impact rankings. This is a truly outstanding performance and a credit and testament to the hard work and commitment of all our colleagues and students at the university. The strength of our collaborative relationship with the university is something we value very highly, and I’m absolutely delighted for them on this achievement.