Focussing on our People

You might have seen the latest BBC coverage of the Trust on Wednesday. Filmed over the last fortnight, BBC Medical Editor Fergus Walsh returned to Newcastle to look at the future for covid, highlighting the research we’ve led, the treatments we’ve developed, and how we have pushed the boundaries and utilised the breadth of our experience through the pandemic. We will always be incredibly proud of the remarkable role that we have played in supporting our patients, and the wider NHS.

As we look forwards, I hope that we will be able to focus on treating more patients who have waited too long for treatment and care. I want us to use the same expertise, skill and drive to innovate to do that, so that we can be really ambitious about what we can achieve. We need to leverage all of our resources – our clinical excellence; our relationship with the Institute for Health Improvement; our own Newcastle Quality Improvement ability; our digital innovations; our capital and estates infrastructure and our excellence in transforming care.

Over the next few blogs I will look at some of the challenges and opportunities that we face, and set out the plans we’re developing. I know that we will approach them with that same Newcastle spirit of innovation and improvement and I’m keen to share examples of some of the great work that teams and directorates are carrying out. I’m always delighted to hear about the achievements that you are particularly proud of.

None of our ambitions will be achieved without a clear focus on our people, so that’s where I will begin.

The response from every single team member at Newcastle Hospitals has been remarkable over the last 2 years. In every area of our hospitals, in our communities, clinical staff and those working in support and corporate services, our volunteers, those who returned to work with us and those who contributed from home while they were shielding, each one of us has had a unique experience and has faced different pressures. I have heard moving personal stories from many of you over recent months, and I can see that the initial feedback from our staff survey illustrates that this has taken its toll.

We all need to take the time to process what we have lived through. Some may want to access support services, some will need time to reflect and recover, and others will want to throw themselves into the next challenge. All of these responses are valid. It’s important to remind each other that support is available – through the staff hub, our Togetherall service, which offers support with a wide range of mental health and wellbeing issues, and through events like our Schwartz rounds. You can also talk to staff side colleagues, our chaplains and your line managers and we’ve introduced schemes to support you with practical help if you are in financial difficulty or in need of independent advice from the Citizens Advice Bureau. Asking for help in any of these ways can be difficult – but please don’t struggle in silence.

In the longer term we need to continue with the cultural change that we started when I joined the trust in 2018 – almost 4 years ago. I was clear when I arrived that we would work together to develop the way we work in Newcastle so that we create an environment in which everyone can liberate their full potential. That’s important, because we know from multiple studies, that happy, well supported staff deliver outstanding care – that’s an indisputable fact, and one which I reflect on every day.

I was pleased to see Amanda Pritchard’s letter to the NHS last week which also highlighted the central role of our workforce in the NHS recovery. She made the point specifically that ‘we cannot build the recovery on our staff working at ever increasing levels of intensity’. This is an important commitment from the top of the NHS and one which we need to take account of locally.

I’ve recently been inspired by members of the team who have taken part in our series ‘Geordie Hospital’. Many have talked about the joy and meaning that they find in their work, what led them to their careers and how they enjoy working here. Their pride is clear to see and that’s been reflected in the pride of colleagues watching the programmes each week. The final episode will air on Tuesday (21 February).

But we know that there are still many things which get in the way of having a good day at work, and we should be relentless in our focus on changing these and identifying new and effective ways for us to work smartly and flexibly throughout every part of our organisation.

Over the last 12 months, despite the pandemic, we have been talking with staff and working with our improvement partner the Institute of Health Improvement. We have been listening to and capturing staff voices through ‘what matters to you’ conversations which have involved hundreds of people across the Trust. Through that we are identifying themes and work streams to make changes – both practical ones like providing better access to hot food at the RVI (especially over evenings and weekends) and more systematic ones like looking at our policies and processes to make sure that they support positive working practices.

As we move forward from these two long hard years, we need to really challenge ourselves to ensure that Newcastle remains a provider of outstanding care, and becomes the best place in the NHS to work. We shouldn’t pretend that this won’t be difficult, but by focussing on what matters to our teams and our patients, I’m sure we will succeed.

When we talk about ‘creating an environment’ where people can flourish – what we are referring to is our organisational culture, or ‘the way we do things around here’. Our Flourish framework helps us to think about how we need to work to create and reinforce this culture. As you know, there are three clear areas of focus in our framework:

1. Leadership: Developing our leaders to build healthier and strong teams
2. A clear strategy and effective governance framework (system 1)
3. Dynamic networks of activities led by empowered staff (system 2)

Alongside that, everything we do is underpinned by our values which were developed by our staff and are fundamental to the care we provide. The diagram below summarises the framework.

You can view our new infographic here which explains each of these three elements of the Flourish Framework in more detail.

Although we still don’t know all of the challenges we will face, or the detail of the issues which we will deal with, we do know that using the Flourish framework as our guide will give us the best chance of being successful.

Here is a summary of each area:

Leadership: Developing our leaders to build healthier and strong teams

The most important relationship most people have at work is with leaders around them – line managers, and equally important, those in clinical leadership positions. Great leadership is crucial to culture and delivering high performance and compassionate care. As well as having the knowledge and technical skills to lead – it’s important leaders pay attention to their own physical and psychological health and to their behaviours. It’s important that we have a clear leadership framework so that there is a consistent and appropriate response by all of our leaders.

Our aim is to create a culture in Newcastle where leaders can operate with a ‘discovery’ mindset – as opposed to a defensive one. This supports leaders to feel comfortable with curiosity, innovation and creativity.

We provide a wide range of leadership and management development programmes internally and have access to many opportunities externally. During 2022 we will refresh both our leadership programmes and importantly we will review and agree the behaviours that we expect from our leaders.

Our Strategy and Governance Framework (system 1)

Without a clear strategy, we cannot see where we are heading. Delivering outstanding care and performance requires an efficient operating and governance framework to organise and guide us in our day to day work. In the NHS there are hundreds (indeed thousands) of standards and compliance targets and regulations we are required to meet. In an organisation of our size (£1.3 billion turnover and around 18,000 staff) our operating and governance framework provides the structure and mechanisms to support effective decision making, monitor progress and outcomes and manage risk.

We are continuously reviewing this and ensuring it is fit for purpose. It is a key focus of our inspection and regulatory process by external bodies such as the Care Quality Commission and Health & Safety Executive.

It supports the Board of Directors and our management teams at all levels, day to day. We refer to this in our Flourish framework as ‘system 1’. I often think of it as the ‘science’ element of the framework. Vital in its own right but made more effective by the work done in ‘system 2’ – which adds the ‘art’ to the science.

Dynamic Networks of activity (System 2)

Change happens through passionate people – coming together to tackle issues that matter to them. By creating opportunities and outwardly encouraging this, we create energy, motivation and pace. Work in system two can really accelerate change. We need to ensure that people have freedom within their roles to make improvements, act upon suggestions, focus on quality improvement and ‘do the right thing’. System two doesn’t have hierarchy and isn’t about what happens in formal meetings. The groups and networks in system two can be informal, short lasting or endure over time. This approach spreads ideas, innovation and improvement rapidly. It provides the opportunity for all staff to get involved, feel valued and contribute in the best way they can.

Summary

All three areas of our Flourish framework are equally important. We will support and encourage development across them all. We will ensure our programmes such as continuous quality improvement, sustainability and health and wellbeing link to the overall approach.

I want the Newcastle Hospitals of the future to be a place that enables everyone to be the best they can be, so that we create and maintain an outstanding organisation together. A place where people are proud to work and want to be. As we go forwards I can assure you that this will be at the forefront of our thinking.

Thank you for the role that you play in our journey.

Operational Update

Since my last operational update, the NHS and Government have set out a blueprint to address backlogs built up during the pandemic and to tackle long waits for care, which is something we are increasingly turning our attention to although this is going to take time to fully address.

Our priority is to focus on the longest waiters first, particularly the 206 people who have waited over 104 weeks and over 3,800 who have waited over 52 weeks for their operations, and our directorates and operational teams are making a concerted effort to get these patients – many of whom need particularly complex procedures that can only be provided at a tertiary centre like Newcastle – into hospital as soon as possible.

I’m pleased to say that the number of patients in our hospitals with coronavirus continues to reduce and is now around 25 patients and our staff absences rates have reduced.

Visit to Northern Centre for Cancer Care, North Cumbria

Thank you to staff at our Northern Centre for Cancer Care, North Cumbria who welcomed the Prime

Minister on Monday evening. Kath McCourt, Deputy Chair, attended to represent the trust and was also able to tour of the facility for the first time. She met a number of nursing staff and therapeutic radiographers during the afternoon and commented that she was inspired by the commitment to excellent patient care that she saw throughout and the genuine enthusiasm from everyone she met.