Here and now

I wanted to begin my blog by reflecting on the last two weeks for the NHS which have included three days of junior doctor strikes on the 13th, 14th and 15th of March. Last week, the medical director and I wrote to our consultants to express our sincere thanks to each of them for their incredible efforts.

I want to extend that thanks to all our staff. I know that industrial action is disruptive and upsetting for everyone, and it has required everyone to work harder to keep our patients safe.

Yesterday, the BMA announced a second round of junior doctors’ industrial action – a 96-hour walkout from 11 to 15 April – and already we are starting to work through our contingency plans for this.

I continue to be hopeful that the breakthrough in the pay talks with some unions is a positive sign that we are moving towards an agreement between the Government and Trades Unions overall.

Visit to cancer services

The Northern Centre for Cancer Care is a jewel in our crown and is internationally renowned for providing high-quality cancer care and excellence in research, pioneering leading-edge drugs and innovative therapies.

On Tuesday, I visited the haematology and oncology wards (34 and 35) and the day treatment unit (ward 36) at the Northern Centre for Cancer Care. Matron, David McClinton, assistant directorate manager, Jane Egerton, and deputy directorate manager, Cheryl Buchanan, showed me around we and talked about the benefits for patients and staff that they were seeing from seven-day working on ward 36.

Introduced fully in January 2022, the changes have reduced the average waiting time for chemotherapy from four weeks to less than 14 days by creating more capacity to see patients. In addition, a pharmacy dispensing hub has been created to increase the range of treatments available across the week.

This has involved the whole team working differently, including medical, nursing, administration and pharmacy staff, and the strengthening of valuable volunteer roles to support patients who are receiving treatments over long periods of time.

Alongside this, the team are also working to promote the availability of chemotherapy in community venues, including at the Manor Walks centre in Cramlington and the developing Lloyds pharmacy IV clinic. There is also a longer-term plan to create a new ambulatory care unit as part of NCCC by transforming the old medical records area.

I also heard about the 24-hour emergency triage line to provide specialist advice for patients and to support those with urgent concerns and provide reassurance, as well as the work of the acute oncology team to support patients dealing with side effects of their treatments.

On ward 34, I talked to some of the teenage and young adults team who provide dedicated care to young people with cancer from across the region, supported by the Teenage Cancer Trust. This team includes both specialist nursing and social work input, with youth support co-ordinators also available to support patients.

Of course, our own ‘Newcastle Hospitals Charity’ and the Sir Bobby Robson Foundation also support our cancer services extensively, including by providing complementary therapies for patients across the centre.

Across the services I visited, I was delighted to hear about the developments in specialist nursing roles that were apparent. Staff talked about the way they were able to build their skills and knowledge within this supportive team, and I heard plans to further develop nurse prescriber roles and other development opportunities. I was particularly interested to hear about the brachytherapy service for gynaecological cancer, and how these patients are supported by the staff on ward 35. Brachytherapy is a type of internal radiotherapy where a small radioactive material called a ‘source’ is put into your body, inside or close to the cancer.

I heard about the role that our specialist nurses play in supporting patients as they undergo these procedures, and it was a great example of the range of treatments that are routinely available from Newcastle Hospitals as we remain at the forefront of developing science.

Inevitably, my visits to services leave me with an overwhelming sense of pride as I hear about the challenges that have been overcome by the team in recent years and the passion and determination that they hold for providing the very best care for our patients and their families.

Each year across the trust we deliver around 6,383 first cancer treatments and 9,302 subsequent treatments. The work we are doing to introduce a Clinical Board structure will help us to see the opportunities for synergy and economies of scale.  We will see benefits from standardisation of processes and the way we work, streamlining and harnessing new innovations and best practice to spread and share.

I am very grateful to everyone who supports cancer pathways across the whole organisation – at the Freeman, RVI and our Northern Centre for Cancer Care in North Cumbria, as well as those who work in the community and at other venues across the region.

Clinical Board Chair appointments

I am delighted to announce the clinical leaders who have been appointed to our new management structure below:

They will join the previously announced Director of Operations for each Board and will take up their posts from early April as we continue to develop our new ways of working.

You can find out more about our changes as we develop our ‘Fit for the Future’ programme in our regular newsletter available on the intranet.

How are we doing?

We are fast approaching the end of the NHS year where we finalise our financial and activity performance. I have written many times this year (and over the past 3 years) about the unprecedented challenges for the NHS which we have felt acutely here in our trust, yet despite that we have continued to do our best to meet the standards that we are set, and which our patients expect.

Reaching these standards is also important because they give us the independence to make our own decisions within our organisation, rather than seeing additional oversight from our regulators and commissioners.

What they will never show though, is the care and compassion which we are so committed to and which underpins the many thousands of interactions we have with patients each week.
Over recent weeks we have made significant inroads into bringing down our long waits with only a few patients now waiting more than 104 weeks for their treatment, which is often complex surgery.

I know teams are continuing to work incredibly hard to tackle our waiting list backlog amidst ongoing operational pressures including high volumes of patients coming into the trust, loss of beds due to infection control measures and the actions we’ve had to take in response to the recent wave of industrial action.

Our backlog of cancer patients waiting over 62 days has also halved from where it was last summer to around 200 patients and we are now looking at how we can sustain this initially and then improve further.

Our emergency department also remains under pressure and continues to experience high volumes of attendances and longer waiting times for some patients requiring specialist mental health assessment and input.

Theatre efficiency programme

In my February blog, I told you about our ambitious plans to implement a new care co-ordination system (CCS) to support us in optimising our theatre capacity and I’m delighted to say the system went live in urology this week.

For the first time, CCS is now providing a single consistent waiting list view that is visible to our clinicians, schedulers, theatre teams, operational managers, and administration staff. Our urology waiting list team have already scheduled around 30 patients, using the connected intelligence within the system. No longer do they have to review multiple systems, paper diaries or Excel spreadsheets, they have all of the information at their fingertips to ensure patients are treated at the right time, in the right clinical priority order and within required timeframes.

In addition, our Freeman theatre management team have deployed CCS to support their 6-4-2 theatre scheduling meetings to achieve optimal utilisation of operating sessions and promote safe and efficient throughput of our patients, whilst preventing unavoidable patient cancellations on the day and maximising the use of staffing resource including surgeons, anaesthetists, theatre teams, etc.

Over 100 theatre actions have been created within the tool across 33 urology lists in collaboration with theatres, consultants, directorate management and peri-operative care.

Assistant directorate manager, Jeanette Blenkinsopp, said: “We have been using the system to great effect this week, working in collaboration with our peri-ops colleagues to view our upcoming theatre lists and resolve issues that CCS is alerting us to. We look forward to continuing the roll-out with our clinicians and seeing the ongoing benefits for patients and staff.”

I will keep you updated on progress as we consider wider roll-out across the Trust.

Freedom to speak up strategy

Across the trust, we are committed to promoting an open and transparent culture to ensure every member of staff feels safe and confident to speak out about any issues that concern them.

A Freedom to Speak Up strategy has been developed which provides guidance to all staff on the behaviours expected to ensure everyone is treated respectfully at work and the services available to any staff needing support.

This is an important document as it underpins the development of a culture that embraces transparency and supports raising concerns to improve patient safety. It can be found on the Speak up we’re listening page of the trust’s intranet.

Building a greener NHS

This week, the Shelford Sustainability leads, including the trust’s associate director of sustainability, James Dixon, shared an introductory blog which sets out how the sustainability agenda in the NHS is fundamentally rooted in health and wellbeing, and describe our members’ role in contributing to the NHS net zero target. You can read it here.

Patient Engagement Platform (PEP) launch

Patients at Newcastle Hospitals are now able to view and manage their appointments, with the launch of our Patient Engagement Platform (PEP) in our Musculoskeletal department. Developed with input from our information management and technology (IM&T) directorate and the ABC booking team, the PEP gives patients access to their appointment information, via the NHS App.

I’m delighted to see our patients at Newcastle Hospitals benefit from easily accessing their appointment information digitally and, most crucially, securely. By allowing patients to take more control of their care, this can help reduce missed appointments and improve staff capacity. I think I speak for many of my trust colleagues when I say I’m excited to see how the system develops and expands across our patient services in the future.

Awards and achievements

‘Veteran Aware’ – I’m delighted to share Newcastle Hospitals has been successfully reaccredited as a ‘Veteran Aware’ trust. This reaccreditation affirms our commitment to providing the best standards of care to the Armed Forces community – past and present – and their families based on the principles of the Armed Forces Covenant. My thanks to everyone involved.

Supporting our transplant patients – Our new patient information website for heart and lung transplant assessment patients has won an award from the Society for Cardiothoracic Surgery in Great Britain and Ireland.

The trust has been working in partnership with the University of Northumbria on the development of this site – funded by Newcastle Hospitals Charity – which aims to help patients better understand, prepare and recover from a heart or lung transplant.

It also comes after the team was recently highly commended for this work for excellence in education by NHSBT – a fantastic achievement.

Keep on running! – Congratulations to Freeman Hospital healthcare scientist Wayne Hartley, who ran 35km in four hours on World Kidney Day, to raise awareness of chronic kidney disease as well as getting some practice in for the World Transplant Games in Australia next month. You can read his original story here.

Congratulations – Two members of the paediatric oncology team from the Great North Children’s Hospital were recognised at the recent Children’s Cancer and Leukaemia Group conference:

• Professor Rod Skinner, consultant paediatric oncologist who was joint winner of the Johann Visser Award for Outstanding Contribution
• Louise Ollett, clinical educator for paediatric oncology who was named winner of the Innovation in Practice Award

Good luck – To our Finalists at tonight’s British Journal of Nursing Awards who have been shortlisted for the Continence Nurse of the Year (twice) and Infection Control Nurse of the Year. You can find out more on the news section of our website.

Bright Ideas in Health Awards – I’m delighted for the teams that were winners in last night’s Bright Ideas in Health Awards. Our work on the ‘Development of a New Hazardous Patient Transport Device’ won the Outstanding Industry Collaboration category while the NCBD Stoma Programme team who took home the Cross-organisation Working to Deliver Research award. There were ten categories in total with the winners receiving a cash prize and support from innovation experts at the Academic Health Science Network for the North East and North Cumbria to progress their ideas. You can see the full list of winners here.