How are we doing?

It is a question I’ve asked everyday throughout my 20 years as a Chief Executive and I’m sure it’s
a question that you often ask as well. It has two equally important meanings. Firstly, as we continue to recover from the last 15 months of incredibly hard work through the pandemic it is something we ask each other on a very human level.

I know how genuinely concerned and conscious everyone is about the wellbeing and resilience of our friends and colleagues, and indeed of ourselves. Few of us will have escaped the feelings of fear, exhaustion, isolation and an uncomfortable lack of control. Each of us needs time, and care from those around, us to recover.

On a personal level, I am finding that recovery is not a linear process. We each have good days and bad days. The kind of tiredness that many of us feel is not fixed by a weekend off or even a holiday. That helps, of course, but it will take time to fully regain the energy that we used to take for granted and to feel that we have left some of the hardest days of the COVID crisis behind us. Secondly, we also need to ask  how we are doing as an organisation. How are we doing in supporting our patients? That is why we come to work. It is what we all feel passionate about and it’s what gives us the motivation to keep making a difference.

Secondly, we also need to ask how we are doing as an organisation. How are we doing in supporting our patients? That is why we come to work. It is what we all feel passionate about and it’s what gives us the motivation to keep making a difference.

We don’t work in the kind of jobs where we can close our doors for a fortnight to get a break. I suspect that most of us thrive on the busyness of our roles and the positive impact we have on those we care for. I am incredibly grateful for all of the hard work that everyone continues to contribute, but we do need to be mindful of balancing the pressure we put on ourselves with the activity we want to deliver.

The NHS now has amongst the longest waiting lists we have ever experienced. We see people every day who have had to wait long periods of time for essential treatment. One thing that is incredibly clear is
that recovering our services will take time.

I was struck by comments from our clinical directors and directorate managers at a recent Trust Management Group. They reflected that in the past, we might have tackled a waiting list with an
intense sprint of effort to manage a short term problem, and there was something of a ‘Dunkirk spirit’ about achieving good results and pulling together.

That is not going to be possible in the current circumstances. We will need a much more fundamental change to the way we work if it is to be sustainable and successful in meeting the challenges from the pandemic for the long-term.

It is important to also acknowledge that we have many variables that are still emerging. We currently have around 15 patients in hospitals with COVID-19, up from five a fortnight ago. There are questions about how significant another wave of infection will be and what impact further opening up will bring and we are worried about the potential for flu being a significant concern this winter.

We continue to work in an environment where we will need to respond to unknowns, but the core of what we need to do remains absolutely the same – to provide outstanding care to our patients.

Alongside that, you will know that nationally the NHS is experiencing incredibly high levels of emergency activity. In Newcastle, our Emergency Department attendances increased again last week, exceeding the pre-pandemic average for the second week in a row.

Our type 1 attendances (those patients seen in the main RVI emergency department) were already at their highest rate since at least 2015, and increased by an extra 9 patients each day in the last week. On a single day (Monday 14 June), our teams saw 484 type 1 patients – a full 5% higher than any previous daily total. Despite this, performance remained remarkably high.

This level of pressure places unprecedented demand on our whole medical directorate and further across the hospitals. I am very grateful to the team in the adult, children’s and eye emergency departments and in our urgent care centres for their hard work, and also to everyone who supports this response, in our assessment suite, on admission wards and emergency theatres, and from the whole host of other teams and staff who play a vital role.

I also wanted to share with you some of our other key performance figures because they really do give a glimpse into the hard work and significant achievements that everyone is contributing to.

Activity recovery across the Trust continues to look promising, with outpatient consultations consistently exceeding 100% of the pre-COVID average. Elective overnight spells are almost 100% recovered and day cases are on the cusp of this too.

Importantly, two-week wait appointments for those with suspected cancer have also reached up to 100% of the levels of activity we reached before the pandemic, which is incredibly reassuring.

We should not forget though, that we have significant numbers of patients who remain on our waiting lists, some for many months. Behind each of these numbers is a patient and their family with worries, pain and distress and a significant impact on their quality of life. It is vital that we continue to innovate and challenge ourselves to work in the most effective ways to support those patients as promptly as we can.

I know that every service – both in our hospitals and in the community – is taking on these challenges and developing solutions at incredible pace. The pathway change and improvement that we saw at the height of the pandemic shows no signs of waning.

Last week I heard from the endoscopy team about their plans to introduce a range of strategies to improve speed of access for patients with cancer. This included reducing DNAs from 10% to 3% of patients, creating tech solutions such as a pre-assessment app, which was funded by Newcastle Hospital Charity, and improving Paperlite admin solutions alongside making some increases in capacity.

While this helps the team to see more patients, it also has other benefits; it is safer for patients as there is less chance of losing a referral for example and less clinical variation, it enables the team to be clearer about their future strategy and workforce developments as well.

Although there is still a significant challenge, and much work to do, it was reassuring to see how much control they had taken over their planning, and to hear about the clinical passion that had driven those improvements.

Similarly in musculoskeletal services, the team have taken a whole system improvement approach to their processes when scheduling patients, utilising theatres, configuring beds and providing therapy. They have a sharp eye on patient experience as well as efficient and safe care. Each member of the team – both clinicians and support staff plays a vital role in this, and helps to deliver the most streamlined patient pathway.

On level seven at the Freeman Hospital, a dedicated orthopaedic admission unit has been developed. This unit admits all patients who are planned to have an overnight stay into one area prior to going to theatre as opposed to patients being admitted onto several ward areas. This improves patient flow through the wards and provides an improved patient experience.

There are so many examples of similar pieces of work in every part of our organisation, many of them underpinned by the PDSA cycle – plan, do, study, act and by exceptional engagement and clinical leadership.

I was delighted to see so much interest and excitement in the recent call for improvement projects to take part in our work with the Institute for Health Improvement. As we build improvement science skills and methodologies across our teams, we will inevitably recognise many more areas where we can continuously improve, remove unnecessary tasks, focus on the things that really matter to our patients and enhance satisfaction in our work. I am conscious that sounds idealistic, but if there is one place where that can happen, it is here in Newcastle.

The future might be uncertain and difficult for a while, but we have the opportunity to continue to tackle this challenge head on. I will continue to keep you up-to-date with how we are doing as an organisation and I want to keep hearing from you about how it feels, and how you’re doing. My regular check-ins with teams continue to be the highlight of my week so that I can hear your experiences and achievements directly.

Let me finish by encouraging you once again to take care of each other, and to take care of yourselves and to say a heartfelt thank you for being part of Team Newcastle.

Move more

Huge congratulations to everyone who took part in our Flourish Move More campaign over the last four weeks. Together we’ve taken over 45,300,000 steps and our overall winners, with an impressive 2,834,925 steps, were the PSCs.

Shuffling Sole Mates are our best team name winners and we also had a further 20 teams who exceeded the target daily step count. Thank you to everyone who took part and to Newcastle Hospitals Charity for supporting Move More. The Flourish team will be in touch with our winners soon to arrange prizes and you can see the final leaderboard here.

Reservists and Armed Forces week

This week is Armed Forces week, with Reserves Day on Wednesday (23 June) and Armed Forces day tomorrow (Saturday 26 June). This week of celebration is an opportunity for us to say thank you to our Armed Forces community. We very much value the extra skills and experience that they bring to our organisation.

Throughout the week some of our Armed Forces veterans and Reservists colleagues have been sharing their stories on the Trust website.

Council of Governors Elections

The annual elections to the Trust’s Council of Governors will take place later in the summer and there are many seats available within a number of staff classes and all three public
constituencies.

Our Governors play a key role in making the Trust publicly accountable for the services it provides. By joining the Council, you will represent the views of your staff class, you will also have the opportunity to review Trust performance and contribute further to the achievement of the Trust’s vision and values.

The initial term of office for Governors is up to 3 years, with formal Governor meetings held bimonthly and are attended by myself, the Chairman and members of the Board. Further information on the role of Governors can be found here.

To stand as a Governor, you must first be a member of our Foundation Trust. If you aren’t already
a member, you can sign up here.

Awards and achievements

• Kim Williams-Davies, infection prevention and control assistant, has been named a finalist
  in the RCN Nursing Awards in the category ‘Outstanding contribution to infection prevention
  and control’, for her work in the implementation of a monthly infection audit to help reduce
  COVID-19 infection rates amongst staff.
• The HR team, supported by IT, were awarded the ‘Best Augmented Workforce’ award at the
  IDC European Future of Work Awards 202. Their digital ‘bots’ have saved us the equivalent of
  more than 9,000 hours in staffing time a year!
• Dr Kate Hallsworth, a senior research physiotherapist at Newcastle’s Liver Unit, received a
  Rising Star Award from the European Association for the Study of the Liver for her outstanding
  commitment to improving services for patients with non-alcoholic fatty liver disease (NAFLD).
• Consultant gastroenterologist, Dr David Nylander, received the award for services to health in
  Sierra Leone and the UK as part of the Queen’s overseas and international birthday honours
  list.

Huge congratulations to you all!

CQC IRMER Inspection

Thank you to everyone in Nuclear Medicine and Radiotherapy who have hosted a CQC inspection this week which looked at our compliance with IR(ME)R regulations. Both teams received excellent feedback and the inspectors commended their work very highly. A successful outcome at these inspections is dependent upon there being an effective governance process in place across all our systems and processes to protect patients and staff from the potential hazards of exposure to radiation. These inspections require detailed preparation, and we are grateful to everyone who has supported this effort.

Biomedical Science Day

Biomedical scientists play a key role at most stages of diagnosis and health care, often providing important detail needed by consultants, pharmacists and nursing staff to decide next steps.

Yesterday, on Biomedical Science Day, we recognised the vital roles of our teams at the Freeman and RVI, one of the largest integrated laboratory departments in the UK, which deals with around 3 million requests a year, resulting in a staggering 15 million individual tests to identify, study and monitor disease. Over 580 people work in the labs, around half of whom are biomedical scientists.

Biomedical scientists have also played a central role in running the region’s COVID-19 testing and innovation labs, which are helping to monitor the pandemic and develop new COVID diagnostics.

You can see a short video of work in our labs here