Navigating together through 2023

First things first. Let me start by wishing each and every one of you a very Happy New Year. I hope that everyone managed to have at least some time with their family and friends over the festive season.

The last few weeks have felt far from festive for the NHS. The intense pressures that we have been seeing throughout our urgent care and emergency services have also been highlighted by the public and the media across the UK.

In the last week we have seen the Prime Minister hosting an urgent roundtable event alongside Amanda Pritchard to focus on the immediate ways to release pressures at a national level.

We find ourselves, once again, in unprecedented waters, managing in situations that none of us expected. I want to acknowledge the toll that this is taking on members of the team at every level and in every area, and the impact that the current pressures are having. I continue to be incredibly grateful to everyone for their hard work and perseverance.

I have had feedback this week from several patients – they say things like ‘the care I’ve received was amazing’, ‘the staff couldn’t be more lovely’, ‘everyone is doing their very best’.

Despite the difficulties and pressures, it’s important to remember that we are doing a good job – the best we can – and that the care we provide is appreciated by our patients and their families.

As is often the case, the eye of the storm has been at the front door of the hospital – our emergency dept and assessment suite – and the high levels of emergency attendances and admissions we are seeing has had an impact throughout the whole trust.

The Clinical Director and Directorate Manager of our medicine directorate are Chris Gibbins and Keecia Bailey, and they along with matron Angela McNab and Matthew Straker are responsible for these pathways.

They wanted to express their sincere thanks to everyone who has supported the emergency patient pathways throughout the whole of the organisation.

Chris said: “The last month has brought the most extreme emergency care pressures that we have ever experienced. The sheer number of patients attending our Emergency Department coupled with huge pressures on bed capacity have resulted in patients who require admission waiting for prolonged periods.

“The numbers of medical boarders are the highest we have ever recorded, peaking at 220 patients earlier this week. Throughout this period of intense pressure, the teamwork from everybody has been phenomenal and the incredible support that people have shown each other has been critical in keeping everybody going.

I am sincerely thankful for all that has been done by teams both within the medicine directorate and by those teams caring for medical patients on wards outside of the directorate. Keecia and I are forever humbled by the work ethic, compassion and professionalism that is displayed by yourselves, working in the most difficult of conditions. Thank you for all that you continue to do for our patients and for each other.”

On 23 December the NHS also published the NHS Operational Planning Guidance for 2023/24 and a suite of supporting documents. These set out the 2023/2024 priorities for the NHS and reconfirms the ongoing need to recover our core services and improve productivity, making progress in delivering the key NHS Long Term Plan ambitions and continuing to transform the NHS for the future. Helpfully this is simplified and streamlined guidance compared to previous years, and it provides a baseline of standards that all NHS organisations should meet.

As a leading organisation which has patient care and quality as our primary aim, this is a standard that we don’t just want to meet, but to exceed.

The publication of this guidance helps us to frame our plans for the coming year so that we can navigate through this year positively. This will help us address the many challenges that we see everyday which have been created by a multitude of factors including the pandemic, current demand, long recognised workforce shortages and financial pressures amongst others.

The plan we are pursuing is to:

• Stabilise and decompress current pressured pathways (particularly urgent care), assessing and addressing the impact on cancer care and long waits for elective care.
• Build a plan for 2023/2024 following the initial planning guidance. This will include introducing our new leadership and management structure to help us manage the future more effectively and optimise delivery. It will also rely heavily on our Quality Improvement approach and ongoing work with the Institute for Health Improvement.
• Finalise delivery in 2022/2023 to gain the best performance and financial position so that we can begin next year in the best way.
• Continue with a relentless focus on our workforce and the well-being of our staff.

As an executive team, our attention is on improvement and driving up our performance so that we can support more patients.

We are working with staff across services and directorates, and with our partners in other NHS organisations and local authorities, to breakdown the challenges we face into achievable actions. We have strong foundations to build upon and while these are not simple issues to solve, I wanted to share with you some green shoots of progress.

Our new endoscopy suite which opened at the at the RVI, taking our capacity up to seven endoscopy rooms in total across the RVI and Freeman, is already having an impact on waiting times for diagnostic tests and treatments. With this room open we are now seeing 420 patients a week, compared to 340 a week in May, and our waiting list has dropped from 2,000 in July to 1,400.

Our Day Treatment Centre, which opened in late September, has already allowed us to provide over 1,000 additional procedures so far. The centre was specifically designed to provide a greater number of less complex treatments, to relieve pressure and free up slots in our main operating theatres.

It’s positive to hear the difference the centre is making and to see the fantastic feedback from patients from across the region who have been treated there so far. You can read more here

We’re also introducing two new IT solutions to help support teams, firstly the Optica system will support working across agencies and will give us a single view of our discharge pathways.

Secondly our Care Co-ordination System (CCS) will streamline theatre usage so that we can enhance productivity and make the best possible use of our precious theatre space to enable teams to treat more patients. I will share more about these developments in future blogs, particularly looking at community services and discharge next time.

I know that we all remain as committed to this organisation – and to our patients – as we ever have. Times are undeniably hard, and there will be many more difficulties to face, but we can – and we are – making a difference. Thank you for your hard work and your commitment.

Welcome to Christine Brereton

I’m delighted to welcome Christine Brereton who has joined our leadership team as Chief People Officer at this crucial time. In Newcastle, we have an ambition to be the best place to work in the NHS and its vital that we develop a long-term view of how we can recruit, retain and support our staff so that we can continue to provide outstanding services.

I know that Christine will bring energy, expertise and a compassionate approach to this important task and I look forward to working with her.

New Year’s Honours

It was fantastic to see Medical Director Andy Welch being awarded an OBE for his services to healthcare and patients in the New Year’s Honours list.

Congratulations also to:

• Professor Roy Taylor, an honorary consultant in diabetes at the trust and Emeritus Professor of Medicine and Metabolism in Translational and Clinical Research at Newcastle University, who received an MBE for services to diabetic research.
• Professor Chris Day – Vice-Chancellor and President of Newcastle University – who received a CBE for his pioneering clinical and academic work in Newcastle which has improved the lives of many local patients, while his clinical research has had a worldwide impact.

Learning and Sharing event

Sharing improvement stories is a fantastic way of spreading ideas, inspiring others and growing awareness about quality improvement.

Newcastle Improvement’s next learning and sharing event is a half-hour session delivered by physiotherapist Róisín Fallen-Bailey on ‘Making Movement Matter’ next Thursday (19 January) at midday and 5pm. Email [email protected] to join in.

Maternity services

Maternity services across Newcastle Hospitals have once again been rated among the best in the country for their care provided to mums and babies. This week the Care Quality Commission (CQC) published results of its national maternity survey and the trust was rated as much better, better or somewhat better than most trusts in a number of categories.

I know the team pride themselves on delivering outstanding levels of care at all stages of the maternity journey and the results – and feedback – are a testament to all of their hard work. You can read more here.

This week, the team have also rolled out a new electronic records system so that expecting parents cared for at Newcastle Hospitals can now access their maternity healthcare records remotely, with the launch of the Badger Notes app. We are replacing paper records with a new electronic BadgerNet Maternity system across the Trust and its community settings which will allow parents-to-be to log into their notes from their mobile device or computer.

My thanks to the maternity team for the efforts they have made this week in rolling out the new IT system alongside facilitating a two-day CQC inspection as part of a national maternity inspection programme they are currently undertaking.

Music to our ears

Thanks to a partnership between Newcastle Hospitals Charity and Music in Hospitals & Care, we were recently able to facilitate a pilot project with live musicians across some of our wards, through an open call.

I know Katie Hickman, the charity’s arts programme manager, has received some lovely feedback (and a Greatix), some of which I’ve shared below:

“When passing in the corridor music was heard floating out from the opposite ward. Due to this we transferred one of our patients who has severe cognitive impairments to listen outside the ward – the patient’s profession was making music. The ward sister kindly invited the patient in (thank you ward 40 at the RVI) – the patient burst into tears and had the biggest smile. The power of music and the clear importance of it was overwhelming – it has a clear positive influence on both patients and staff.”

“Our young patients with schizophrenia and personality disorders were visibly calmed by the music and the great impact the social aspect had on them being included with other patients on the ward all coming together.”

“Our palliative patients were calmed, very upset and emotional but commented this was due to the beauty of the music and the beauty of life it bought to them – they said they would not have wanted to miss it even though it bought out this emotion.”

The charity is currently writing up a report on the trial and will work with the patient experience team to find the best approach for continuing the programme.

North East Innovation Lab celebrates two-year anniversary

Happy birthday to the North East Innovation Lab, which is two years old this month!

Originally established under the umbrella of the Integrated Covid Hub North East, the lab is now part of Newcastle Hospitals and has a remit to support the development of a wide range of cutting-edge diagnostics. This includes new technologies and ways to identify viruses and other health threats, such as sepsis and cancer.

It has been fantastic to witness and support the lab’s growth over the past 24 months and I’m proud that our scientists are playing such a key role in bringing the latest diagnostics to the mainstream.

Since opening, the team has engaged with an impressive 100 test developers from the NHS, academia and industry, and worked on over 45 projects with 21 companies across the globe from the UK to the USA and China to Australia.

The lab is a great example of how we are able to work innovatively and flexibly with partners to develop new ways of improving patient outcomes. This short video provides more information about the team’s work.

300th robotic lung resection

We’re proud to be at the leading edge of innovation and technology here in Newcastle so we can provide the best healthcare to our patients. At the end of last year Mr Dharmendra Agrawal, thoracic surgery lead at the Freeman, performed his 300th robotic lung resection (removal of part of lung) using the Da Vinci robotic system. This technique not only significantly reduces a patient’s length of stay but post-op recovery is also much quicker. Congratulations to Mr Agrawal and the team for reaching this fantastic milestone.

Awards and achievements

I’d like to congratulate our estates apprentices who have been recognised locally and nationally for the work they do.

• Chris Barnett – Having just completed a four-year apprenticeship at the RVI in mechanical engineering, Chris is now a fully qualified member of the estates team. He firstly won the regional fourth year apprentice of the year award (2022) and was overall winner of the IHEEM National Apprentice of the Year – a testament to the commitment shown in his work.
• Harvey Smith and Tony Reed – Harvey, a second-year mechanical engineering apprentice at the RVI, and Tony, who joined the trust in 2016 as a maintenance assistant before embarking on a mature apprenticeship in electrical engineering in 2020, were both finalists in the IHEEM National Apprentice of the Year Award.
• Kyle Rutherford – Kyle, who is described as keen, enthusiastic and always willing to go that extra mile, received a trust People at Our Heart Award.

Deputy Director of Estates Gavin Evans said: “The apprenticeship route remains a fundamental part of the Estates recruitment strategy and as such it is great to see the high calibre of those continuing to come through system, with significant credit also owed to the mentors and management staff supporting them.

Having three nominees for the National Apprentice of the Year Award, including the eventual winner, is something I think the whole team can be rightly proud of and shines a light on the good work being done both here and across the region supported by Eileen Bayles and the regional training programme.”