Newcastle improvement

 

Earlier this week I spent some time with our cancer and haematology team as part of my regular Chief Executives check ins. As we reflected on the experiences through the early stages of the pandemic, I was struck once again by the amazing lengths that everyone across the team went to, to care for our patients.

In areas like radiotherapy, there was very little drop in referrals or treatments delivered – but the way of working needed to change dramatically to keep staff and patients safe. In other areas there was significant concern about patients who weren’t presenting to services.

Everyone across the directorate, and I know that this was repeated across the Trust, needed to find new ways to provide the same high quality services. The situation is still evolving by the day, and in many ways the pressures are even greater now as we all work to continue to provide services and address the backlog of patients needing our support. This would be a difficult ask without a pandemic, but of course we are also dealing with the realities of COVID and the particular uncertainty it brings at work and in our home lives.

In Newcastle, the quality of care we provide is something that we are – quite rightly – proud of. We have a long history of being at the cutting edge of science and innovation. This need for us to think differently is likely to be required even more as we face the future, and I want to make sure that we are in the strongest possible position to address the challenges ahead.

With that in mind, we formed ‘Newcastle Improvement’ on 1 October, bringing together the service improvement and transformation team (SITT), transformation and financial improvement team (TFIT) and quality improvement, to form one team under the leadership of our Chief Nurse, Maurya Cushlow.

This will bring together the expertise to support a culture of continuous quality improvement and the capacity to facilitate service and quality improvements alongside clinical teams.

I’ve invited the Institute of Health Improvement to support us in this work. They bring their world class experience of supporting international health systems to develop and achieve excellence. I’m excited about the potential we can reach by bringing our outstanding services together with their expertise in improvement science and continuous quality improvement. A key element of developing this programme will be training Newcastle Hospitals’ staff in the techniques and theory of improvement science, so they can empower teams to make positive change and evaluate and celebrate success.

As I’ve highlighted in my previous blogs, I’m very conscious of the emotional impact that the pandemic has had on us all, and that impact will certainly continue. Finding the energy to change and transform services can be difficult, but at the same time I’ve been told many times by teams across the Trust that making positive change in their areas was an important and empowering factor in helping them to remain positive. I’ve heard that change in this environment is in some ways easier than it was before.

We shouldn’t forget how fundamental some of those developments are and how essential they have been. Almost overnight, we were able to provide up to 52% of all our outpatient activity virtually. Even now that we are able to reintroduce more face-to-face appointments. Around a third of our appointments are virtual – that was almost 30,000 patients in September alone. That’s potentially 30,000 less stressful car journeys for our patients.

Over 5000 of those appointments were video consultations, with therapy services, ENT and neurosciences particularly  embracing video technology. Importantly, feedback from patients has been incredibly positive with 94% saying they are pleased and confident to continue to receive their outpatient appointments by video.

Kevin Whitehouse who lives in Egremont, just south of Whitehaven, had lifesaving heart surgery in February 2019, to repair a major tear in one of his arteries, and was one of our first video patients. He and his wife Jackie have highlighted how this allowed them to both be involved in the appointment, asking questions in a relaxed environment and avoiding a long and tiring journey for them.

I was also struck by this quote from one of our clinical psychologists, Andrew Wilkinson. He said ‘If you said to me at the start of the year that I would be using video calls to do EMDR (eye movement desensitisation and reprocessing therapy) for complex post-traumatic stress disorder, I would have been horrified – but in actual fact, with only a few minor adjustments to what I’d do in the office, it works brilliantly.’

I’m sure we have all had a few of those moments when we look back and can’t believe how much things have changed. Of course, virtual outpatient appointments also require us to think differently about the whole patient journey, and our pharmacy delivery hub is another great example of patient focussed improvements that have been swiftly established and evaluated, with 84% of patients in a recent survey saying that they were satisfied with the service and many hoping that it continued.

In surgery, our liver and pancreas surgical team at the Freeman launched an Enhanced Recovery after Surgery programme for patients undergoing elective liver resection and pancreatic surgery. The programme provides specialist support which begins in clinic prior to surgery, enhanced post-operative recovery pathways with daily patient centred goals complimented by a 7-day physiotherapy service and pre-operative, inpatient and post operative specialist dietician and nurse support.

They have seen early successes in optimising patient’s health prior to their operation with excellent feedback from patients and their relatives as well as faster patient recovery after major surgery. The education element of the programme has enabled patients to be more prepared for not just the physical, but also the psychological challenge of undergoing major surgery. I know that the team have found this a particularly rewarding element of the programme. This approach has been embraced in other areas as well, with the colorectal team at the RVI being another excellent
example.

Every team that I speak to has great examples of new ways of working that they have tried or would like to try, and I hope that by strengthening our quality improvement approach in the trust, we can help to facilitate even more positive change. When we improve services, we improve lives – both the lives of our patients, but also our lives at work. We can remove unnecessary processes, think differently and focus more clearly on what matters.

The pandemic has given us a different lens through which to see the world, and I hope we can embrace the opportunity to make some changes that might not otherwise have happened. If you’d like to know more about Newcastle Improvement, please contact Iain Bestford, project director, email: [email protected] 

NHS Nightingale

I know that staff have questions about the Prime Minister’s announcement on Monday that Nightingale Hospitals have been asked to prepare for service. I want to reassure staff that the numbers of patients we are seeing with COVID are well below what we experienced at the height of wave one.

While we have been asked to prepare for the next phase, we still hope that we won’t have to use any beds at all in the Nightingale in the North East.

There are a number of steps that we can take to increase our bed capacity before we need to look to the nightingale, and I will advise all staff of our position through my regular communications, and through the COVID bulletins.

Climate emergency strategy launch

In my last blog, I reflected on the NHS net zero panel report being published, which set out an ambition for the NHS to become the first ‘net zero’ health service.

I am delighted to say that next week (Thursday 22 October) we will be launching our Trust Climate Emergency Strategy, which outlines the climate action we will embed in the Trust to achieve our goal of net zero.

You can join the virtual launch of the strategy by registering your interest at: [email protected].

Flu jab – not just any year

We’ve had a great start to our flu campaign so far. I was amazed to hear the progress we had made in just the first week, with over 5000 staff vaccinated against the flu.

It’s great to see so many staff has taken this opportunity to get protected. We know this is anything but a normal year and getting the vaccine is the best protection against this circulating virus.

You can still get your flu jab from a booked appointment or from your peer vaccinator in a clinical area. Keep an eye out for available appointments on the website.

Staff survey

The staff survey has been open for just over two weeks and we’ve had a great response with over 2,600 responding so far. The staff survey is really important as it gives each of us the opportunity to share our views on what it’s like to be part of the Newcastle Hospitals team. It doesn’t take too long to complete, so if you can find the time, please do fill it in. We really want to hear your feedback – this year more than ever – it helps shape future changes and developments and lets us know what is important to you.

Awards

•  Queen’s Birthday Honours – Congratulations to our catering manager Geoff Moyle who has been recognised in the Queen’s Birthday Honours and awarded ‘Medallists of the Order of the British Empire’ for services to catering in the NHS during COVID-19. He and his team, including volunteers, were some of the unsung heroes who kept us all fed and watered during lockdown including handing out more than 40,000 packed lunches to staff day and night.
• Royal College of Nursing Award – Congratulations to Ben Hood, Research UK senior nurse at the Sir Bobby Robson Cancer Trials
  Research centre who has won this year’s Royal College of Nursing Award for Nursing Excellence in Cancer Research. You can find out more about Ben’s award winning work here.
• Gary Logue Colorectal Nurse Awards – Congratulations to Allison Sharpe, colorectal nurse specialist, who was awarded a Gary Logue award by Bowel Cancer UK, for the difference she makes to the lives of her patients and colleagues.
• BMJ Awards – Congratulations to Nancy Redfern and Roo McCrossan who was part of the team from the Association of Anaesthetists, Royal College of Anaesthetists and Faculty of Intensive Care Medicine who won the Workforce and Wellbeing award at the BMJ Awards for their work to fight fatigue.

AHP day

Earlier this week we had the opportunity to say thank you and celebrate the work of our wonderful AHPs. We have 659 AHPs working across Newcastle Hospitals and with over 250,000 inpatient contacts each year they make such a huge difference to our patients in hospital, at home and in the community. This short video features some of our AHPs and is just a snapshot of some of the ways they contribute to patient care.