No place like home
As promised in my last blog, over the next few weeks I’m going to focus on some of the investments – of time, effort and resource – that we’re making to support the organisation. While everyone is working so hard, and tackling challenges each day, it’s important that we sometimes pause and look at the bigger picture – the things that will hopefully make a difference in the medium to longer term.
We often focus on the immediate pressures coming through the front door of our hospitals, but today, I want to look at the ‘back door’ and the fantastic work going on to support patient flow and safely getting people home.
There is a whole team of people who help our patients get back home – including discharge nurses on each ward, intermediate care teams, reablement teams and social workers to name but a few. They all have extensive experience of supporting safe and timely discharge.
Experience tells us that this is not an easy task. Patients can experience delays in finding support outside of hospital and the social care and health systems can be difficult to navigate. We are all aware of the pressures on the NHS and social care and it is vital that we work as a system to find the best solutions. But we must keep challenging ourselves. It can’t be right that we have more than 60 people currently in our hospitals who don’t need to be there.
We’ve recently appointed Faye Kirkpatrick as ‘system flow co-ordinator’ to oversee our entire discharge process and ensure that we are minimising delays and maximising outcomes for patients as much as we possibly can. Faye was previously the deputy directorate manager in our community directorate and has been in this new post for almost three months. She has spent time getting to know the different teams who are able to support this pathway and understanding the different perspectives and barriers to overcome.
She explained that each patient who needs to leave hospital is allocated to a pathway. Pathway 0 are those people who can go home independently without any measures being put in place. Pathways 1,2 and 3 are for people who need greater levels of support, which may be a change from their previous living circumstances.
Each of the people on pathway 1,2 or 3 is reviewed at the discharge ‘hub’ meeting, a daily meeting which takes place at 10am at Freeman Hospital and 11am at the RVI. This is a multi-disciplinary meeting attended by staff from the local authority and integrated care board as well as our discharge nurses and community staff, with relevant specialist staff able to dial in virtually to advise where necessary.
This approach enables staff to really understand the needs of the patient and family, and to develop a package of care that considers the person’s, and their family’s wishes. There are challenging discussions which ensure that we promote independence and wellbeing, while considering essential factors such as DOLS (deprivation of liberty safeguards) and other safety concerns. The team asks themselves ‘what is the best we can do for this person?’ They then agree very clearly who has responsibility for taking that forward.
Faye gave the example of a patient who was over 90 and had always lived in their own home. After a spell in hospital, it was initially suggested that a residential care home would be most appropriate for them. However, the hub discussion generated a much more bespoke understanding of what the patient needed and what it would take to get them home – a better outcome for that patient and their family.
While it’s true to say that discharge has always had a multi-disciplinary approach – what is different now is the robust framework which has been put in place. This avoids delays where there may have been disagreements or a lack of understanding about what needed to happen to move someone towards going home. It has meant that delays for social work or community support have been minimised and everyone has ownership of the importance of getting people home. Staff from all agencies involved now describe this as a critical meeting and it’s a great example of Collaborative Newcastle in action.
The next step will be to implement the OPTICA – optimised patient tracking and intelligent choices application – system. This will replace the current spreadsheet based records and will bring together information from all the different organisational systems to give a single, city-wide view. It will help us reach a new level of collaboration to share information and track individual patients effectively enabling everyone supporting a patient to have visibility of live information.
On top of these developments, there has also been investment through the Adult Social Care Discharge Fund which we have been able to influence. This has brought additional resources including agency and bank staff to support patients and we’ve invested in more profiling beds for use in the community through Newcastle Loan Equipment Service. We’ve been able to introduce a handyman role in the city, who can install key safes in people’s homes to enable care staff to have secure entry. We have also provided additional pharmacist expertise to reconcile and reduce medication where that’s appropriate. These are all very pragmatic and common-sense investments which make a practical difference to get people home more promptly and will pay dividends in coming weeks and months.
All this good work comes from linking up systems and people. Creating the environment where everyone can think about what the right thing for each individual person is – and crucially – giving staff the autonomy to do the right thing. It’s about building trusting relationships, having access to the comprehensive information and above all, being focussed on making a difference for our patients. Thank you to everyone who is contributing to this important work.
Visit from Lord Victor Adebowale
Lord Victor Adebowale, chair of the NHS Confederation, visited us on Monday 16 January.
Victor was able to visit our emergency department, assessment suite and also our command centre at the RVI. He visited at a particularly busy time which allowed him to see the realities of the pressures we are facing. Victor was very grateful to the staff he met, and recognised the ‘courageous care in very challenging circumstances’ that he saw. I know that Victor will draw on this visit as he meets with national decision makers over future weeks.
Integrated Lab Medicine goes green
Last week I was pleased to see the Integrated Laboratory Medicine Sustainability Group launch work and workshop events to engage the directorate on their sustainability plans.
ILM have long been one of the directorates leading the way with sustainability, with a number of keen and active green champions, so it is no surprise that they have been an early adopter of the framework developed by the sustainability team to help embed sustainability throughout a directorate’s structure.
A number of excellent examples of projects have been developed by the team – including a re-usable sample transport box which has significantly reduced the amount of single-use plastic bags being used to move samples around the hospitals and between sites. This was a great opportunity to showcase the work so far to a wider audience and encourage new ideas to come forward, and greater involvement with the programme.
For more information or to find out about the framework contact [email protected]
Cancer funding award
Congratulations to Newcastle’s Experimental Cancer Medicine Centre (ECMC) which will receive almost £3million in funding to help doctors and scientists find the cancer treatments of the future for both adults and children.
A partnership between the Trust and Newcastle University – ECMCs work to provide access to cutting-edge cancer treatments.
The funding has been made possible by a partnership between Cancer Research UK, the National Institute for Health and Care Research and the Little Princess Trust specifically for children’s cancers.
Professor Ruth Plummer, Newcastle ECMC lead said “We are delighted Newcastle has secured this funding.
“Clinical trials are crucial to new and improved treatments becoming adopted as standard treatments by the NHS and this funding will allow us to further advance how we can treat cancer effectively.
“Thousands of patients have been provided with access to new drugs and therapies through the Newcastle ECMC and this funding will benefit people with cancer in the North East and beyond.”
Cervical cancer prevention week
This week is Cervical Cancer Prevention Week and I want to encourage people to come forward for their cervical screening. Latest data shows nearly a third (30%) of those who are eligible for their cervical screening have not taken up the offer of this potentially life-saving test.
Cervical screening is available to staff who are due or overdue a smear test at the women’s health unit at the RVI – an offer which Caroline Docking, Assistant Chief Executive took up last year. Caroline said “I had put off having a smear test for far too long, not least because the screening appointments at my GP surgery weren’t convenient. Jill and Jilly offered me an 8am appointment at the hospital so I could go first thing in the morning and get it out of the way. They were brilliant and made me feel very much at ease. I was so pleased that I came forward for screening and would encourage anyone else who is overdue a test to make an appointment.”
You can also find out more information about cervical screening here.
Launch of Leadership Development and Talent Management Strategy
We have inspirational and outstanding leaders at all levels – and in many different roles – across our organisation. It is important that we continue to work hard to support our staff and invest in developing our workforce. Today I’m delighted to see the launch of our Interim Leadership Development and Talent Management Strategy. The strategy not only outlines our key priorities over the next year, but also looks back at our achievements since 2018.
We want to create a culture and environment where all of our staff can liberate their potential and be their best selves. The strategy also outlines our plans to further develop leadership capability and capacity through a variety of development opportunities – ensuring these are available to all levels of leadership, as well as those with leadership potential. The strategy is available to read on the trust intranet.
LGBTQ+ History Month
LGBT+ History Month is a month-long, annual celebration and remembrance of lesbian, gay, bisexual and transgender history. It aims to do two things: promote equality and diversity and remember how changes have been made over the years about people’s rights. It can also be a time to look to the future, thinking about what more can be done to promote inclusivity.
Our local theme is ‘Be Proud! Be Loud! Be Heard!’ and members of the Pride Network have pulled together a series of events and sessions for you to access. These range from ‘Handing on Our History’ an art exhibition by artists Phyllis Christopher & Richard Bliss (with the opportunity for you to be part of the project yourself!), a session on the lost language of Polari to a social evening with nibbles and a screening of the newly released Blue Jean followed by an exclusive performance by Northern Proud Voices and much more.
Everyone is welcome to participate so please take a look at the programme of events, share with your colleagues and join us where you can.
Exercise Serpent Exchange
As part of our many legal responsibilities, we have a team whose job it is to keep our hospitals ready to respond to all kinds of emergencies or disasters. Among the extensive hazards and risks that they plan for, one of the more challenging elements is preparing for chemical, biological, radiological or nuclear incidents – known as CBRN. These sorts of hazards are complex and pose a real challenge to identify and treat, not to mention to the wellbeing of our staff. Threats such as these highlight how important it is for our teams to be highly trained and well drilled in their procedures.
On Saturday 14 January a group from our Emergency Department, along with our emergency planning lead, Michael Clark, took part in Exercise Serpent Exchange. This was a joint exercise with the Army’s 201 Field Hospital (based just up the road at Fenham Barracks), the North East Ambulance Service and our partner trusts across the ICB. Our team spent the morning being trained by clinical experts from British Army in the identification, decontamination and treatment of patients exposed to CBRN substances. In the afternoon there was the chance to put their expertise to the test with some challenging drills, all done in full chemical PPE.
Keep an eye out for our teams undertaking more drills and exercises on site over the next few months. These will culminate in a live major incident simulation in early May. For more information, or to get involved in Emergency Planning then please contact Michael Clark – [email protected]
Awards and achievements
Huge congratulations to Dr Chris Lamb who has been recognised as one of the most promising emerging scientists for his research into inflammatory bowel disease.