Our journey moving forwards

It’s been an overwhelming week for me personally as I’ve had the opportunity to share the news that I will be stepping down as Chief Executive in December.

I’m incredibly grateful to everyone from across the trust and the wider NHS, who has reached out to me this week. Many people have expressed their good wishes and reflections on our time and achievements together, through good times and difficult ones.

Making a decision like this takes a lot of thought, and as I mentioned in my announcement message to you earlier this week, it’s one that I have been reflecting on for some considerable time.

There is never a perfect moment to leave a role like this, and I very much wanted to see us on a firm footing after the pandemic and subsequent recovery before I handed over the reins. So, when I made my decision in the spring, I knew that these would be a crucial few months to begin the transitional process to my successor.

Sadly, ongoing industrial action and other pressures mean that we are not fully where I would want us to be, but as I look back over the last five years I’m proud of the work we have done together to develop the culture of the trust, deliver our strategy and above all, continue to provide the very best care for our patients.

Newcastle Hospitals has always been a beacon of excellence in clinical care in the NHS – that’s down to everyone, across the whole team, who contributes to that front line excellence from wherever you work.

I’m proud that over the last five years we have been able to build much stronger relationships with our local partners in the city. We’ve developed our governance and strengthened the executive team, improved our operational frameworks and supported our senior leadership arrangements through our eight new Clinical Boards.

We’ve also focussed on health improvement in our wider communities through Collaborative Newcastle and our partnership with the Institute for Health Improvement has helped us to embed quality improvement science in everything we do. I’m also proud that we listened to our passionate staff by taking action to address climate breakdown and declared a climate emergency. I know these are all areas where you will share my pride in our achievements.

However, having had a long career in the NHS, and leading a variety of provider organisations, I know that the job of continuing to develop and grow is never done. There is always another challenge around the corner, and so it has been with our recent Care Quality Commission inspection.

As you will be aware, the CQC undertook their unannounced inspection of our services at the end of June with a focus on urgent and emergency services (ED), medical care, paediatrics, surgery and NECTAR, as well as looking at the progress we’d made around the care we provide to patients with a mental health issue, learning disability and / or autism.

This was followed by their ‘well led’ inspection in July and included 16 staff focus groups being held, a staff survey, a series of interviews with various individuals and teams over several days and further visits to wards and departments.

So far, we have received over 750 information requests and I would like to thank everyone for welcoming inspectors into their areas and responding to all of these requests. I know it has been a lot of work.

As I write this, we are still some weeks away from receiving a draft report but I do want to share with you some initial feedback. Our correspondence so far suggests that they have seen skilful and caring interactions with patients throughout their visit and heard many experiences of personalised care being reported from patients.

In children’s services inspectors saw that the care offered to young people was personalised to their needs and that families were appropriately involved in decision making. They also positively commended our safeguarding practices.

As mentioned in my last blog and our operational updates, some areas were identified where improvements need to be made. It’s always disappointing when we fall short of the high standards that are expected and we are responding quickly to put things right.

These include points in relation to medicines management and storage of some cleaning substances (which has been rectified and monitored with ongoing audits), observation of the ED waiting room, which has been addressed, and elements of how we use our electronic patient record – a work in progress.

Through our ‘care for me with me’ programme of work, we continue to focus on the quality and safety of care for patients with mental health needs, a learning disability and / or autism by ensuring all of our staff have the confidence, knowledge, skills and training to do just that, as well as understanding the principles of the Mental Health Act and capacity assessments / best interest decision making.

There is more to do but I want to thank everyone for their ongoing hard work to ensure our practice is as good as it can be in these areas.

We’ve also received some feedback about the ‘culture’ in the organisation and have been asked to share information on how we support staff to raise concerns, speak up freely and report problems.

Our cultural change journey has been an important focus over the last 5 years and we have invested heavily in Freedom To Speak Up, What Matters To You and our staff networks, which have resulted in many positive indicators in our staff survey.

However we recognise and accept that there is clearly more we need to do. We need to ensure that our staff feel confident to speak up and raise concerns, safe in the knowledge that our leaders will listen and act, including tackling poor behaviours. We know that if we do this, it will make us all feel even prouder to work at Newcastle Hospitals.

This week, I met with senior leaders from our clinical boards at Trust Management Group to share this feedback and begin to think about additional specific actions we can take to support our staff.

This includes the development of our new ‘People Plan’ for the trust, which will put actions in place to address the issues that we know are troubling our staff. It is vital that we build this with staff, and so our Chief People Officer Christine Brereton will be leading this work, beginning with an extensive series of face-to-face and teams staff focus groups. There will also be other ways to contribute through online anonymous platforms.

We are keen to hear from staff about your priorities, and importantly ensure that we are quick to take action on the issues that will make a difference and help to strengthen Newcastle Hospitals as a kind and compassionate place to work.

A key element of this work is embedding ‘our Newcastle Way’ – the behaviours we expect to see from everyone in the trust, which flow from our values. These were developed by staff and are widely recognised, but we need to do more to share them through our new clinical board structures and embed them in the expectations we have about the way we will all work – focussing on our ‘people’ rather than our ‘processes’ and putting fairness and kindness at the centre of all we do. This work will start soon and we will communicate with you further on this.

As we hear more from the CQC, I will continue to provide updates, but we expect there to be a number of weeks before we receive a formal report from them.

In the meantime, the preparations for the process to recruit a new Chief Executive have been underway for some time, which has enabled the advert to be published imminently online. This process will take at least a couple of months and will be guided by our Remuneration and Appointments Committee – a sub committee of the Board of Directors.

As I have said already, until December it is business as usual for me. I will look forward to hearing from you about your successes, challenges, and ambitions for the future. And as ever, we will continue working as a team to do the best we can for our patients.

Junior doctors’ strike

As we head into the first day of the junior doctors’ strike, our operational teams have been working hard to put plans in place to safely staff our hospitals and community services.

However, we are anticipating this wave of industrial action will be particularly challenging due to summer annual leave, meaning staffing levels in wards and departments are much lower than usual.

Patients are likely to experience significantly longer waits in the Emergency Department and we’re asking people to ONLY attend our accident and emergency if they are in need of urgent treatment or care. We’ve got further information on our website which you can find here.

Other news

Identifying diabetes – Newcastle Hospitals’ biggest study to date – known as INGR1D2 – is helping to identify infants at high risk of developing Type 1 diabetes to study new treatments with the aim of preventing the development of the condition.

It’s being led by Honorary Consultant Obstetrician Professor Stephen Robson, Professor of Fetal Medicine at Newcastle University, and delivered by the trust’s reproductive health and paediatric research teams.