Our Mid-Year Review
The summer holidays can give us the opportunity to step back slightly and review how the year has gone so far, what we’ve achieved, what we’re proud of, and of course what we still want to accomplish.
In the NHS, our financial year starts on 1 April, so we have just over six months left to achieve our ambitions for 2019/2020.
I suspect that the first half of the year will take some beating! Our second rating of Outstanding by the CQC has given us a very high bar to top. Now, we need to really focus on our performance across a number of areas to make sure we keep setting the standard nationally.
The National Clinical Review of Standards is currently underway and this may lead to some changes in the targets that we need to meet. I’m personally involved in this work and have been making sure that we are leading the way in setting the highest standards for what outstanding care looks like, and to which other trusts aspire.
But it’s also important to say that this year is challenging. I can see the effort that everyone is putting in across the Trust to provide such excellent care in a timely way. As I’ve highlighted before, it’s unlikely that the pressure will lift, and it is a huge credit to everyone that so much is delivered in Newcastle.
The progress in all of the areas I’ve highlighted is a result of the pride and passion from you all to deliver excellent, high quality care. I want to thank you all again for your efforts.
Quality and patient safety, along with timely access and prompt treatment, is our number one priority – and something that each of us wants to get right.
I wanted to share with you the headlines of how we are doing in some key areas.
Emergency care remains our highest performance priority and we are committed to delivering the 95% four-hour standard for the 240,000 patients who attend for emergency care every year.
Our current performance is around 94.9% so far. We are the 3rd highest performing trust in the country, and around 10 percentage points higher than the England average.
To help us keep up with rising demand we are focussing on;
- Improving patient flow through expanding same day emergency care and #ReducingDaysAwayFromHome for patients throughout the hospitals
- Enhancing processes to ensure that our sickest patients (those who have trauma, stroke, heart attack, sepsis etc) get consistent access to the best standard of care within the first golden hour and;
- Working as a system to do better for patients in mental health crisis, so that fewer are brought to the stressful environment of A&E, and so that those who need ongoing help get access to this without delay.
We are a huge provider of elective care, every day receiving 1,350 referrals, seeing 5,000 patients in outpatients, and admitting 550 people for elective inpatient or day case care. There are 74,000 patients currently on our active waiting list for treatment, which gives us the 6th largest waiting list in country. For the last few months we have been the only Trust with a waiting list of over 50,000 patients that was delivering the referral to treatment standard of 92%.
Regrettably last month we also dipped below the standard with a performance of 91.8%. This has happened because we have seen our waiting list increase by 15,000 patients over last 18 months, driven in roughly equal proportions by;
- The introduction of the Tyneside Integrated Musculoskeletal Service (TIMS) across Gateshead and Newcastle,
- A change to the way we need to count some patient pathways
- Demand outstripping supply, particularly in cancer and ophthalmology.
Reducing waiting times for elective patients is a key priority. For example in outpatients we are focussing on reducing outpatient DNA rates through telephone reminders and the Appointment Booking Centre.
As a major specialist centre for cancer services we receive around 100 urgent referrals for patients with suspected cancer every day. We provide some of the most complex treatments anywhere in the NHS, and with really good clinical outcomes.
From January to May this year, we received 13% more urgent 2-week referrals and gave 21% more patients their initial cancer treatment than during the same period two years ago.
Keeping pace with this rate of growth and ensuring that patients with suspected cancer get seen and treated quickly is one of the most important things we do. Unfortunately we are only currently achieving one of the eight cancer standards for timely access. We are working closely with the Northern Cancer Alliance to do everything we can to create additional capacity and use it as effectively as possible.
Our Financial Performance
It’s no secret that NHS finances are stretched, and here in Newcastle we have a strong track record of delivering our required savings while continuing to improve clinical quality. This year, we need to deliver £32 million of savings from our £1 billion budget. That’s more than most of us can imagine, but it’s in line with what we have found in previous years. Thanks to the hard work of clinical, corporate and directorate leaders we have identified £15million so far and are actively developing plans to bridge the gap, and we will need everyone’s help to make sure that we can balance our books this year.
Infection Prevention and Control
This is an area where we should be very proud! Our last MRSA bacteraemia was on 17 August 2018, a year ago this weekend. In addition to this, at the end of the first quarter of 2019 we have had a significant reduction in all healthcare associated infections – reducing almost every category of infection by 10%. This is a fantastic achievement for the Trust and a reflection of the focus of all teams to reduce harm and focus on patient safety and quality.
Overall, we continue to be one of the strongest performing organisations in the NHS, and I want us to stay that way. It’s important because behind each of those numbers is a patient, and a family, who need and deserve the very best care that we can offer.
Responding to Complaints
Despite everyone working hard to deliver outstanding care to our patients every day, on some occasions we fall short of what our patients expect from us. Often these issues are resolved quickly so that a formal complaint is not necessary. Last year, we have received just over 470 complaints which is a tiny proportion of the patients we see.
Feedback from patients and families tell us that receiving a late complaint response has a negative impact on their overall patient experience, leaving patients feeling not listened to and that the Trust is “hiding something”. Disappointingly, almost half of our patients or their families received a response to their complaint later than they expected, and this is something that I would like us to improve upon.
I want to make sure that when we don’t get it right, we are able to respond to patients as quickly and positively as possible.
To support this, complaint investigation and response writing training will take place on Tuesday 5 November, Friday 8 November and Tuesday 12 November. This training will be initially targeted to directorate managers, senior clinicians, matrons and complaint staff. Please look out for further information over the next couple of weeks.
Recently Executive Chief Nurse, Maurya Cushlow and Medical Director, Andy Welch, wrote to all staff about the upcoming flu season. This is a vital message. We must do everything we can to be prepared, so that we can protect our staff, our patients, our families and ourselves from flu through the winter.
Last year we saw the highest levels of staff vaccination we have ever had with 74% of staff vaccinated. High risk areas achieved at least a 75% vaccine uptake overall, which was a fabulous achievement and we hope to improve that position this year.
We are busy planning our flu campaign and have listened to your feedback from last year. As a result this year there will be even more availability than ever before: longer drop-in clinics, over 100 peer vaccinators and more twilight, weekend and night clinics to help give staff as much opportunity as possible to get vaccinated.
We also have vaccinators visiting community bases and outreach areas and the flu vaccinators will be attending all wards and departments for those who find it challenging to leave their areas of work.
There will also be a ‘flu hotline’ to contact to request vaccinators to attend departments and lots of other plans within the campaign. Details will be available in early September.
If you think we can do more or have different ideas, please contact the Occupational Health team
Remember, vaccination is the best means we have to prevent infection and to protect those around us, both in and outside of work. I would like each of us to take personal responsibility for ensuring that we achieve high vaccination rates quickly.
To launch our August #Flourish theme of sustainability, I was pleased to share this ‘opinion piece’ about our declaration of a climate emergency in the HSJ. You can read the full article on our website here
You’ll also find information about what you and your team can do to make an impact. Small things really do make a difference.
Date for your diaries – Project Menopause
We’re holding two events in September to talk about menopause. You’re welcome to join us for a chat with colleagues, and to hear from our resident menopause expert Dr Diana Mansour.
You can find out more and download a poster on our Intranet site and if you’d like to know more about the menopause there is lots of useful information here.
BAME staff conference
Our inaugural conference for black and minority ethnic staff will take place on 1 October at St James Park. The conference will focus on the national and local prospective and provide personal insights from people who have progressed in their chosen field.
We hope it will be a starting point to seek to remove the barriers in the workplace and encourage a positive culture change at all levels. I would love you to attend and with this in mind all Directorates have been asked to make a concerted effort to release staff to enable maximum attendance. To book a place, email or call 0191 21 31613.
Awards and Recognition
Congratulations to Hilary Tedd who had been awarded the Emerging Women Leaders Programme
Fellowship, a development programme commissioned specifically to address the under-representation of women in leadership roles within the RCP and the wider medical profession.
Greatix – will you be our 3000th winner?
Since its launch in November 2016, 2,900 people and teams have received a Greatix to recognise their excellent work. In July, 223 nominations were submitted, which means that our 3000th Greatix is just around the corner – could it be you?
If you witness excellence from a colleague or team, please take the time to share it and submit a Greatix by clicking on the link here.
It’s great to see so many people signed up for both the Great North Run and Great North 5k. We still have a handful of places available for the 5K event at a subsidised rate of £10 so if you want to join NHS colleagues on the Quayside on Saturday 7 September, sign-up through our Benefits Everyone website.