We’re never as good as we want to be…

Trust Management Group (TMG) is our regular meeting where directorate managers, clinical directors and senior managers from corporate functions meet together with the executive team every 6 weeks.

This is where we can take some time to consider the important strategic issues which affect us all. It’s an important event which is always well attended and with lots of contributions from members.

At our meeting last week, we once again turned our attention towards our driving factor – quality and safety.

Virtual meeting on a PC screen
Virtual Trust Management Group meeting

I’ve noted many times before, that our ambition to provide such high quality services in Newcastle is what sets us apart and makes us successful. As I listened to the achievements that were highlighted and the discussion on what more we can do, it struck me that no matter what we achieve, we will always strive for more.

We don’t rest on our laurels. We are never as good as we aspire to be, and that is something very powerful.

On Tuesday, I was reminded of this again when I visited our new acute cardiac care ward (ward 50) at the RVI. I was immediately drawn to the enthusiasm and pride of the team as they showed me their new facilities. They heaped praise on members of the wider MDT who weren’t present to highlight their contribution to patient care and outcomes – especially the physiotherapy and occupational therapy members of the team.

Meeting staff on our new acute cardiac care unit

While they were delighted with their new environment, they were also clearly focussed on what more they could do. They were keen to talk about the developing plans and business cases they are working on to create new roles, new ways of working and to strengthen their focus on working with the community cardiology team to support people in their own homes without needing to come into hospital. The positive energy coming from the whole team was palpable and infectious.

At TMG we reflected on the quality standards we had achieved through the coronavirus pandemic – including having the second lowest mortality from COVID-19 in the UK (14.79 deaths per 1,000 inpatient days compared to the national average of 24.88 per 1000 inpatient days) and being in the best performing 20% of trusts with low rates of hospital acquired COVID-19 infections. This is a remarkable achievement especially when we cared for such a significant number of patients who were transferred into us from across the region and the wider UK.

What has made our response to the pandemic successful is inevitably not one factor but many.

Andy Welch, our medical director began the session by highlighting that during the pandemic he felt that the trust worked as one collective team more than he had ever known before. HR, procurement, admin, finance, estates and facilities, IT – everyone went through the storm together and everyone demonstrated unprecedented flexibility and achievements to support our clinical frontline to do what we do best.

We also heard from Associate Medical Director Gus Vincent, Consultant Physician Chris Gibbins and Associate Director of Nursing Lisa Guthrie about how clinical teams have faced up to the challenges of the last year.Member of staff on a ward in PPE

They reflected on how we completely shifted the way we managed covid patients with lung injury as the disease progressed in spring 2020. Of course this was a condition that no-one had seen before and there was no evidence base, so small working groups of our local experts were established to look at all of the available information internationally and agree the right thing to do.

They co-ordinated guidance very quickly and enabled us to provide the best care, from initially expecting everyone would need to be ventilated, to understanding quickly that non-invasive ventilation or CPAP was much more effective for some types of patients.

Our clinical teams were also prescribing anticoagulation on discharge before almost anywhere else in the country because of that positive and innovative approach. It was very emotional to hear how quickly we were able to make those changes to respond to the clinical knowledge that was emerging, and how the speed of innovation saved many lives.

They explained how we acted rapidly to minimise patient movements between different wards to limit cross contamination, and how much effort that took from the whole hospital team to ensure the flow of other patients through the trust. They highlighted that new equipment and techniques were adopted promptly to keep people safe, for example introducing rapid PCR tests in the Emergency Department.

Our workforce was, of course, at the heart of our response and it’s quite amazing to think that we were able to train 844 staff to work in critical care, over 600 of them were trained in a very intense 3 week period. I know how much everyone wanted to do the right thing, and it’s worth remembering that back then we really knew so little about the impact that the pandemic would have on our friends and loved ones. There was a lot of fear in those early days, and yet everyone carried on doing their best.

At a time when everyone felt so far apart, we relied on technological solutions to bring us together. It’s remarkable to think about how we became so reliant, so quickly on digital tools that we had perhaps used reluctantly before, but were able to embrace. Our Chief Information Officer, Graham King has shared his reflections of this transformation in a blog and this infographic demonstrates the impact of digital solutions very well.

And despite the last 12 months, the national audit standards and quality improvements in non-covid services are too numerous to mention.

As we move towards the future we are already focussing our attention to how we emerge from the pandemic stronger and with even higher quality standards. In my next blog, I’ll be looking at some examples of how clinical teams are thinking differently and providing services differently so that we can continue to maintain our excellent services and support as many people as possible in this new post covid reality.

To help us with that and thanks to a generous donation from our Newcastle Hospitals Charity, we’re working with the internationally renowned Institute for Health Improvement over the next two years. We aim to make sure that staff have the skills and abilities they need to maximise our quality improvement work, and to understand and enhance the opportunities for learning and sharing good practice between teams.

Every step of our programme will take us closer to the level of excellence that we aspire to. It will take all of us doing our bit to move us in that direction, and I’m grateful to each and every member of the team for everything you do for our patients each day.

Building for a greener NHS

To mark Earth Day, I spoke at a Public Policy Projects webinar with Dr Nick Watts (Chief Sustainability Officer for the NHS) and the Rt Hon Stephen Dorrell about ‘Building a greener NHS: Reaching Net Zero’ and the work we’re doing in Newcastle to address climate breakdown. You can find out more in my blog here

Equality, Diversity and Human Rights Week

Equality, Diversity and Human Rights Week (#EQW2021) will take place from 10-14 May. You may recall we sadly had to cancel many events last year due to the pandemic but I’m pleased to say we have a full programme for 2021 (mostly virtual) and full details on how to book places are available on our intranet home page.

It’s also a good opportunity to think about the role of equality, diversity and inclusion as part of our own road to recovery and reset which is very much what the national focus is this year.

International Day of the Midwife

This Wednesday (5 May) also marks International Day of the Midwife which is a great opportunity to celebrate and recognise the work of our midwifery team. Over the last year (April 2020 to March 2021), 5,831 babies have been born at the RVI and throughout this pandemic, the team have continued to deliver outstanding and personalised care to women. My heartfelt thank you for all the work you do.

Move More Challenge

We’d love you to join our Flourish #MoveMore challenge in May, with the aim of getting in 8,000 steps a day for four weeks. It starts on 17 May and to register, simply get a team of six together, email us your team name, your team members’ names and the department you work for to nuth.flourish@nhs.net

Each Monday we’ll email the total amount of steps and update our score board and and further information about the challenge will be available shortly.

Don’t worry if you can’t record your steps on your phone we have pedometers available email nuth.flourish@nhs.net

Awards and Achievements

Congratulations to Surash Surash, who was highly commended in the ‘Ground Breaking Researcher of the Year’ category of the National BAME Health and Care Awards for his key role in the comprehensive pay-gap and workforce review carried out in the trust. Well done also to Hloniphani Mpofu who was a ‘Clinical Champion’ finalist.

Congratulations to Lisa Gemmell, Lead dietitian in HPN, who received recognition in the BDA ‘Roll of Honour’ and COVID-19 Community Heroes section of the BDA British Dietetic Association Awards last night for her work to support patients throughout the pandemic and beyond.