What matters to you?

The last 18 months have made everyone think hard about what’s important to us – both at home, with our families and friends, and also at work. I expect that’s especially true for those of us working in the NHS and seeing the ‘sharp end’ of the impact of the pandemic each day.

Before COVID-19, we had begun our work to improve staff experience at Newcastle and you will know that I have always been committed to making sure that we create the best place to work that we can.

As Chief Executive, I have a responsibility to set the standards and expectations but it’s important (and in my experience much more effective) if we work together to create shared aspirations about the conditions we want to work in throughout our organisation.

I want Newcastle Hospitals to be a place where we listen to everyone’s views, where we communicate clearly and openly, and where we are all able to make changes and influence what happens here.

Through the pandemic, our priorities changed and keeping staff safe became our first and foremost concern. Thanks to the remarkable efforts of many members of the team we were able to support our shielding staff to contribute to our COVID-19 response from home, we had reliable supplies of PPE throughout and we had fantastic help from our infection prevention control and testing teams. Every one of us gave our best.

We’re now entering a phase where we need to manage COVID-19 as an illness which will be with us for the long term. Currently we have 57 patients with covid in hospital, a figure which has stayed relatively stable over the last few weeks. We need to consider how we support potentially two wards of covid patients for the foreseeable future. Alongside this we need to focus on the care that people have missed out on – especially for those patients who have waited more than 52 weeks, and more than 104 weeks in some cases, for their operations. This is against a backdrop of the huge personal pressures that many are feeling. I visited wards 4 and 20 at the Freeman Hospital last week and heard from staff about the roller-coaster of emotions they felt. I know our personal reserves are low and everyone is tired.

I believe that we can only be successful in tackling this next challenge if we refocus our efforts on supporting, listening to and responding to our staff.

Last year in our staff survey 91% of people said that they would recommend Newcastle Hospitals as a place to receive care – that was one of the highest scores for the question in the country, and reflects the clinical excellence that we provide every day. However, only 75% of people recommended us as a place to work. Again that is a respectable result against our national comparators, and well above average, but it’s not good enough. It says to me that we have a lot more to do make Newcastle the best place to work.

Our aspirations

Our Flourish programme gives us a way of thinking about where we need to improve –and you can read more about our framework here. It’s important to say that flourish is an aspiration – it’s absolutely not something we have achieved yet. But it is a way that we can all take the initiative in our teams and departments to make positive and active changes.

Over the last 3 years, by working together, we have started to change the culture of the Trust. We have become much better partners, working as an integral part of services in the city. We have introduced much clearer ways of regularly sharing important information, we have focused on equality very clearly and we have encouraged a more open and inclusive style of leadership.

Through the engagement work that we have done, we know that there are some important priorities that make working here unique and which we want to emphasise and maximise – particularly the work to support sustainability in healthcare and our Quality Improvement approaches. I want staff experience to be of equal importance so that we make significant steps towards being the best place to work.

What next?

So we have a framework, we’ve set out the areas where we want to improve and we’ve made some significant changes already, but we know that we have much more to do and we know that making change can be difficult. I am also very conscious that we haven’t in the past had consistent and reliable ways to listen and respond to staff.

It’s time to really accelerate this work, so I’ve asked the Institute for Health Improvement (IHI) to help us. The IHI are supporting both our quality improvement developments and our staff offer as I see these two elements as sides of the same coin. Driving up the quality of care we provide alongside the experience of staff has to be the best way to move forward and we can apply improvement science as we test change ideas to improve our working lives.

Over the summer the IHI, working with our local leaders, have been helping us to listen to staff and identify your priorities.
We are testing this approach at our leadership congress on Tuesday 12 October and have already held over 30 staff focus groups to find out ‘what matters to you’ by asking two questions:

• What does a good day look like?
• What are the pebbles in your shoe? (What gets in the way of a good day?)

What you’ve told us

I want to start by saying thank you to everyone who has shared their honest views by taking part in focus groups, surveys and other discussions. It’s very important that you keep speaking up. You’ve told us lots of examples of positive changes, including better communications in your teams and more flexibility in the way you work. It’s clear that people are very proud to work here and enjoy the time spent working with their colleagues.

When it comes to the ‘pebbles in your shoes’ there is remarkable consistency of the themes that are being raised across our staff survey, focus groups and other feedback.

The IHI have themed these for us, and they are issues around:

• Autonomy and control – including things like flexible working and scheduling; having more permissive policies and having more discretion about how work is organised.
• Participative management – this centred on staff being consulted and involved in decisions about their workplace and understanding the reasoning behind decisions that are made.
• Psychological and physical safety – people highlighted that it can be difficult to raise concerns in some situations and rising levels of stress can have a negative impact on teams under pressure.

We’ve had hundreds of comments within these themes and we’ve asked a group of staff to review the detail and help us to agree some initial priorities. Many suggestions need to be resolved in teams and directorates, but others require trust wide changes which may take some time.

I’m committed to continuing to listen and making sure that we report back about how we are responding to those bigger issues. I’m also committed to supporting leaders at all levels to be the ‘authors of the solution’ in their own spheres of influence, with their teams and directorates.

What we need to do now

As I’ve highlighted before, we have some important tasks underway. We are looking at how we can improve the staff food offer at the RVI and have introduced ‘click and collect’ through the food to go app and created new staff rest areas. We are also working hard with the staff networks to prioritise and celebrate equality. Some of these task do take time to complete and progress can be slow but we are making gains which I will keep you updated about.

Listening to staff is something that should be part of every leader’s job at all levels in the organisation and we need to refresh our leadership approach and invest, so that we can develop leaders who understand what we expect of them.

We also need to keep listening. The national NHS staff survey will launch in early October, and is a really important way of hearing from a wide cross section of staff. Importantly, our staff survey is carried out by an external company, so it’s completely independent and it enables us to hear views from different groups of staff in a consistent, quantitative way. Please take the time to complete your survey as soon as you receive it so that your voice can be heard.

Beyond that, I want us to really challenge ourselves to do things differently. I’m keen that we collectively engage in debating what the new ‘rules’ should be here – what needs to change and how can we create new behaviours that more closely reflect our future rather than our past.

Three Newcastle teams are joining IHI’s Wellbeing & Joy in Work Results-Oriented Learning Network over the next 18 months to test their change ideas, to improve their own staff experience and as they learn they will also share their insights.

I want to invite everyone to positively engage in this important work, taking the responsibility for the things that are within our power to alter and being alert to opportunities. As ever, I am very keen to hear your experiences of what is working well, how you are tackling the pebbles in our shoes and how we can remove barriers to support you. Together we can create the best place to work that we aspire to, even in these challenging times, and that really is what matters.

Our Council of Governors

Our Governors are a key part of the Newcastle Hospitals team and throughout the pandemic have continued to meet and work together.

Over the summer the nominations committee helped select the newest non-executive director of the Trust and the people, engagement and membership working group supported the development of the Trust’s new membership materials.

The working group chairs helped to update the new governor induction session – designed to support newly-elected governors learn about Newcastle Hospitals and find their feet in their first months on the Council of Governors. Thank you to all of our governors for their contribution.

Research launch and 10,000th study

I was delighted to open the clinical research strategy launch event on Monday. The event reflected on our research success to date, but looked to the future as colleagues set out the vision for research at Newcastle over the next five years.

It was timely then that we recently registered our 10,000th clinical trial, a fantastic achievement.

The 10,000th study will test the effectiveness of a treatment called extracorporeal photopheresis (ECP) on patients who develop severe organ rejection following a lung transplant. ECP is a type of therapy which is designed to stop a group of white blood cells, known as lymphocytes, attacking the body following an organ transplant. Sadly, some patients become very poorly with organ rejection after their lung transplant and don’t survive, however it’s hoped that this study could help to change this. The study (NIHR 130612) is being led by Professor Andrew Fisher from the Institute of Transplantation at the Freeman Hospital and Newcastle University on behalf of all five lung transplant centres in the UK and is funded by the Efficacy and Mechanism Evaluation (EME) Programme, an MRC and NIHR partnership.

Our first clinical trial was registered in 1975 and today we recruit more than 10,000 patients into hundreds of clinical trials each year. Some of our trials have led to scientific breakthroughs and drug discoveries, helping to improve the quality and longevity of patients’ lives.

Of course, none of this would be possible without the passion and dedication of our teams who work tirelessly to run and manage clinical trials. We couldn’t do it without the efforts of everyone involved.

If you couldn’t make the event, I would really recommend listening to the recording, which you can find here. You can also read the clinical research strategy here.

Our special delivery

Last week Newcastle mum Kaja Gersinska became the first person in the UK to use climate-friendly pain relief during labour after giving birth to her beautiful daughter Rosie at our Newcastle Birthing Centre.

Kaja breathed the gas and air into a Mobile Destruction Unit (MDU) – a machine designed to collect and destroy residual nitrous oxide from exhaled gas and air.
The technology, developed by MedClair collects the exhaled nitrous oxide, a potent greenhouse gas and ‘cracks’ it into nitrogen and oxygen which are harmless.

I was delighted to meet the team from Medclair and those involved in developing this project within the Trust. This pilot project is just one example of how were are continuing to strive to make our healthcare services more sustainable.

Annual Digital Summit

The Digital Care Programme for the North East and North Cumbria Integrated Care System hosted its annual Digital Summit this week.

I was pleased to be invited to say a few words about the impact of digital innovation here at Newcastle and how it is crucial in so much of our work. The event covered a number of areas, including a session by our CIO Graham King, on the Great North Care Record. It also included information on the region’s Digital Strategy, digital diagnostics, NHS Health Call as well as data and population health management.

It was especially moving to hear Steve Cram telling his own personal story about his experiences with his parents before they passed away and why he is the Great North Care Record Ambassador. It really brought to light how sharing information on the Great North Care Record both helps our staff to provide safer, more joined up care – but crucially has an incredible impact on patients and their families. You can listen to Steve’s story here.

World Patient Safety Day

We deliver safe, high quality care every single day, but when things do go wrong we learn and work hard to identify ways to stop similar incidents happening in the future.

Today is World Patient Safety Day which this year focusses on ‘safe maternal and newborn care’. We’ll be celebrating the fantastic work we do here in Newcastle to keep mothers and babies safe throughout the day and the quality and safety midwives are also highlighting some of the safety initiatives they’ve implemented across the Trust. You can read more about their work here.

You can also listen to this podcast featuring Emma McCone, matron, vaccination programme Nightingale Hospitals, and Jo Turner, midwife/transformation and improvement manager, as they join Karen Hooper, midwifery lead for the National Maternity and Neonatal Safety Improvement Programme (MatNeoSIP).

Great North Run

Last Sunday saw thousands of runners descend on Newcastle to take part in the 40th Great North Run. Huge congratulations to everyone who took part on the day and thank you to everyone who chose to run in support of our Newcastle Hospitals Charity.

As part of the 40th anniversary celebrations, Sister Jade Trewick, was one of four ‘NHS heroes’ to officially start the event. Jade has been key to the success of ward 49 – a respiratory support unit which provides both intensive care and step-down care for COVID positive patients.

I was also delighted to see that Catriona Johnston, an advanced clinical pharmacist at the Freeman, joined as an Elite in the Women’s Wheelchair racing and achieved a fantastic time!

A very special thank you to all of our staff and volunteers who worked across the weekend, continuing to provide outstanding care to all of our patients.

Awards and Achievements

• Congratulations to consultant orthopaedic surgeon Kenneth Rankin who has been shortlisted in the Bone Cancer Research Trust’s Bone Idols for the use of fluorescence in surgical research to inform and improve accuracy and effectiveness.
• Dr Graham Burns was appointed as one of the first national specialty advisers for long covid with NHS England. This is a key role in helping the NHS meet the demand for ongoing care for people with long-term effects of the virus. Read more here.
• Our recruitment team have been shortlisted in the recruiting back better category at the RIDI (Recruitment Industry Disability Initiative) Awards, in particular for the recruitment campaign for the Integrated COVID Hub North East, where the team demonstrated their commitment to supporting a diverse workforce, with a focus on being an inclusive, compassionate place to work.