It has been a busy few weeks, with other writing and speaking commitments as well as the day job! Here are some recent highlights
Media interest / Kennedy Report
Quite busy on the media front of late. We are expecting the publication of Sir Ian Kennedy’s report into his review of breast care services at Solihull Hospital later this year, but this story carrying claims made by a solicitor acting for some of the women affected required a response from us, which you can read here
We commissioned the review from Sir Ian to fulfill a commitment given to some of the people affected by my Medical Director and myself. The aim was to examine the process followed, and actions taken, after concerns were raised, in order to learn lessons and improve in the future. Despite the challenges, I remain convinced that this open approach was the right one to take
Emergency pressures and Quarter 2
Really disappointed that we haven’t achieved the 4hr target in Q2 – it looks impossible now with two days to go. We have a really extensive winter plan which includes additional nurse and medical staffing, and capacity, but these do not come in until October (Q3)
Our staff have worked really hard but summer has been very busy with spikes in activity and July seeing our highest number of attendances ever. August has also been very pressured everywhere, with a large rise in acute surgical admissions, but our failure to achieve any ‘headroom’ earlier in the quarter means we miss the target. We will be over 94.5% but it is an ‘all or nothing’ standard
Our winter plan gives us over 120 additional ‘beds’, mostly in the form of home care capacity. Much of this we have commissioned from other organisations, so we don’t have to find all the staff ourselves. On top of this we implement the supervisory ward sister model in October – a really good initiative which will help our wards considerably
As a health economy we will receive £9.3m ‘winter monies’ to support plans drawn up by the CCG’s. I, as the acute provider, was required to sign for it although just £2.3m comes to us, while most (quite rightly) goes to the local authorities and community provider
By apportioning 75% of the funding to local authority and community health providers, the key role they play in managing emergency pressures (and supporting the acute hospital to achieve the 4hr target) is being recognised by commissioners. We made this point last winter, and this progress is welcome
Ward visits and staffing
I have been visiting our Heartlands wards to discuss staffing levels, and the deep clean and refurbishment we are undertaking during what we expected to be (but wasn’t) a quieter period for the hospital. Doors on each bay will greatly help our excellent infection control team manage any Norovirus outbreaks over the coming winter
Nurse staffing is a no-go area for cost improvement plans, but high turnover and sickness rates are leaving us short at times. The continuing pressure on staff from high activity levels has, I think, slowed the expected improvement in sickness absence from the high rates seen last winter. And every organisation locally is recruiting actively for winter, so people are submitting multiple applications and then withdrawing
Thanks to our brilliant weekend recruiting events I am now seeing large numbers of new starters at weekly induction. We are increasing the support to newly qualified starters, and offering guaranteed training, to ensure we keep those we do recruit
Our staffing numbers (planned and actual) will be displayed on each ward soon. I hope this will give clarity to staff, patients and public over this hugely important issue
CEO Team – strategy
We meet for the day each month to create time for discussion on both pressing issues, and future planning. This meeting included some weighty items on the agenda. We looked at staffing in great detail, and looked too at some really major decisions on service changes in surgery across our sites, transforming acute and general medicine in line with the Future Hospital Commission report, and early talks on some truly exciting estates plans to accompany them
We are putting our strategies for each locality into some easy to read leaflets so that we can start communicating the plans widely. Given the challenges we face it is critical that we take some bold decisions and I know our Board is keen we start to do this soon
National Hip Fracture Audit
This was published last week. We are thrilled with the improvements made, particularly at Heartlands Hospital which is now a positive outlier on mortality! Many congratulations to the ward, orthogeriatric and orthopedic teams for making such fantastic progress
And our thanks to Michele Paduano and the local BBC for their great coverage!
Are you enjoying our Health Blog Round Up? It is updated every week and you can see it . Next week it is our annual Staff Recognition Awards evening – always an uplifting event and I will update next time!
Bob Brown
Thanks for your refreshing and candid blog Mark – I imagine your teams appreciate the transparency you are role-modelling.