CEO Diary w/c January 13
My first Diary of 2014 – some familiar themes and some new ones too!
Performance since the ‘Perfect Week’
The big question – have the benefits of our ‘Perfect Week’ initiative been sustained? The answer is certainly ‘yes’. We have had a much better Christmas and New Year period than last year, and bearing in mind this is the most difficult time of the year we have performed well despite considerable pressure at times. It is fair to say that Heartlands has continued the improvement more successfully than Good Hope, and our analysis suggests that this is because the improvement was based on improving discharge performance, whereas Good Hope relied more on ‘front end’ changes. However, the new team in Good Hope have picked up the baton and, supported by really good engagement from the staff, are conducting another Perfect Week starting tomorrow (sincere thanks again to Pete Gordon of ECIST for supporting).
There will be no let up. Heartlands will be focusing strongly on the Acute Medical Unit this week, and Solihull Hospital are getting in on the act too, with a ‘Beyond Perfect’ initiative (!) coming very soon!
These charts show the whole Trust 4hr target performance in recent weeks. The Perfect Week initiative commenced on Monday 16 December
As a Trust under scrutiny, it is great to be performing ‘in the pack’ rather than behind it. It is also fantastic to see the staff feeling the benefit of systems that are working better, and engaging in further improvement work, which can only be good for our patients
Actions following the Kennedy Review
Following the publication of the Kennedy Review, we have pulled together 10 work programmes. Our Chair will oversee the implementation of these over a 6 month period, and I am delighted that a representative of the affected patients has kindly agreed to join us. Here is a flavour of the actions:
- values-based recruitment of consultants
- strengthened whistle blowing policy
- building a patient-centred culture (we are delighted that Professor Sir Muir Gray is helping us with this)
- review of disciplinary processes to ensure patient safety is not compromised as an unintended consequence
- review of our approach to gaining the consent of patients for procedures
- improved support for medical leaders
- improvement to the breast clinic environment
- revision of quality information coming to Trust Board
- revision of work plan of Board Quality and Safety Committee
These are forward-looking programmes that will, I believe, place us at the forefront in many respects. Six months is a tight timescale but it is important we move speedily
CQC report and Quality Summit
Following our visit by the Chief Inspector of Hospitals in November we recently received the final report and had our Quality Summit on Jan 9th. We were visited at a time when we were really struggling in our Emergency Departments, just before the recent improvement work and additional community capacity came on stream. The various impacts of these difficulties form the main negatives in our report, so we were not surprised. We were surprised to receive a Warning Notice so long after the inspection, given that the team declared there were no significant safety concerns when they were with us. However, as I have documented we have made substantial progress since then and I am confident the issues in the Notice have been addressed. Our improvement actions in respect of urgent care are progressing well and are part of our formal Enforcement Undertaking with Monitor, so our response will include, in essence, the same actions
We were pleased that the written report re-affirmed the caring and committed approach of our staff, who acquitted themselves very well
No ‘Ofsted-style’ rating as yet. I expect it will be soon, and I guess it will point to the improvements required in our ED’s and related areas. These are tough times for our Trust, but we are focusing on the right priority areas and I am sure we will continue to improve steadily in 2014
Cedarwood opening – Good Hope Hospital
On Friday we had the official opening of this unit, based at Good Hope Hospital. It is a collaborative venture with the excellent Midland Heart, who run the unit using their care staff, rather than health workers. Cedarwood is a reablement unit designed to bridge the period between recovery from acute illness and a return to independent living. It opened to patients in November and is now full with 29 residents. We planned a maximum length of stay of 30 days but, so far, it is running at around 7 days, which is excellent. Here is some of the BBC coverage. This is an innovative venture, which we will extend if the evidence shows it is effective. It is also an excellent example of how collaboration between the NHS and other sectors can benefit patients
There are many heartwarming stories already, and I was delighted to hear that the Kings Fund will be evaluating the project for us. I am very grateful to Esther Rantzen for coming to mark this occasion, which included the residents and was great fun. Esther also took the opportunity to remind us of the Silver Line initiative that she founded, which offers support to older people
Innovation at Heartlands
Continuing on a positive theme, I am delighted that the innovation of one of our doctors, Ajith George, has been recognised with a substantial grant from the Research Innovation Fund by NHS England. Ajith has worked with colleagues in ENT and IT here at Heartlands to develop a device that uses the power of smart phones to capture images of patients’ ears, noses and throats – these can be used to explain conditions to patients, and for recording and referral purposes. This website has more information
No expensive equipment is needed, so it will have wide application across the world. Excellent!
NHS Change Day
And finally, I must mention another excellent initiative – NHS Change Day. It started last year and it represents a true social movement within the NHS. Last year I led a Twitter Chat with two colleagues. This year I have risen to the Kickstarter Challenge and made a pledge:
“I will support 5 new patient experience improvement projects, from 5 clinical teams, if 300 of our staff sign up for the #hellomynameis initiative”
We are just sorting the 5 initiatives but ideas so far include new visiting arrangements in day surgery, hot food for patients having chemotherapy, and improved overnight facilities and arrangements for relatives staying in hospital to help out with patient care and support
A brilliant initiative, as indeed is the #hellomynameis idea that was started by Dr Kate Granger and is gaining very widespread, and well deserved, support
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