Friday, 22 December 2017

Thank you and best wishes for the festive season

As the end of the year approaches it provides an opportunity for reflection, thanks and a look forward.

2017 has been a particularly significant year for Pennine Care with many achievements and challenges along the way.  Some of the most notable things to happen have included posting a financial deficit for the first time; strengthening joint working arrangements with commissioners; moving forward with the CQC/quality improvement plan; mobilising the Manchester Resilience Hub in response to the Manchester Arena attack; implementing the new operating model to create locality groups and combining mental health and specialist, as well as the appointment of a new Chief Executive and Chair.  So it’s been a pretty eventful year! 

Despite the amount of change and challenge facing the organisation as a whole, our staff have continued to work tirelessly to provide care to patients.  This applies to those in clinical roles and enabling support roles.  In fact, staff couldn’t be working harder and many services are running over capacity.  I’ve talked about the need to redress the balance between demand and quality previously and this will continue to be a priority theme into next year. 

When I joined Pennine Care in September, I said that I wanted to refocus on staff engagement because I believe that if we properly look after our staff, we will in turn provide the best care to patients.  From speaking with many of you, there is clearly a great deal of passion and commitment from staff, who put in a lot of discretionary effort, but there is a sense of people being quite tired and weary.  My overall impression is that staff do like working here and there is a strong sense that people are really up for a new approach to take us into the future.  Improving how we support and develop our workforce will also be a key priority for 2018.  

This year we have also held our largest ever giving back campaign to provide those less fortunate with food and gifts over the festive season.  The response from staff has been phenomenal, everyone has been extremely generous.  We raised £150 from the Christmas jumper day, donated 35 Christmas shoeboxes to homeless appeals and made many considerable donations to food banks around the Trust footprint, enough to fill 58 car boots! 

I would like to thank each and every one of you, staff, volunteers and supporters alike, for your continued hard work and commitment over the last 12 months, it hasn’t been an easy journey but there is much to be proud of.  I want to continue to build on our success into the next year and work more closely together across the Trust to overcome the challenges we face. 

I wish you all the very best for the festive season, especially to those working over the Christmas period.  I look forward to working with you all in the New Year.

Many Thanks

Claire Molloy
Chief Executive

T: @ClaireMolloy2

Friday, 8 December 2017

Delivering on our intent

I’d like to start off by saying thank you to everyone who took the time to read or respond to last week’s blog – it has been viewed nearly 1600 times and I have received direct feedback and comments from around 40 members of staff.  

If you haven’t read it, the post basically talks about how we need to strike a better balance between the capacity and demand on services, so we no longer compromise on quality standards.  Too often our services are being stretched too thinly to meet increasing demands.   It obviously struck a chord with many of you and I am very appreciative of you taking the time in your busy working lives to read the blog and comment. We just have to deliver on this intent now!

As I mentioned, we have started to address these issues with commissioners and a key meeting is being held next week between our executive team and the chief officers from our clinical commissioning groups to discuss the approach we would like to take and to put some stakes in the ground. We need to find ways of supporting our managers and clinical leaders to have some of these conversations too, within a framework but knowing we have your back.  Whilst it may involve complex negotiation, I am determined that we will be driven first and foremost by quality standards that ensure our services are safe.  

Because we know this will involve transformational change, we need to find ways of bringing the leadership of the organisation together to have those difficult discussions about how to tackle our financial challenges in such a way that we don’t compromise quality. To support our collective leadership, I will be holding a workshop next week involving our managing directors and senior leads to agree how we will approach this. As you know, the Board has agreed to run a deficit for this year and next and we know we can’t improve the financial position by simply top slicing budgets further and further. But we do need to explore how we can deliver our quality aspirations in an affordable way.  

The Board and the Council of Governors had a workshop this week to go over some of the Trust’s main priorities.  I have talked about these in my blogs before, but this includes:
  • being clearer about our long term strategy; 
  • implementing priorities around quality, people, partnerships, money and infrastructure; 
  • and changing the way the organisation is run to create a positive culture of learning and improvement.
It was a welcome opportunity to work more closely with our Governors as representatives of people who use of our services and it was helpful to listen to their views.  We had a particular focus on progress on delivering our CQC Improvement Plan and in particular, the need to address mixed sex accommodation issues on our mental health wards. I am keen to ensure we continue to have an open, co-production approach with the Governors, involving them in future service redesign.

Finally, because I had such a good response to the last blog, I am really keen to hear from staff about what other topics you think are important.  Whilst my blog is an opportunity for me to tell you what I’m up to, it is a platform for you to ask for comment or feedback on burning issues.  If you have anything you think staff would like to know more about, do drop me an email to let me know. 

Many thanks

Claire Molloy
Chief Executive 


Friday, 1 December 2017

No more compromises on quality

Over the last few weeks I’ve been hearing some pretty strong messages coming from staff about the pressures they are under, facing increasing demands and a never ending flow of referrals.  From talking with clinical leaders and managers at the planning day last week, I heard lots of examples of where services are stretched too thinly and as a result you aren’t able to provide the safe and high quality levels of care you want to.     

We have very caring and committed staff who want to do their very best for people who use our services and I know you have been very accommodating in trying to stretch services to meet increasing demand. But it is not acceptable for our services to be stretching caseloads beyond their means without this being recognised with additional resources. This isn’t good for our staff, it certainly isn’t good for patients and it hides a fundamental problem of a mismatch between the expectations of our services and available resources. 

So what are we going to do about it? 

As a start, we need to be having a different conversation with our commissioners about what we can provide within the resources we are given, as is starting to happen at a national level about the total funding the NHS has.  We should not be trying to meet greater and greater demand, with an expectation we can continue to provide everything we currently do, if this means we are providing a lesser standard of care.  There should be no more compromises on quality. 

In order to change things, we are beginning to have this conversation with our commissioners about the quality, financing and demands of our services.  We have signaled an intent to agree some clear and fixed standards of quality for all of our services and to co-produce with staff and our commissioners a service offer that ensures we can deliver to these standards. 

This may mean not being able to provide everything we currently do. I know how difficult it is for staff to say ‘no’ when all you want to do is provide care and support to everybody who needs it.  But if it isn’t safe or affects quality, then we are going to have some difficult discussions about a different service offer and what we potentially won’t be able to do. So, agreeing these standards, thresholds and pinch points needs to be a clinically-led discussion, in collaboration with our commissioners, service users and local communities.

As a starting point, we are currently working on putting some quality principles into our contracts for next year for those services that are struggling the most, which includes our mental health wards, district nursing and community mental health teams.  This will provide us with a lever through which to start negotiations about what resources these services need in order to meet demand and provide safe, high quality care.  It also means that staff can be clearer about what is and isn’t acceptable and are empowered to escalate when safety or quality is being impacted.  

These improvements won’t happen overnight, but I want to reassure staff that you have the full support of the Board to address the challenges facing you on the frontline.  We need to support you to get back to providing the very best care you can, without compromise. 

I’d be really interested in hearing your thoughts about this, so do email with any feedback.

Many Thanks

Claire Molloy
Chief Executive