Friday, 16 February 2018

What is our North Star?

For those of you who have worked in the NHS for some years, you will recall it is just over 5 years since the publication of the Francis Report. Published in 2013, this report was the
culmination of a public inquiry into serious failings at Mid Staffordshire NHS Foundation Trust.

The damning report detailed first and foremost the appalling suffering of many patients. This was primarily caused by a serious failure on the part of the provider Trust Board, which didn’t listen sufficiently to its patients and staff or take action to address quality failings.

Also in the news over the last few weeks has been the report of the Independent Review undertaken by Sir Bill Kirkup outlining widespread failings surrounding community health services at Liverpool NHS Community Health Care. The findings make depressing reading as they highlight once more the dreadful impact for people of a disproportionate focus on the prioritisation of cost improvement plans over quality and patient safety; and the stress and adverse consequences for staff who tried to raise their concerns.   

As a number of key publications have done in the national media, this latest story calls into question just what has changed over the last five years? I have been ruminating on how we here at Pennine Care can avoid some of the mistakes highlighted in the report, especially given our challenging financial position. Of course, we all need to ensure we do everything we can to reduce waste and stop doing things that don’t add value. But how we do ensure that we do this in a way that doesn’t unintentionally impact on quality?

With this in mind, I think there are three key areas we need to focus on to mitigate this risk:

1) First and foremost we need to be clear on what guides us – what is our North Star? We should always place the development of high quality, compassionate and continually improving care and support at the heart of everything we do

2) Secondly, we need to ensure that any proposals to change services or reduce costs are always properly assessed for their impact. And not just with regard to each scheme but collectively. I keep saying that it’s like losing weight – a pound seems like a small amount, but if you keep losing a pound every week, pretty soon you are going to be in serious trouble! So, we must assess risk properly and produce Quality Impact Assessments to ensure any savings proposed are done so with a robust consideration of the impact on quality and safety

3) Finally, building on the Francis Report, we need to create a culture where people feel able to tell someone if quality is being compromised. You are our eyes and ears of this organisation and if you see things you’re not happy about, you should not be afraid to speak up. And if you hear or see stories of people who have been penalised for doing so, this is not acceptable and I want to know about it and understand why to ensure it doesn’t happen again. Our Freedom to Speak up Guardian (Lisa) is always on hand to listen if you don’t feel able to raise concerns with your managers.

I want to end this blog on a high and to say how pleased I am that our ‘Fluperheroes’ have worked so hard to ensure we are in the top 5 most improved Trusts in the Country for vaccination rates – well done! We are just a handful of people short of our 60% target, so if you haven’t had your vaccine yet, please see the intranet for details of how to get this done.

I’m always keen to hear your thoughts, so do email with any feedback.

Claire Molloy

Chief Executive

Friday, 2 February 2018

A couple of weeks with a focus on partnership working

Over the past couple of weeks, I have been meeting with partners to discuss our service contracts and plans for next year. We’re really getting down into the nitty gritty now of what we can and can’t do and we will hopefully be crystallising some joint decisions over the next few weeks or so.

I have been flagging with commissioners the implications of funding for some of our critical improvements, such as safe staffing, and what the potential consequences are if money isn’t forthcoming. I have talked previously about the need to ensure our service offer matches the resources we are being given and we have an important workshop on 20 February to try to reach some agreements about a number of key areas. We would then be taking these to our Board on 28 February to agree our Trusts approach. So watch this space for further updates.

This week, I also met with colleagues from the Northern Care Alliance, which is collaboration between a number of NHS Foundation Trusts currently bringing together five local hospitals, 2,000 beds, specialist and acute services, a range of community services, and over 17,000 staff from Salford Royal NHS Foundation Trust and The Pennine Acute Hospitals NHS Trust.

We discussed potential opportunities for Pennine Care to work collaboratively with the Alliance and spent some time sharing each other’s agenda’s and looking for ways we could work more closely together, particularly on Out of Hospital’ models and Urgent care pathways. This could, for example, include some joint posts going forward. 

We haven’t agreed anything specific at the moment, but it was a productive and friendly meeting and we have agreed a follow up session soon to explore what some of these opportunities might look like in a bit more detail. We will ensure colleagues in our locality teams are kept engaged in this and I will continue to keep you informed of progress on this key piece of work.

One thing that has struck me this week on a visit to HMR community services is the spirit of our staff and their ‘can do’ attitude. It’s been a difficult six months for the team and services there, with a lack of Managing Director until very recently and ever increasing demands on their services. But they have really stepped up to the plate and continued to provide the level of service our patients expect and deserve. They have established good relationships with our partners and demonstrated some great examples of cross borough working, which I think is fantastic. Well done everyone!

I appreciate that there’s a lot of change going on at the moment, and I have picked up some anxiety and concerns from you all about what this might mean. The implication of our financial position and what services we will be able to provide in the future is no doubt a worry to many of you. I also know that when money is tight people worry about what it might mean for them personally. 

Through our Partnership Officers at our JNCC meeting this week I have picked up some concern that some of the engagement we have been doing recently, for example on our Mental Health Strategy and case-loads within Community Mental Health services, is creating some anxiety for people about what it means. 

Can I just offer some reassurance that this engagement comes from a very positive place of recognising just how much pressure our services are under and trying to seek your views about we should do to try to address these pressures. We have hugely caring and skilled staff and we need to do everything we can to retain people. 

The improvements we most need to make are about reducing the stress and strain on our staff not about reducing our workforce. So please be reassured, I am committed to keeping you engaged and informed in how we can improve things, and will continue to engage with you on a personal level and via our leadership teams.

And on the subject of engagement, I would encourage you all to participate in the Go Engage surveys which take place across the Trust once a quarter; these help me and the Board to understand what it feels like for you working here. The next one is due out very soon and there is a celebration event of the teams who have engaged in this programme in March which I am very much looking forward to attending. No doubt details about this will follow shortly.

I’m always keen to hear your thoughts, so do email with any feedback.

Many Thanks,

Chief Executive