Across the country the NHS is continuing to tackle the challenge of balancing limited capacity with high demand. That’s the number of patients needing healthcare but also their acuity, the extent of the clinical issues they have. Locally that’s affecting the ambulance, community, primary care and social care services…it’s not just us. To deal with that in the hospital our teams have been huddling and planning how we respond, creating a plan, while continually adapting the plan to the most recent information. It’s at times like this when you see how good our staff are, and how they keep it going (it’s very impressive – and I do like how we huddle to access the experience and brilliance of individuals).
The actions from our huddles are about creating flow in the hospital so that patients can move to the next stage of their care more effectively. They include: agreeing the additional areas of the hospital where we can use beds for emergency patients (or sometimes put in extra beds where it is safe and we can staff them), the order in which we open them (and, importantly close them, to enable planned appointments to go ahead); we are tracking every single patient who is fit to leave and working with partners to find them placements and care packages, working with the South East Coast Ambulance Service over the peaks of ambulance arrivals to reduce ‘batching’ and ensuring we can take their patients as quickly as we can so they can get back on the road, and; liaising with other trusts so ambulances go to the best place at any particular time.
We’re very much working as a system on all this. Ashford and St Peters have been accepting more ambulances at specific times in order to support us, Surrey and Sussex social care teams, First Community, Sussex Community and the Integrated Care Boards [and more besides] have been working assiduously with us, patient by patient, on that list of people ready to leave hospital. I met the Deputy Finance Director of the NHS yesterday (Peter Ridley) and he was interested to hear what was going on behind the data they see centrally. I said that although all this takes us away from some strategic work it means that the new integrated systems are establishing in real life the ways of working that we need to embed if we are to meaningfully establish integrated care. [It was really helpful to have the conversation with someone from ‘the Centre’ in a small group yesterday and I appreciate how he and the Finance Director of our Region (Steve Gooch) approached that].
I should also say something about mental health services, which are also experiencing pressure on their capacity. My meeting with Peter and Steve included the visit to Farnham Road Hospital in Guildford (part of Surrey and Borders Partnership - SABP) that I mention below, and the SABP team told me about the increase they have seen in demand. Again that’s numbers, but also acuity.
So NHS and social care staff are all dealing with these pressures and I am impressed with everyone’s continued focus on calmly doing the right thing for our patients. I recognise it’s been tough, and that’s one of the reasons we’ve worked hard to make sure our Big Thank You event can take place again this year. This year we are inviting our partner organisations, so it’s great that we are able to invite all health and care staff in the patch to the event on 2-4 September. Tickets went on sale yesterday and you can buy them here.
I really enjoyed the visit to Farnham Road Hospital yesterday and thank you to Ian, Andy, Claire and Sima for showing me round. I got to see first hand the care and attention that they provide to their service users and what a modern mental health unit looks like, including their ‘place of safety’ suites and one of their secure wards. The ward has individual bedrooms for service users and, my goodness, it’s good that we’ve moved way beyond the dormitory wards we had open even a few years ago. There was some striking digital kit there too, and I was particularly impressed with their remote monitoring technology and how it helps them to check on vital signs of service users at a distance and therefore maintain safety.
We must not forget our Green Plan! We launched it earlier this year and I wanted to take this opportunity to tell you about a couple of bits of progress..both are also about the benefits of investment.
Firstly, I’m pleased to hear that a project to introduce multi-use sharps containers orchestrated by the estates and facilities and health and safety teams (with some skilful steering by Lee Edwards our Head of Procurement, even though this wasn’t really about procurement) has had a really positive impact on our waste management system. We identified the need to retire old products due to their non-environmentally-friendly disposal method, which would see both the containers and their contents incinerated after one use. Since establishing new Sharpsmart containers in February, the team has prevented 13,620 single-use containers from being manufactured, meaning that almost seven tonnes of single-use plastic will not be incinerated. The new products have also contributed to the collection of 1,000kg of metal materials for recycling. It’s also improving health and safety with sharps. Well done to all involved!
Secondly, this week I met with Lewis Jackson from Metrobus, the company that runs many of the buses that transport staff and patients to and from our hospitals. It was great! I am really pleased that our conversation confirmed how aligned our two organisations are on two specific things: 1) on our approach to green actions from using public transport and their zero emission investment (they are buying very expensive new buses), and; 2) our wish to reduce general reliance on cars to get to the site and helping patients and staff be better informed about using public transport. The investment is huge. Metrobus is swapping one third of its fleet for hydrogen-fuelled vehicles next year (so diesel buses go) and plans to become carbon neutral by 2025. This aligns with our Green Plan, which we published earlier in the year and sets out our goals around public transport…and it follows our ethos of commitment and actually doing something. On the point about improving information about public transport - keep an eye on SASHnet for details on the cheapest way to travel with Metrobus via their app! I also had the chance to put to him some of your questions from our Ask Paul session a few weeks ago and I’ll be in touch with updates from our discussions around improving evening bus timetables and connections between Crawley and East Surrey Hospital – watch this space.
Finally, a few weeks ago when I wrote this update I told you about the lung cancer screening in the community that our teams have helped set up as part of the cancer alliance. It was great to see footage from the launch publicised this week, with our very own Dr Kofi Nimako explaining clearly why this screening is so important.
Angela returns from her break on Wednesday next week, and I look forward to telling her about how everyone’s been working while she’s been away.
Best wishes
Paul Simpson
Deputy chief executive, chief finance officer and director of estates and facilities