Everyone at Blackpool Teaching Hospitals continues to focus a great deal of time and effort on making improvements to services and ensuring that the quality of everything we do makes a tangible, positive difference to the lives of local people.
This has continued even alongside the huge and undeniable draw on our energy and resources from a virus that has dominated our lives over the past 12 months.
In particular, we have been working on the issues raised as part of the feedback from our latest Care Quality Commission (CQC) inspection in 2019. The regime, often likened to the way Ofsted works within educational settings, categorised the Trust as ‘requires improvement’ overall, although there were some areas recognised as providing ‘good’ services and our community health services for adults were ‘outstanding’.
This is important. There are great people doing great things in the Trust and while we need to improve, we should always remember that too.
Over the past 18 months or so and in direct response to some of the issues raised in the CQC report, the Trust has implemented some significant changes and improvements, even as we have been truly stretched and utterly exhausted in our monumental response to Covid.
I’m really proud that we have been able to do this and I’d like to thank teams across the Trust for their determination, resilience and hard work. Everyone has been amazing.
I wanted to share some of the results, which I presented in an update to the health and social care system in Lancashire and South Cumbria last week, supported by colleagues from the Trust and the wider team across health and social care in Blackpool, Fylde and Wyre. The depth and breadth of improvements really is incredible and whilst we’ve still some way to go, I wanted to share some of the headlines with you too. They included:
- A focus on staffing and ensuring we have the right people in the right ratios on our wards to ensure safe and effective care is in place – this has been difficult during Covid as the number of people needing hospital care escalated beyond any previous precedents
- The pressure on staffing meant a quick and determined focus on recruiting more trained professionals and this has included an overseas search with almost 200 much needed registered international nurses welcomed into the team
- The introduction of a ‘ward accreditation process’ aimed at raising standards and celebrating best practice across the organisation using unannounced visits has been developed and introduced – we are already celebrating some ‘silver’ wards with a real ‘race for gold standards’ underway
- Investment in Quality Improvement techniques across our divisions and clinical teams is making improvement everyone’s day to day focus
- Prioritising the health and well being of staff, including encouraging them to complete their staff survey to identify the most important improvements, bolstering our Freedom to Speak Up approach and ensuring everyone has been vaccinated against both seasonal ‘flu and Covid
In addition, the Trust has worked across the wider health and social care system to ensure the annual winter pressure found in our hospitals has been managed effectively, particularly alongside Covid this year. We have focused on improving patient flow even when faced with huge demand for inpatient treatment, drastically reducing the number of people who wait more than 12 hours for a bed and also working with colleagues at North West Ambulance Service on efficient handovers between paramedics and the A&E team.
The national ‘111 first’ programme which introduced the ability to book urgent care appointments in advance instead of ‘dropping in’ was piloted at The Vic and successful in reducing both the number of people in A&E and Covid infection spread too.
We have also revised our governance structures and processes to ensure our work plans are effective and we can provide assurance to the Trust Board and regulators about effective progress and improvements being delivered.
Whilst we have not been fully reinspected by the CQC, the team did conduct an unannounced visit to A&E and some of our medical wards on one of the busiest Mondays in January at The Vic.
I was delighted they found no issues for immediate action and moreover that they were complimentary in their feedback, specifically in relation to:
- A busy but well controlled and calm environment at A&E
- Staff who were helpful and supportive despite the moment being pressured with huge demand for services
- The general cleanliness of the hospital
- The way we were managing staffing under huge pressure in a positive and measured way
We have not yet received the final report but that we will respond positively to any actions required of us in the report.
We have also recently been visited by colleagues from the North West team at NHS England and NHS Improvement (NHSE/I) focused primarily on infection prevention control measures in place and also by Health Education England’s North West Team (HEENW) checking in on our support for junior doctors and medical education. Both provided positive feedback and will help us to continue to identify how we can be more effective.
The Trust will implement a new structure on April 1 designed to provide more capacity, more capability and better outcomes for both staff and local people. The review of our current structures began last summer and has explored, in significant detail, whether a different approach to the way services are grouped and managed would deliver improvements.
The new structure includes the creation of a tertiary division as part of the Trust and four reconfigured, complimentary divisions to deliver services. I am confident that it will deliver the best possible, integrated care for local people and the most effective support for staff to develop and be supported to achieving the very best quality of care.
The new structure aims to ensure services are in the right place being delivered by the right team, avoiding duplication, inconsistency and inequity of roles. It will also help us develop services such as our cardiothoracic, haematology, the National Eye Service and cystic fibrosis. It also provides a real opportunity to look at the way our current divisional structures work together to support integration and collaboration with partners locally, regionally and nationally across the NHS, wider health and social care, local government and voluntary, community and faith sectors.
I talked last week in the blog about ‘cautious optimism’, in the context of the welcome reductions in community prevalence of the virus and hospital admissions connected to Covid.
This week I would like to be bolder in the wider context that we are making improvements, we are making a difference and we will continue to do so. On this front I am feeling very optimistic indeed.
Chief Executive, Blackpool Teaching Hospitals NHS Foundation Trust