Our virtual Board meeting will take place tomorrow at 12.30. The papers are available online. Ahead of it, I thought it might be helpful to share with you my Board report.

Best wishes. 

Tony Chambers
Chief Executive

Chief Executive’s Report May 2021 

It is a great pleasure, after the year we’ve all lived through, to start my report with some positive news. I’ve written repeatedly about the priority I place on the wellbeing of our staff. At the end of last month, we took some concrete action and organised a Thank You Week. The seven days of events were the culmination of months of planning by many individuals including the members of our Wellbeing Forum and our Wellbeing, Estates and Communications teams. 

During the week there was a real buzz around our organisation. We announced that we would be awarding everyone an extra day of annual leave and we gave our staff a gift voucher. One person wrote on social media that they would be using the additional day off to visit their father who they hadn’t seen for 17 months. 

We received the backing of West Ham players and the support of our partner Ceri Jacob from the CCG. The events that took place included yoga, African drumming and a fitness session run by Mr Motivator. The Metropolitan Police provided pet therapy when two of their horses and their wellbeing dog paid a visit. It was lovely to witness staff enjoying themselves after the difficult twelve months we’ve all experienced. 

Covid-19

The Thank You Week was a success and was well-received. It will not be a one-off. We will have an unremitting focus, in the months ahead, on caring for our staff as they continue to recover from the impact the pandemic has had on their professional and personal lives. Thankfully, the numbers of patients we are seeing with Covid-19 continues to reduce. The success of the vaccination programme - which we are proud to be a part of - and the work being done to encourage take up are significant factors. Vaccine hesitancy was one of the topics that was discussed when my colleagues Magda Smith and Remi Odejinmi were interviewed on BBC Radio 4’s The World This Weekend. 

As I mentioned in my March report, we marked the first anniversary of when the World Health Organisation declared the outbreak a pandemic. It was an opportunity to pause and reflect on its impact. Karen Chui, one of our orthopaedic registrars, is an amateur photographer and she has documented how those in our intensive care units responded during the peak of the second wave. Few people have escaped unscathed. After Robbie Muir (who worked for the London Ambulance Service) died last year those who knew him well at our Trust decided to fundraise for a bench in his memory. 

Closer working with Barts Health 

I have always been a strong advocate of health and care organisations working together for the benefit of the residents we serve and as a means of addressing and ameliorating the inequalities that exist in our communities. Now, under the umbrella of the north east London integrated care system, we are exploring with the Barts Health NHS Trust ways in which we can work together more closely to transform healthcare services for the benefit of patients, staff and communities, while remaining separate statutory bodies. 

Our discussions are at an early stage regarding the shape and nature of this collaboration. We will be talking to as wide a range of staff and stakeholders as possible over the coming weeks to listen to their views and to inform our discussions. We aim to come to a broad agreement on a model that will maximise the strengths of all of our hospitals, while delivering added benefits for our local communities.

Planned (elective) care

Like all NHS trusts across the country, the intense waves of Covid-19 that we responded to have had an impact on the other services we provide. Many though, including our Ophthalmology team, continued to operate through the second lockdown. The presence of the virus in our hospitals also made some anxious about attending appointments. So, it was helpful when the comedian Jimmy Jones was able to speak so positively about his treatment during the pandemic and it was inspiring that we were able to carry out a life-saving procedure for Dean Watson during a complex, 19 hour long operation. 

It is only by working with all our partners in north east London (NEL) that we will tackle our waiting lists properly. We started to resume our face-to-face outpatient appointments last month and partners were, once again, able to attend all maternity scans. Our diagnostic services are on track and running at full tilt helped, in part, by the opening of a new endoscopy room at Queen’s Hospital. 

When it comes to those still needing treatment, we must balance the requirements of urgent patients with those who have been waiting a very long time. It’s expected that the number of people on our 52-week waiting list will be down to below 2,000 by the end of June, which will be 800 fewer people than we had predicted a few months ago. Our cardio-respiratory physiology unit have been tackling their backlog by running clinics early in the morning, at lunchtime and on Saturdays.

With all of this work we must ensure we address health inequalities and not make them worse. Our cancer services are benefitting from not just one, but two important clinical trials we are taking part in.

Four-hour emergency access standard

We were starting to see promising signs as we built on our work to improve our performance and we reduced the variations in the delivery of the standard. This progress was interrupted following the recent Bank Holiday weekend, but we have worked hard to get back on track. Our goal, by the end of October, is for eight out of every ten of our emergency patients (all types) to be admitted, transferred to another provider or discharged within four hours. If we achieve this (with the ongoing help we’re receiving from our colleagues at the Homerton and Barts Health) we will be in the median of all other London trusts when it comes to measuring this crucial performance indicator. 

In March, we opened new facilities at our Emergency Department at Queen’s and our Beech Frailty Unit at King George Hospital (KGH) is caring for elderly patients in an environment that is much more conducive to their needs than a busy and noisy emergency department. 

As a result of the success of Beech, we now want to open a similar unit at Queen’s. It would support collaborative working at a NEL level by bringing together Geriatric and Frailty multi-disciplinary teams. Together, they would enhance the patient experience and ensure individuals were being treated in the right environment, at the right time, and by those best qualified to care for them. 

Our finances

Each month, we are still spending £6m more than we receive. This underlying monthly deficit excludes our spending on Covid-19. Our detailed plan is to end this financial year with a monthly run rate that is better than £5m. To achieve this, we have two priority areas we will focus on. 

We need to reduce the amount we spend on expensive agency and bank workers. We have improved both the recruitment and retention of permanent staff, but we’ve not yet seen the necessary reduction in temporary workers. We spend around £80m annually on temporary staff and a quarter of that amount covers the cost of premium rates. 

We also believe we can save £20m each year by carrying out our planned surgeries more efficiently. We’ll do this, in part, by maximising the use of available theatre time. 

Paediatrics update

In my Board report in November last year, I wrote about the temporary overnight closure of KGH’s paediatric Emergency Department (ED).  We are now in a position to re-open the department overnight in June, two months later than originally planned. By this time, we will have opened a Children and Young People’s Assessment Unit at Queen’s which will enhance the paediatric care we offer. 

I am delighted to also report that some of our doctors who work at both of our paediatric EDs are involved in a ground breaking research project that is focusing on young people who presented to ED with diabetes at the height of the pandemic. 

Our workforce

Quite rightly, our recovery programme - as we emerge from the ravages of Covid-19 – will focus on elective care, non-elective care and staff wellbeing. This needs to encompass our recruitment and retention and the ways in which we  enable people to fulfil their potential. These opportunities were explored at our recent careers conference that was attended by more than 150 delegates. The keynote speakers included Prerana Issar, the NHS’s Chief People Officer. 

Every day, as I travel around our sites, I meet and hear about some of the many extraordinary people who are dedicated to improving the life chances of the residents of our three London boroughs. 

In closing, I’d like to bring to your attention just three individuals whose recent experiences have stuck in my mind. Emily Petersen volunteered to support the teams working in ICU; one of our speech and language therapists, Dani Ferraris has been reflecting on how she gives patients in critical care a voice; and Clare Bailey has decided to speak out about living with a stammer. As Clare puts it, “having a stammer can be exhausting, if you let it overcome you. I live with it and don’t let it control me”. 

I am sure their stories will inspire you, in the way they have inspired me. 

Tony Chambers            
Chief Executive
May 2021