Chief Executive’s Report January 2020

I am pleased to provide my update for January 2020 for the Board’s attention which has been written during my first few days at our Trust. I am devoting this time to meeting and listening to as many members of staff, partners and stakeholders as I can, so I can build a coherent picture of what our Trust has achieved and what our priorities should be at the start of this new decade. What I have learnt so far has been encouraging and I would like to thank my predecessor, Chris Bown for the work he has done.

Our latest CQC report was a particularly pleasing read. Although our overall rating has remained the same, we are now rated as good in three of the domains, including well-led; our staff were praised for their kindness and compassion; and we were told by England’s Chief Inspector of Hospitals, Professor Ted Baker, that we were definitely moving in the right direction.

Another indicator that we are changing for the better is that close to 6 out of every 10 members of our staff took part in the annual NHS Staff Survey which is our highest completion rate in fifteen years and it will improve the feedback we receive on what it is like to work here and the changes we need to introduce. We will share the survey results with you when they are published.

Financial recovery

Our year to date results for December show a deficit of £41.9m which is £5.9m better than the same period last year but £4.8m behind our plan for this financial year. We continue to spend more than we earn at a rate of £5m per month. This is happening because our Quality Cost Improvement Plans (QCIPs) are delivering at a slower rate than expected. In response to this we have tightened and strengthened our processes around how we spend our pay and non-pay budgets. We are also now looking at why the QCIPs have not delivered in the way they should have done.

Our financial position is clearly a stubborn problem. We will have to raise our game and do better in the next financial year when we must find a way of reliably delivering our savings programme. I am optimistic that we can. I am keen that we are really purposeful when it comes to the parts of our non-pay budget that we have discretion over.

We have almost finalised our plans for spending the £9m capital loan that we have received. It will support the first phase of investment in our IT infrastructure (subject to Board approval of the business case); much needed replacement of medical equipment; and essential maintenance work at King George Hospital (KGH).

I was delighted to learn during my first (of many) visits to KGH about one example of where our limited capital resources are being spent to good effect. Our 16 year old cardiac catheter laboratory (cath lab) equipment has been removed; a temporary mobile unit is currently being used; and the newly refurbished cath lab is due to open in two months time.

Constitutional standards

It is clear to me already that we will have to deliver a step change in our urgent care performance and put in place improvements now that will pay dividends by the time we, once again, start the cycle of the winter months at the end of this year. We must reduce delays not just because of our targets, but because of the impact they have on our patients and on our staff.

On the four hour target our performance for December was 67.65% which falls short of our agreed target set with our local system of 82.71%. Last month, average daily attendances increased by 10.25% when compared with December 2018. If attendances had remained the same as the year before, our performance would have been 74.9%, a 7.81% improvement on actual performance.

At the end of last year, we took the opportunity to refresh our data relating to the 62-day cancer performance for the first 6 months of the financial year. We have established that we met the target of 85% from June to September but did not do so in October or November. This was mainly due to challenges in our prostate pathway which we are addressing, in part, by investing in additional pre-operative assessment capacity.

On Referral To Treatment (RTT), we reported 9 patients over 52 weeks for November which was in line with the trajectory we have agreed with our commissioners.

Our diagnostic performance dipped in December, after two months of meeting the target, with a performance of 1.16% breaches against a national standard of 1%. One of the contributory factors was a slightly higher number of breaches for MRI which was caused by machine breakdowns last month.

Clinical Strategy

With the General Election and the period known as purdah now at an end, we can once again resume our conversations about the future shape of our two hospitals with our councillors, stakeholders and the public. To this end we are holding a series of public listening events in Ilford, Romford and Barking that I and my colleagues are attending.  

Partnership working

Previous CEO reports have covered the partnership board that we have established with our neighbouring trust, Barts Health. This has now expanded to include another of our neighbours, the Homerton University Hospital Foundation Trust, and has become the Acute Collaborative Group for the acute providers in north east London. It will focus on key clinical pathways including neurosurgery, vascular, mechanical thrombectomy and neuro-rehabilitation.

Closer to home, we continue to support our commissioners who are leading on the work to design how the health and social care provided in Barking and Dagenham, Havering and Redbridge (BHR) will look from April 2021 onwards. We are also working with our partners within BHR on the development of Primary Care Networks and on the implications for health and care of the growth in housing stock (with developments at Barking Riverside, St Georges and Beam Park) and the related and anticipated growth in population. In addition to all this work, we are collaborating with the North East London Foundation Trust (NELFT) to better understand what will be the benefits for our patients and staff of working more closely with them and forming what is known in the NHS as a Group Model.

Some amazing statistics

As you can imagine, I have read and watched a lot in preparation for taking on this role. One of the many things that caught my eye was our Trust’s end of year film capturing and providing a flavour of the sheer scale of the work we do across our hospitals, each and every day. I hope you enjoy it.

It just remains for me to wish you, very belatedly, a happy New Year. I am confident that 2020 will be an exciting and productive year for us all.

Tony Chambers
Interim Chief Executive
January 2020