In the two months since we last met, our Trust, our country and our world have been “changed, changed utterly” in the words of W B Yeats. Covid-19 has affected all of us, but its detrimental and devastating impact hasn’t been felt uniformly.

Despite the very best efforts of our clinical teams, 403 people (at the time of writing) have died from the virus at our hospitals. On behalf of the Board, I extend my sympathies to their families.

I would like to remember, in particular, two of those who died who worked with us. Amrik Bamotra was one of our radiology support workers. Paying tribute, his colleagues spoke of losing a “kind-hearted, patient and caring individual” and his son told us that his father had “touched so many people’s hearts with his personality”. Onyenachi Obasi was a healthcare visitor who worked for many years, at the weekends, as an agency nurse at our Trust.  She was a popular and much-loved nurse and her niece said she was an example of “unconditional love” and was dedicated and caring.

As well as our obvious sadness at the loss of life, we have drawn comfort from the fact that more than 1,300 people have been discharged from our hospitals who had either suspected or confirmed Covid-19. We are capturing the growing number of recovered patients with our Tree of Life displays at Queen’s and King George (KGH). A sticker of a bee is placed on one of the trees each time someone goes home. We often mark their departure with applause as they leave our wards. This is particularly pleasing when the patient is a member of our own staff.

I am immensely proud to be Chief Executive of this organisation and its 7,000 employees. Our doctors, nurses, and healthcare assistants; our porters and cleaners; our admin, IT, corporate, procurement, estates and pharmacy staff; and our AHPs, therapists and scientists have all worked tirelessly to ensure our patients receive the very best care. They have been flexible, agile and embraced new ways of doing things. Many have adapted quickly to working in different areas and in new roles. Together we have navigated the many and varied challenges that have included, among other things, changing our bed base at pace, personal protection and testing. We’ve approached them all with a resolve and a good humour that has frayed only occasionally!

Since March, Queen’s and KGH have been transformed as we’ve adjusted to Covid-19. We increased our intensive care capacity five-fold and the teams, who achieved that feat, also managed to get a renal dialysis unit up and running in critical care in ten days. Three months ago, our outpatient departments were operating in ways that had remained the same for decades. Last month, almost 5,700 appointments were held over the phone.

We went from having three Covid wards at the start of the pandemic, to running 20 as we neared the first peak in the number of infected patients. We protected those with cancer by moving their treatments to a ‘Covid free’ nearby hospital and we did the same for people needing trauma care.

Thanks to the support of our partners we have made our hospitals as safe as possible. One of our achievements has been to ensure prompt discharges which we have done by working closely with our three local authorities, our commissioners and the North East London NHS Foundation Trust (NELFT). In one week, at the end of March, we went from having 408 patients who had been with us for seven days down to 140.  NELFT has also helped us with our discharges by setting up 117 additional beds at their Goodmayes site – in just 15 days – to be used by those who are medically well enough to leave an acute hospital but who still require a community bed.

Another aspect of our partnership working that I am proud of is the fact that our lower paid workers, who are employed by Sodexo and Interserve, now receive the London Living Wage. I am determined that those employed by our contractors feel just as much a part of Team BHRUT as everyone else.

Throughout this process, we have kept our patients, our stakeholders and our public informed. One of the really difficult things we have had to do, to ensure patient safety, has been to limit the number of people who have been able to visit our wards. We have tried to ameliorate this by using donated iPads for video calls and setting up a Thinking of you service for people to send in messages that we then deliver to our patients. We have received more than 1,000 such messages via our website.

We have also used our website, our social media channels and the mainstream media to update people on our progress. Our Chief Medical Officer, Dr Magda Smith, has appeared a number of times on The World This Weekend on Radio 4 to talk about the achievements of our teams.

I am aware that these achievements have taken their toll on our staff. It was one of the reasons why, with our Chair, Joe Fielder, I wanted to write to the relatives, loved ones and friends of our employees to thank them for the support they have given our colleagues.

It has been an anxious and a stressful time. We have responded to the increased wellbeing needs of our employees by setting up dedicated rooms at both sites where people can sit, relax and recharge during their breaks. These spaces have proved invaluable and will continue to exist, going forward. We are also offering psychological support on the phone and in person.

Our charity has played a key role supporting the needs of our staff. One aspect of their work has been to coordinate and distribute the extraordinary range of donations we have been privileged to receive. These have included in excess of 100,000 portions of food and drink; 12,500 Easter eggs; and sofas for our staff to use in our wellbeing rooms. 

Another critical concern that we are responding to is the emerging evidence that Covid-19 is having a disproportionate effect on our black, Asian and minority ethnic (BAME) communities. The Office for National Statistics' figures recently showed BAME people are significantly more like to die from the virus than white people. We have made this issue an absolute priority at our Trust. While we wait for the outcome of the work that is being carried out by NHS Employers, we have decided to act immediately and decisively.  

Our focus is on finding out more about what is happening to our BAME staff and making sure that everything is being done to support them. This programme has the following elements: data collection; sickness absence review; staff testing; review of risk assessments previously undertaken; and a further round of risk assessment. As a precaution, we decided to offer risk assessments to be completed by BAME colleagues similar to the ones we have done for those categorised as vulnerable and at risk. The data collection has involved an evaluation of our staff (by ethnicity) who have tested Covid-19 positive; self-isolated; and/or been deployed to Covid-19 areas.

We are fortunate to have Joan Saddler as one of our non-Executive Directors. Joan is co-chair of the NHS Equality and Diversity Council and she helped to produce a recent NHS Confederation briefing on the subject. 

 

We all know that we have to adjust to life with Covid for the foreseeable future, rather than to life after Covid. The experience of recent months has left many of our staff both understandably weary (we are ensuring people access the support they need and take leave) and very proud to work for our Trust. We’ve filmed some of our colleagues and given them an opportunity to articulate their experiences. Their messages are varied but can be summed up with the words: No Going Back.

I am determined not to return to redundant ways of working and not to squander my colleagues’ pride in our hospitals. In the coming weeks, we will provide more information as to how we will bring back services we have paused, while also caring for Covid and non-Covid patients across our sites. The challenges that now confront us are even more complicated and complex. In the coming months we may be doing all this as we also respond to further waves of infection.  

I would like to end with a word of thanks to the communities we serve in the boroughs of Barking and Dagenham, Havering and Redbridge (BHR). Our residents have abided by the advice of the government and endured the restrictions we have had to impose on visiting. They have shown considerable understanding and have helped to ensure that we were well placed to tackle the virus and not be overwhelmed by it.

Every week, people have gone out into the streets to clap for NHS staff and other key workers. I will, for ever, remain grateful for the responsible way our residents have responded to this crisis. In return, we will work hard to provide them with safe, reliable and outstanding services.

Tony Chambers
May 2020