Chief executive's blog - 25 November 2013
In my personal blog, I will keep you up to date on what is happening at the Trust, sharing what I think we are doing well and what we can improve.
Fiona Dalton, chief executive
Firstly I wanted to say thank you so much to everyone for the warm welcome that I have received to Southampton, both in person, by email and through this blog. I have been very touched by everyone's comments. Several people have said to me "welcome home" - and whilst I am originally from Yorkshire and therefore will never be able to admit that anywhere other than that beautiful county is really home, it does feel great to be back in Southampton.
So far I have been chief executive here for three weeks and we have been on 'black alert' for bed pressures every one of those weeks. Every week, I have been acutely aware of what this means for our patients - those that come in as emergencies and spend too long waiting to get to a ward, and those that need elective care and whose operations are cancelled.
One of the consequences of these pressures is that we are currently failing the ED four hour target. I am absolutely clear that our objective is safe and high quality care for our patients and the four hour target is one of the useful tests of whether we are achieving this. However it is not the objective in itself.
Incidentally, I suspect the lesson from events that unfolded in Colchester is that there are unintended consequences when people hear a message that the sole objective is to achieve a target. I am confident that what happened in Colchester wouldn't happen at Southampton because I believe that we have a strong enough culture of real focus on the patient.
But to improve the situation for patients and achieve the four hour target we know that we need more beds in the hospital. We are creating these beds and our new wards D10 and F11 will open over the next three months. We also have four more intensive care beds opening this winter to help care for the sickest patients.
We also know that we have a significant issue with the number of patients who are medically fit to leave hospital, but need health or social care closer to home. Our partner organisations in health and social care are really working hard to try to improve this situation and it's my job to work with them, to help and encourage them and to keep this issue at the top of everyone's priority list.
In frustration with this issue it's very easy to forget about the individual patients so I went up to G5 this week to meet one of our patients who has been waiting since July to leave this hospital. Effectively G5 has become her home. My experience of travelling for several months earlier this year has emphasised to me the importance of a home (even if it's a tent!). An acute ward, with no real place to put your own personal things such as family photos, very little privacy and nowhere to sit and eat a meal at a table is not the right home, particularly if you are elderly and confused. The only consolation for me was seeing the care, compassion and patience with which the ward team were looking after all the patients, both those who were unwell and those who were waiting to go elsewhere.
However, we also know that there are things that we can change within the hospital to improve patient flow, to reduce unnecessary waits and to help our patients to be diagnosed, treated and discharged more quickly.
This week I am therefore asking everyone to consider what we could do differently, and if possible take the opportunity to actually try doing something different. I know that people who work on the front line, actually treating patients, can see the problems most clearly and can often also see the solutions. Myself, and the executive and divisional management teams really want to hear these ideas from the front line. I absolutely believe that no idea is too small - every little thing can make a difference.
Making the changes that we need to make requires excellent leadership throughout the organisation and we are very fortunate to have many outstanding leaders in UHS. I wanted to particularly congratulate Dr Arvind Nagra, Dr Mayank Patel, Dr Phil Hyde and Rosemary Chable for all winning Regional Leadership Awards. (Read more about their awards). They will now all go forward to the national NHS leadership awards ceremony and of course we wish them the absolute best of luck in this.
Finally, I have talked in this blog about the pressures on the emergency care system and my admiration for our staff who despite their workload continue to provide truly compassionate care. I will therefore give the last word to a patient who was recently cared for on the ED and AMU. He wrote with thanks to the whole team, including receptionists and the staff who served him meals, as well as the doctors and nurses. His letter included the following words:
"...during my time in Southampton A&E and in AMU2, I always felt that I was being treated as a human being and not just a number.
"All too often we do not appreciate what we have until we need it and I have to say I appreciate everything that the team in Southampton have done for me, and feel extremely fortunate to have been treated by a team of true professionals who are not just doing a job but are proud to be serving and providing the care they do ... I treat people in the way in which I like to be treated, without doubt that can be said in abundance of the teams in Southampton, each and every one are a credit to the Hospital"
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