Fiona Dalton, CEO

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"

Fiona Dalton


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Page comments

I am very sorry to hear that you are waiting longer than you expected for treatment. As a trust we do meet the access time standards set for patients with cancer, but this doesn’t mean that everyone gets treated as quickly as we, or they, would like. It is very important that we are clear across the Trust that clinical need is our first priority in scheduling treatments. Targets are an important indicator of the quality of our services, but not something to be met at the cost of safe clinical care. If you would like to discuss your specific issues please contact our patient support service on 023 8120 6325 so that we can take this forward.
Fiona Dalton (09/12/2013 15:40:30)
You are mistaken if you believe that the culture is any different in Southampton General Hospital from that exhibited in Colchester. My GP referred me in Summer 2013 as a suspected cancer patient. I have now been old that the earliest my treatment can start is early 2014. This will result in a wait from GP referral to start of treatment of fractionally over four months. It is clear that the scheduling of treatment in Southampton General Hospital is governed more by the ambition of the hospital to achieve targets than it is by any patients clinical need.
Anonymous (08/12/2013 21:17:14)
I am very grateful to you for taking the time to describe the personal impact on your family of cancelled surgery. I would like to apologise unreservedly for the experience you have had of our service which falls short of the standards we expect to meet. You are right that our hospital is under pressure and unfortunately we are having to cancel planned surgery at short notice for some of our patients. We are working hard to increase our bed capacity, and work with our partners to enable patients to be cared for outside of the hospital when they can. Our protocol is to take previous cancellations into account when we select which cases to postpone but we do of course have to prioritise clinically urgent patients. I am very sorry that your father’s surgery has been cancelled on so many occasions, and please could you contact our patient support team on 023 8120 6325 so that we have your contact details and can discuss your dad's future treatment.
Fiona Dalton (03/12/2013 15:33:43)
My dad has been sent home today after his surgery was cancelled for a FOURTH time, he's waiting for a shoulder replacement. My dad and I care for my mum who needs 24 hour care following a massive stroke. The organisation and planning that has to be put into place before he can go into hospital is huge and clearly not understood by the hospital despite being highlighted on several occasions. We are staunch supporters of the NHS but issues like this really make us feel like paying for him to have the operation privately if only we could afford it. We do appreciate that there are great pressures on hospital services but there seems to be no understanding by those that make these decisions, of what the patients go through or have to prepare prior to surgery. My dad needs this surgery not just for his own well being but for the well being of my mum who needs him to be physically and mentally able so that he can care for her. Once again we are playing the waiting game.
Jennifer Kimber (02/12/2013 20:33:14)
As a hospital we take the health of patients and staff very seriously. In order to reflect this we already have a smoking policy in place which offers help to patients and staff who wish to stop smoking and encourages people not to smoke near the hospital building.
However, in light of the recent NICE guidelines published in November the Trust will be looking into ways in which we can further encourage smokers to give up smoking and also discourage people from smoking on-site.
Currently, we do have smoking shelters on the boundaries of the site in order to ensure a smoke free environment close to our hospital buildings, and to discourage people from going out onto the street to smoke, and thereby disturbing local residents. Under our current smoking policy people must only smoke in these shelters. These are clearly signposted and there are maps across the site showing where they are. After reviewing the NICE guidelines we will be reconsidering the use of these shelters.
Southampton Quitters is a friendly NHS stop smoking service which provides anyone on site with advice on how to stop smoking. A member of the team in available at the hospital from Monday to Thursday and is contactable on 023 8051 5221. Patients can be visited at their bedside or one of the team can support the patient when they return home.
Fiona Dalton (28/11/2013 15:30:41)
In light of the NICE guidance on introducing a complete ban on smoking on hospital grounds, published today, what action are you planning to take at the General?
Anonymous (27/11/2013 06:41:59)
Thank you for your good suggestion. This will be considered and has been put forward to the commercial development team who are leading the project regarding the new entrance.
Fiona Dalton (26/11/2013 23:29:27)
Positive, realistic and everyday language, not 'managerial speak'. Refreshing!
PS Please could you consider a patient/public hairdresser for the reconfigured entrance/shops? This would be great for patient self-esteem and mental well-being, especially when recovering from illness or when long hospital stay.
Anonymous (26/11/2013 22:20:19)