Fiona Dalton, CEO

Chief executive's blog - 4 December 2017

In my personal blog, I'll keep you up to date on what's happening at the Trust, sharing what I think we're doing well and what we can improve.

Fiona Dalton, chief executive

Over the past month we've been spending time as an executive team with each of the care group management teams to hear about their plans and aspirations for next year.

These are mostly very inspiring meetings – it’s a pleasure to hear clinical and non-clinical leaders from across the hospital describe with enthusiasm and imagination how advances in scientific knowledge, research and creative ideas could make their services better and more efficient in the future.

These ideas and energy are our only good response to the constant challenge for every health system - trying to do the best for our population, and give our patients the benefits of new medical advances, within the amount of money that our society can afford to (and chooses to) spend on healthcare.

And I think that we can all see that over the next few years this challenge is just going to get greater.

Fundamentally I think that we have to keep doing two things:

Firstly, we have to keep working differently. We have a good track record of this - if you experienced a heart attack a few years ago you were admitted to hospital for six weeks of bed rest. Now you receive a primary angioplasty and go home after 48 hours - and your chance of survival is much better. Of course there are hundreds of similar examples – and it’s easy to forget how much healthcare has changed, so quickly.

In the care group meetings I heard many great ideas about how we can continue to work differently. For instance how we better medically optimise patients before surgery so they suffer less complications and need less blood transfusions. How we can use more enteral nutrition and less parenteral nutrition (better for patients but also cheaper). And how we can encourage all of our patients to 'eat, drink, move', whether they are in intensive care or on our elderly care wards.

But secondly, I think we must also do less of the things that don't add value to our patients. I also heard good examples of this, with people asking:

  • Does this follow-up appointment really help my patient? 
  • Does this patient really need to stay in hospital tonight? 
  • With access to the right online medical records, could my patient manage this condition better themselves?
  • How can I automate the simple tasks to free myself and my team up to do the complex jobs?

By doing less of those things that don't add value to patients, I think we can prioritise more NHS money to the things that really do add value - including for instance new groundbreaking interventions such as mechanical thrombectomy for stroke or the new immunotherapies for cancer. And we can try to make sure that we are there for patients when they need us, and that as an NHS we invest in mental health as well as physical health.

I am sure that this is the right thing to do regardless of how we organise internal NHS structures. Most health policy experts would say that it's looking increasingly likely that the purchaser - provider split of the last couple of decades will gradually be blurred into a more integrated system - and this means that hospitals such as ourselves will be more directly involved in the prioritisation of resources.

By continuing to challenge ourselves to deliver value-based healthcare (always asking “does this add value to the patient?”) I believe we can prepare ourselves for this future.

Fiona Dalton


We welcome your comments on this blog.

If you have any specific concerns or need advice about the care you have received at our hospitals, please contact our patient support services on 023 8120 6325 or

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