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January 13th 2017

Gavin Boyle
You won’t be surprised to hear that I’ll be talking about winter pressures in this week’s blog, and focusing on some of the challenges we’re facing as an NHS at the moment.
 It seems you can’t turn on the radio or television or pick up a newspaper without seeing or hearing something about winter and the NHS. But despite everything it’s still possible to deliver good care for our patients; made possible through the dedication and commitment of my frontline colleagues, so continuing with my theme from last week I would just like to thank everybody who’s worked so hard over the last few weeks to keep our patients well cared while it’s been so busy – and believe me, it has been busy. I’ve been looking at some figures comparing the level of activity this winter and last, and it’s really quite revealing. Comparing December 2015 and December 2016 we saw a 7% increase in ambulance arrivals, an 11.5% increase in attendances to A&E by patients over the age of 70, and a 10% increase on the number of admissions from A&E. It’s hard to know what’s caused the increase in demand, but it has meant we’ve had to work harder than ever to deliver a good service. Although some patients have waited in our ED longer than we’d like, we’ve thankfully not been in the situation you may have seen on the television, with patients on trolleys in corridors. We’ve maintained good care and made sure that all of our patients have been safe. This is our priority. 
The four-hour target for A&E has been in the news a lot this week, as many departments, including ours, have been struggling to meet this measure. Although it is important to make sure patients are seen and either admitted, discharged or referred as quickly as possible, I think it’s important to say that quality and safety, rather than speed, is always our main priority. We focused on this topic at our Quality Committee meeting this week. The committee, chaired by our independent directors, reviewed a range of measures around patient safety and experience, as well as looking at feedback from our frontline staff and patients too, to provide reassurance that despite the increased activity the service we’ve provided has been safe and patients have received good care.
This recent busy period has not dimmed the enthusiasm of our staff for coming up with new and innovative ways to care for our urgent patients, improve flow and make sure that waits are kept to a minimum. For example, this week Neil Radford, our Divisional Director for Medicine, led something called the ‘Base Ward Challenge’. The idea was to enable rapid admissions from our Medical Assessment Unit into specialist wards in the afternoon and early evening. The benefit of this is that it makes space in the assessment unit for patients who need to move from the Emergency Department, and relieves the pressure there in the evening when it’s often at its busiest. A whole range of staff were involved in making it happen on three nights this week, and it had a big impact. I love the way staff in our Trust are prepared to try out new ideas and see how the positive results can be built into our day to day way of working. Good for them!
Speaking of which, it was a pleasure this morning to spend some time with Senior Sister Hannah from Ward 404, and a new member of her team, Discharge Support Officer John. This ward has been one of the areas championing our Red2Green approach, which is all about making sure there are no unnecessary delays for our inpatients. John’s role is a new one and although he’s not from a clinical background he works to support the medical and nursing team on 404 to help make sure their plans for patient treatment are carried out and nothing is missed or delayed. All this helps to make sure that patients receive their care in a timely way and don’t stay with us any longer than they need to. This is, of course, good news for our patients - because, after all, who wants to be in hospital if you don’t need to be? - but it also helps us to make beds available for other urgent patients. 
I finished last week’s blog on an optimistic note, reflecting on the way our own colleagues and indeed our health and social care partners across the whole of Derbyshire have rallied together. At the end of another busy week where we have been feeling the heat, I remain incredibly proud of the efforts being made on behalf of our patients to keep them safe and make sure they receive good care. Well done everybody.
Have a great weekend - hopefully snow free!
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Gavin

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