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January 6th 2017

Gavin Boyle
First things first, Happy New Year to everyone, and thanks once again to all those who kept our services running and our patients cared for over the holiday period. I would welcome everyone back to work, but I’m conscious that, for a good deal of us, it feels as if we’ve not actually been away, at least not for long! 
For hospitals the work never stops and we were reminded of this particularly over the last couple of weeks and into the New Year where, despite the festive period, the demands on the hospitals have been greater than ever. Comparing this year to last we’ve seen a significant increase in patients attending our Emergency Department, particularly the most poorly patients brought to us by ambulance and a rise in the numbers of older people needing our services urgently. But, despite this increase in demand, I have this week been massively impressed as ever by the way that colleagues here at the Trust respond when the pressure’s on. It’s all about teamwork and there have been some fantastic examples of how the hospitals have pulled together to keep patients safe and well cared for during an incredibly busy few days.
At the risk of ‘doing a Gwyneth Paltrow’ there are lots of colleagues I would particularly like to thank – naturally our ED team who are often very much at the sharp end – but also our other frontline areas particularly in the Medical Assessment Unit including Ambulatory Care and the assessment units in surgery and gynaecology. Of course, behind these services sit our specialist clinical teams and wards who’ve done such incredible things to ensure that our care for admitted patients is not delayed and, in line with our Red2Green philosophy, to make sure they don’t stay with us unnecessarily. This has the added benefit of releasing beds for patients admitted as emergencies and helps to take the pressure off ED. The teams in Imaging, Radiology, Pharmacy and therapies must also be mentioned as they’ve all gone the extra mile this week, as have our marvellous team in the mortuary importantly caring for the deceased and bereaved too.
I’d also like to thank our ISS and facilities colleagues including portering, catering, housekeepers and cleaners who have also stepped up to the mark, as well as those behind the scenes in admin, managerial and corporate roles who’ve all rolled their sleeves up during this extremely busy period. 
The spirit of teamwork wasn’t only evident in the hospitals but across the whole health care system. I’ve been in contact every day with leaders in health and social care as we’ve pulled together to make sure the whole system has responded to this heightened demand. There are lots of great examples of the system working together. These include the introduction of a GP presence at the front of the Royal Derby Hospital out of hours, extra social care packages and care home beds opened by local authority colleagues, additional community capacity in our community hospitals, good support from the mental health trust and partnership working with EMAS, making sure that patient handovers from ambulances have been carried out in a timely way. 
Over recent years we’ve seen an annual increase in demand for emergency hospital services and while we’ve worked hard to keep pace, the last week makes me reflect that, as a health and social care system, we have to find a different way to meet the challenges ahead. At the end of the day the acute hospital has a finite capacity and we can’t go on with year on year increases in demand expecting it all to fit. One of the aims of the Sustainability and Transformation Plan (STP) (mentioned many times in this blog) is to do just that – to redesign our ‘out of hospitals’ services to help keep people well and cared for in their own home, avoiding a crisis whenever possible. 
This was exactly the conversation we had this week at the Derbyshire Health and Wellbeing Board, (made up of the leaders from all the health and social care organisations in Derbyshire, including elected councillors), when we took stock of our progress with the STP. And, despite all the difficulties of making change happen, not least of which are some of the financial obstacles, there was a renewed determination to make progress in working differently – trying to keep our communities well, providing care closer to home and relying on the hospitals only when it’s necessary to deliver the care required.
So finally, it’s been a heck of a week – but oddly enough it leaves me feeling optimistic for the future. The commitment and teamwork of my colleagues within the hospitals, combined with that of our partners across the wider system, leaves me feeling that not only can we meet the challenges of today but we can also work together to find a better way for tomorrow.
Have a great weekend.

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