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August 11th 2017

Gavin Boyle

Well, it’s not like me to miss a blog – so apologies if you were wondering where it got to last Friday.  Mrs B was due to have a day case procedure at a hospital nearer to where we live and unfortunately this did not run particularly smoothly and the time I’d set aside to write my weekly blog was eaten up as a result!  Now, I may be being unfair but I’m pretty sure things would have run much more smoothly here in Derby!  I’m always impressed by the teams I meet who seem to be constantly looking for ways to make our services more efficient.  We had a visit last week from James Cook, who is the Director of Productivity from our regulator NHS Improvement.  James was here to share some data that compares how different hospitals perform against a wide range of measures to help identify where improvements can be made.  This includes information from the ‘Get it right first time’ reviews, which is a national process led by clinicians to compare their services in this way too.  I was pleased when James described Derby Teaching Hospitals as one of the most efficient Trusts within the East Midlands but this poses a dilemma. At a time when we are looking to find ways to become more efficient – given the significant financial challenge facing the NHS – it’s hard to know where to look next.

However, there are always opportunities and I was powerfully reminded of this last week when I spent a few hours with Dr Sherif Awad, one of our surgeons here at DTHFT.  Sherif specialises in gastro-intestinal cancer surgery but also in bariatric procedures, which help patients who are on radical weight loss programmes.  He introduced me to his team and they described a whole range of things they’d done to make sure that their theatre lists ran as well and efficiently as possible.  Nick Reynolds, who is the consultant anaesthetist within the team, is obviously a bit of a data geek – but he had meticulously collected information about every aspect of the operating list and used this to identify how improvements could be made.  This was really impressive and during the list they made a note of anything which caused even a very small delay – possibly only of a couple of minutes – they then problem solve to work out what could be done to prevent those minor delays from happening in future.  Sherif also introduced me to the team on EPU, which is our 23 hour stay ward.  The team had recently redesigned their service to allow patients to come in for surgery and then safely back home within the day.  What impressed me most was the relentless focus on improvement, with every member contributing to the improvements being made.  The patients too were fully involved and are well prepared in advance of surgery and have an ‘on the day’ briefing to explain what’s likely to happen and how they can help things to run smoothly.  But as well as improving efficiency this is also about improving the quality of the service.  Through a standardised approach, there is less chance of error, and minimising time in the operating theatre also enables patients to recover more rapidly from their procedure.  This was all a great example of how we can redesign what we do to become more efficient but also to also improve the quality and safety of care we give.   

One of the highlights of the last couple of weeks has been welcoming our new junior doctors to the Trust. There’s been about 290 new doctors in training starting with us and both myself and Nigel Sturrock, our Medical Director, have had the opportunity to meet them all, give them a warm welcome and thank them for choosing Derby Teaching Hospitals as a place to work and further their education as doctors.  Please look out for our new colleagues and give them all the support and encouragement you can.  Also, well done to Dr Stephen Hearing and the Medical Education Team who have made sure our new doctors have been given the best possible start!

We’re making good progress in our work with colleagues at Burton Hospitals – developing the further detail for the Full Business Case to be considered by both Boards at the end of the year.  You might have caught Helen Scott-South, CEO at Burton, and myself on Radio Derby on Friday with Ian Skye answering questions from the public about the partnership.  It was a great opportunity to remind everyone of how our partnership aims to sustain services locally at Burton, help us to better use our community hospitals here in Derby but also Lichfield and Tamworth and to give us an opportunity here in Derby to grow and develop our specialist services.  We had some questions from the public regarding stroke care and this is probably the only area where we are looking to centralise a part of that service here in Derby.  There’s lots of strong clinical evidence that if the first couple of days of care – the hyper acute phase – are provided in a specialist centre then patients will have a much better outcome. Although we’d then aim to transfer Burton residents back to Queens Hospital Burton, the community hospitals in Lichfield and Tamworth, or indeed back to their own home, as soon as possible.  Many colleagues ask me about what the partnership might mean for them and I reassure them that there would be no impact on things like terms and conditions of employment or pensions etc. because we are all part of one NHS.  Also we don’t envisage large numbers of staff either travelling between the sites or having to move where they work routinely.  We may well want to make changes in how we organise ourselves but these will be done over time and making use of any natural turnover in our workforce.  I think the partnership is much more likely to provide a greater range of career opportunities for our people and also help us to attract and retain the very best talent. 

It was a pleasure yesterday to welcome Annie Hall, the High Sheriff of Derbyshire, who came to visit the hospital.  She had a packed itinerary visiting our Cancer Services, the Children’s hospital and also the Emergency Department.  I was able to sit in on the first session and it was good to hear colleagues describing the breadth and depth of our Cancer Services, including Oncology, Radiotherapy but also Palliative Care too.  Later in the day I happened to be on the Combined Day Unit on level 1 to visit a patient there who was receiving treatment.  I noticed the new Cancer bell which had been installed there, which gives patients who have successfully completed their treatment the opportunity to ring the bell by way of celebration.  We haven’t launched it officially yet but I understand already that some patients have made good use of it – great stuff!

And finally I finished my week with Gino Distefano, our Associate Director for Transformation, who was hosting a development session for some former general management trainees from across the NHS.  It was good to talk about my own journey and particularly to reflect on how the NHS is moving back to being much more of a ‘system’ rather than a collection of organisations.  I for one am a firm believer that the NHS is at its best when all the bits work together.  After all that’s what our patients want!

Best wishes

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