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January 5th 2018

Gavin Boyle

Well, the pressure has certainly been on this week.  Blog readers will know that we had a sustained period of increased demand for emergency care in the run up to Christmas but as I mentioned last week, this continued throughout the holiday period and became even more intense in the first few days of the New Year.  You can’t have failed to have seen the coverage in the national media about how this surge in demand was affecting the NHS right across the country.  It was the same here in Derby and although we’d prepared for winter and have good plans to increase our emergency capacity, we’ve had to step this up a notch or two.  We’ve seen about a 7% increase in emergency admissions compared to the same period last year – and that felt pretty busy, I can tell you – and we’ve seen some days with record breaking attendances and particularly emergency admissions.  

Part of our response has been to further reduce our planned admissions and since the beginning of December we’ve cancelled over 100 patients and having already planned to reduce our non-urgent activity in anticipation of winter, we’ll extend this for the next few weeks.  I’m massively conscious of the disappointment this causes to those patients who’ll not receive their treatment as scheduled and how for some this could mean a further period of discomfort or an inability to return to normal life.  However, sometimes critical decisions need to be made and it seemed to me necessary to prioritise our emergency patients with life threatening conditions, as well as other patients with time-critical needs, such as those waiting for a cancer related procedure.  

I can’t begin to tell you how proud I am of all of my colleagues here at DTHFT, both at Royal Derby Hospital and at London Road too.  Everyone has risen to the challenge and gone the extra mile and then some to make sure that we continue to deliver good care during what is an incredibly challenging time.  Naturally, we think of colleagues working in those ‘front door’ areas such the Emergency Department and our Assessment Units for medicine and surgery. These teams have done a heroic job at responding to the pressures but actually every area of the hospital has been affected by this and all have played their part.  Our front line nursing, medical and allied health professional colleagues have done a terrific job but so too have the house keepers, the porters, our admin teams, our volunteers and many more.  I’ll resist turning this into an Oscar acceptance speech but if I were to list the names of individuals who’d particularly been brought to my attention over the last few days for their herculean efforts this would be a very long blog indeed.  And I’m also bound to miss somebody!

It’s true at times over the last few days that we have not always been able to provide the high standard of care that we set for ourselves, as the sheer pressure of work at times has not made this possible.  However, I’m always hugely proud to be part of the NHS and genuinely believe it’s an institution that defines us as a civilised society.  

The challenge of the past few days reminds me of the opening paragraph of the NHS constitution – you should read it if you haven’t already – but it goes like this:

 ‘The NHS belongs to the people – it is there to improve our health and well-being, supporting us to keep mentally and physically well, to get better when we’re ill and when we cannot fully recover, to stay as well as we can to the end of our lives.  It works with the limits of science – bringing the highest levels of human knowledge and skill to save lives and improve health.  It touches our lives at times of basic human need when care and compassion are what matter most.’ 

It’s that last sentence that really moves me. Despite the challenges of the last few weeks these are the principals that I see being applied day in, day out in our hospitals.  Our emergency patients come to us at their most vulnerable, when their lives have been interrupted so rudely by ill health.  This is a time when people value the NHS most highly and it is at times like this, when our resources are stretched to the utter limit that this responsibility which we carry can weigh so heavily on our shoulders.  But every day I see colleagues coming to work resolutely cheerful and as committed as ever to our task.  I thank you all.


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