Heartbeat July 2018

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Letters, of less than 200 words please, can be sent to the Communications Department, Trust Headquarters, Sandwell Hospital or by email to swb-tr.SWBH-GM-Heartbeat@nhs.net YOUR RIGHT TO BE HEARD Dear Heartbeat, We have been suffering the prolonged heat conditions on AMU A over many months as we have no opening windows and rely on a ‘trickle’ vent system. The vents are thick with dust probably riddled with bacteria. At any point of the 24hr day 32 patients being cared for and excess of 25 staff, working in a stuffy uncomfortable environment, the fans blowing around the same recycled air, bays and G of 10 patient beds are no better as that ventilation is turned off completely! The problem is nobody will clean the vents whilst there are patients in the area the deep clean requires closing a bay. In honesty it is a job that involves estates and ward services in addition to their daily schedules. Can I ask what is the solution? Do we need to swab for bacterial growth to get action? Environment audits persistently picking up the problem yet there is no workable solution and certainly not comfortable viewing when you see the large clumps of dust falling. I look forward to working towards a solution that makes the environment better for patients/ staff and visitors. Dear colleague, The emergency services building at Sandwell uses an air conditioning system to provide cool air without needing to open windows. I recognise that these vents need regular maintenance to ensure they work effectively and my team are planning, in conjunction with the senior sister, the best time to do this and other maintenance required to improve the environment for staff and patients. Kind regards, Alan Kenny, Director of Estates and New Hospital Project Dear Heartbeat, Why is it that people can apply for jobs without the qualifications and get it over those who have the qualification and don’t get the chance to gain experience in the job they’ve applied for due to the department wanting to keep their current (bank/agency staff)? How are we meant to develop in this trust? Dear colleague, I was disappointed to read about how you feel in relation to job offers in this Trust. We have made considerable progress with our staffside colleagues on improving the equality and inclusion of our recruitment in the past 18 months. I would encourage you to raise your concerns with your line manager and have an open conversation with them about your desire to progress and gain experience and build your career. I hope that your recent performance development review (PDR) allowed you the opportunity to do this and you were able to build a development plan that recognises your career ambitions and potential. If this has not been the case please feel free to talk to me directly, the HR business partner for your group or someone else within your group management team. Best wishes Raffaela Goodby, Director of People and OD Dear Heartbeat, I have worked for the NHS long enough to come to the realisation that there are no new ideas, only snazzy rebrands of things that have been tried before. The proposed smoking ban that the Trust’s current despotic leader has put forward is yet another one of those rehashed proposals, our previous chief exec tried to do this and it ended with a shame faced climb down – why? It’s because you cannot legally stop staff going off site when they are on an unpaid break. Staff just ended up lighting up on the footpath just outside trust property (this included many managers) and there was nothing the trust could actually do about it, we ended up with furious residents that were inundated with discarded cigarette butts all over the place. I understand and totally agree with the push to encourage a healthy life style and as a tax payer I loathe smoking for the burden it places on the NHS. As a lifelong non-smoker, I find it kind of ironic that I feel compelled to argue for a person’s right to smoke as I personally find it a pointless disgusting habit, and I have spent years badgering my friends and relatives to quit. At one point I was the only one in my whole extended family that didn’t smoke now none of them do. But this has to be done through encouragement and support and not blunt force or threats and fines. In reality it is income inequality that is widely believed to the THE single biggest cause of health disparity around the country as a whole. Within the Sandwell and West Birmingham area considered to be one of the most deprived areas of the country maybe our highly paid CEO should be putting his efforts into helping to solve this underlying root cause. But hey – what do I know, I’m just a lowly minion buried by the ever expanding mountain of managers riding the NHS gravy train. Dear colleague, Thanks for the abuse and slight self-pity – we have fewer managers then five years ago and they do a decent job. If we get past all that and move onto the substantive points you raise, which are important, I would suggest that the Trust has gone beyond many, but not yet done enough, to try and tackle inequality. You are right that that drives the health impact, and work like our apprentice programmes, and Healthcare Overseas Professionals, is testimony to a commitment to try and do more. Our Integrated Care System across SWB aims to invest more in housing and employment, if necessary investing less in sickness services. On smoking you are completely right that many attempts have been made. After consulting widely, including through Hot Topics as was, and our public health committees, the full Board reached the conclusion I reported on NHS 70 day. On July 5 2019 we will move to our new no smoking, or perhaps put better, our anti-smoking position. This will include lots of support offers around NRT, revised policies on issues like breaks and uniform, and a clear arrangement for the fines we will regretfully levy for breaches. At the same time the local authority are thinking through what by laws might be applied in local roads. I agree with you that this has to be real. It will take action by many and in many ways to make it so. But the case to do so is very clear. Best wishes Toby Lewis, Chief Executive 26
Toby writes about…going for Good TobyLewis_SWBH TOBY’S LAST WORD In 2017 the CQC visited some Trust services. That, combined with their bigger 2014 visit, produced a situation where about 70 per cent of our services are rated as good or outstanding. And the whole Trust is rated Outstanding for the caring domain. The exceptions lie in the emergency pathway from A&E, through our medical wards, and into our community wards. Whatever we think about the CQC method, or specific parts of the inspection process, that feels right. I do not agree that wards at Rowley Regis were inadequate last year, and for sure they are not today, but as a Board we share the view, and colleagues share the view, that acute adult care is our biggest pressure point – in 2017 our services were not good. But this is not a last word about the need for one site at Midland Met, nor about rising demand as our patients age. In fact, it’s an article about uplifting success. In 2018 we are getting close to, or perhaps even are at Good. Working in emergency medicine is not easy, but our teams’ success is making it worthwhile. As Heartbeat goes to print almost 100 colleagues, from all professions and grades, took shelter from the heat in the education centre – our £2m investment in learning and teamwork – to review progress with consistency of care. After almost eighteen months hard work, imagined before the CQC inspection, but very much on the button for the findings it gave us, work across our teams is showing sustained results. How do I know? Read on: Each Wednesday I am reviewing data that shows shift by shift (typically three shifts a day) how we look after our patients. In medicine and community services not only do we have the Trust-wide Safety Plan data, we also have the peer challenge data from nursing handover. That shows measures for care issues like fluid balance, care rounding, falls assessments and so on. And the data is encouraging. Every single area is above 98 per cent with most now regularly at 100 per cent. The auditors are in, at our request, to check the data is real and consistent. That there is no risk of gaming. But data only takes us so far. The voices of those providing the services confirm the message. So we are doing surveys and focus groups, like the listening into action event, and there is a clear theme. IT resilience is still a problem. Joint working into social care is not yet right. Staffing is much, much better but not yet always right. But care documentation is transformed. Multi professional working too. This week we specifically reviewed the “push-pull” and consultant of the week (COW) project. These aim to get senior clinical time onto our wards every day, giving our patients and nursing teams, consistency of view. This is not NHS-routine. This is a specific investment to drive up quality, not just quality of care but the quality of how we support carers with advice. And the quality of training we can offer all professions based on the expertise of our consultant staff in elderly care, gastroenterology, respiratory medicine and cardiology. Soon we will bring neurology into the fold. Let’s be clear some patients we admit or retain to hospital should be looked after elsewhere. But most need our care and are the most acutely unwell patients. COW is all about getting them the very best care. If you couple that with our big investment this year in critical care and our overwhelming focus on Sepsis, it should be crystal clear that this Trust is absolutely focused on safety and on quality. New hospitals and IT systems are enablers, balancing the books oils the engine, but this is what matter motivates and matters. Listening into action has a deep tradition at the Trust and it is one we are building on. Over recent years we have given rise to projects like the casework investigations unit. Improvement work now in patient transport relies on this involvement. But consistency of care is a shining example of us using this approach over a long term period to develop, implement, adapt and evaluate real change. If you read this and wonder whether it is true, go and have a look. Volunteer for our Almost 100 colleagues from medicine and emergency care and primary care, communities and therapies attended the latest listening into action event The MDT team from Lyndon 4 internal inspections team. Get in touch with a matron in PCCT or in medicine. My point is that the change must be real and sustained. But what was immensely encouraging, what should be a cause for pride, I believe, is the way in which colleagues across medicine have risen to the challenge set down by the CQC, set down by the Board which itself alerted the CQC to our concerns, and which is now being met shift by shift. The session in the sunshine which started this article ended with a big list of “more to dos.” Inspiring ideas and commitments from teams in every ward and area – and when we meet again at Christmas, I am expecting confidently that the teams that are making consistency of care a reality in our medical and community wards will have delivered the next stage in their journey – beyond good and towards outstanding. Five big changes through Consistency of Care: 1 We are working to get the right patient into the right bed and stop outlying. In July 2018 we are “inside” our bed base for the first time since 2015. 2 Care documentation has to pass ten safety checks made on every single shift, with corrections made at the time. 3 Falls and infection rates, already better than elsewhere, are getting even better. 4 Every single discharge from hospital to community is rated by receiving staff for safety – and over 95 per cent are green rated. 5 Each general medical ward has a consultant working on that ward five days a week, in-reaching into acute medicine, providing continuity of care. We believe that changes 4 and 5 are unique to SWBH L-R: Group Director, Chetan Varma; Director of Operations, Michelle Harris; Group Director of Nursing, Claire Hubbard; Craig Simpson, Deputy DGM Admitted Care, Craig Simpson and Chief Executive, Toby Lewis 27
Page 1 and 2: July 2018 Sandwell and West Birming
Page 3 and 4: Colleagues celebrate NHS 70 in styl
Page 5 and 6: Unity end user training - are you b
Page 7 and 8: Diversity and inclusion - the golde
Page 9 and 10: Colleagues come together to celebra
Page 11 and 12: To: Joanne Wright For doing so well
Page 13 and 14: Unity - how ready are you? Later th
Page 16 and 17: Putting our waste to good use waste
Page 18 and 19: AMU team present at Birmingham Medi
Page 20 and 21: 20 Trust allergy service is first t
Page 22 and 23: Fiona says goodbye after 20 years a
Page 24 and 25: 24 News in brief from around our or
Page 28: Events Diary August 2018 EVENT DATE

Heartbeat July 2018

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