The Scalpel's Blog

09.10.19

Providers are delivering – and here’s how

It has been a challenging few years for healthcare providers, yet they have continued to deliver high quality care despite the conditions. Adam Brimelow, director of communications at NHS Providers, outlines just how providers are managing to deliver despite the financial squeeze.

 

It is inevitable that the NHS’ funding settlement and the Long Term Plan will heighten expectations of what the health service can be expected to deliver. However, it will also be vital in the coming months and years to ensure those expectations reflect the reality of growing demographic pressures, workforce shortages and the impact of the sustained financial squeeze, including an impoverished estate and a performance drift away from long established constitutional standards.

Trust leaders are rightly worried about their ability to deal with the ongoing rise in demand for services. This is leading to more patients and service users waiting longer to access the care that they need, as reflected in recent performance statistics.

However, over the last five years many trusts have delivered considerable improvements in the quality of care they provide. Whereas in 2014, over half (68%) of trusts were rated requires improvement or inadequate by Care Quality Commission (CQC), in 2019, the majority of trusts (59%) are now rated ‘good’ or ‘outstanding’. Between August 2017 and August 2019 the number of trusts rated ‘outstanding’ increased from 14 to 24 and the number rated ‘good’ increased from 96 to 107.

NHS trusts are held accountable when they fall short. But we should also celebrate their successes, and promote understanding of approaches and ideas that could benefit patients across the NHS. Our new publication series, Providers deliver, does just that.

Adam B HR

Adam Brimelow, director of communications at NHS Providers, outlines just how providers are managing to deliver despite the financial squeeze
 

The first report focuses on how trusts have responded to feedback from CQC in a positive and systematic way. Through 11 case study conversations, it considers some of the frontline work that has contributed to trusts’ improvements in ratings, as well as exploring the role of trust leaders in providing an enabling, supportive environment in which this work has been possible.

Reading through the case studies some clear and striking themes emerge. The key attributes for improvement highlighted in the report by CQC’s chief inspector of hospitals, professor Ted Baker –  good leadership, effective staff engagement and a strong organisational culture that embraces learning –  surface time and again. The case studies show how these priorities can be deployed in different ways, in widely varying situations, to good effect.

For the chief executive at Dorset Healthcare University NHS Foundation Trust, Eugine Yafele, a central element of good leadership is about being visible and approachable. Similarly, Carolyn Regan at West London NHS Trust places a premium on walkabouts – even at 3am – so whatever their shifts, staff can see her “living the values”.

READ MORE: NHS Providers: National Retention Programme to help workforce shortages

READ MORE: NHS Providers head of policy calls for 'culture shift within NHS' to implement Patient Safety Strategy

The power of effective staff engagement is captured eloquently by Dame Marianne Griffiths, chief executive at Brighton and Sussex University Hospitals NHS Trust, who speaks of having “taken the rocks from out of their shoes”. Daily 15 minute huddles have helped to harness staff expertise in identifying and solving problems. Similarly, the trust leadership at North Tees and Hartlepool NHS Foundation Trust acknowledges that “the people at the frontline are our experts”.

Again, at Kingston Hospital NHS Foundation Trust, we see a sustained focus on listening to staff, taking their views seriously and acting on them. The chief executive, Jo Farrar, insists there is no “magic formula” to staff engagement, but we see here and elsewhere that when it is done well the impact is transformative.

iStock-916855634

Staff engagement is closely linked to a strong organisational culture that embraces learning. The priority given to “quality Friday” and clinical governance learning sessions at Chelsea and Westminster NHS Hospital Foundation Trust reflect a strong emphasis on learning in order to improve care for patients. The “break the rules” week at Cornwall Partnership NHS Foundation Trust shows the same willingness to empower staff in finding better ways of working and delivering care.

This is also borne out in the approach to end of life care taken by South Western Ambulance Service NHS Foundation Trust,, backed by a programme of training for staff that is helping to ease anxiety and distress at a critical time for patients and carers, avoiding unnecessary admissions and supporting a good death.

A further theme is a willingness to act on the data, even if that entails difficult decisions. We see this in Hounslow and Richmond Community Healthcare NHS Trust where, after examining the patient profile, the trust closed one of its rehab wards. Alongside this it developed a more rigorous admissions policy and has since dramatically cut the average length of stay.

VIEW PROVIDERS DELIVER REPORT HERE

At London Ambulance Service NHS Trust as part of the quality improvement approach, all initiatives accepted as a “pioneering service” are given close support and are also carefully monitored, to ensure resources are well directed. This approach quickly demonstrated the success of the mental health car – supporting staff to work more effectively, easing pressures on hospitals and – most important – helping patients to access the most appropriate care. 

Placing faith in staff, encouraging ideas, supporting and refining them, acknowledging and learning from mistakes requires another key quality – courage. As Robert Woolley from University Hospitals Bristol NHS Foundation Trust says, “We’ve made mistakes, but we own it. It’s ours”.

Comments

There are no comments. Why not be the first?

Add your comment

 

national health executive tv

more videos >

latest healthcare news

Safe Haven being provided for Wigan partygoers this Christmas

15/11/2019Safe Haven being provided for Wigan partygoers this Christmas

Front-line emergency services will have some pressure eased this festive period in Wigan town centre. A nightlight safety scheme will be piloted ... more >
Doctor wellbeing solutions could make UK a ‘model for the world’

15/11/2019Doctor wellbeing solutions could make UK a ‘model for the world’

A report for the General Medical Council (GMC) has found that existing good practice on supporting doctors’ wellbeing and patient safety sh... more >
General Election manifesto launched by pharmaceutical industry

14/11/2019General Election manifesto launched by pharmaceutical industry

The Association of The British Pharmaceutical Industry (ABPI) has launched a General Election 2020 Manifesto for Medicine. ABPI employs over... more >

editor's comment

25/09/2017A hotbed of innovation

This edition of NHE comes hot on the heels of this year’s NHS Expo which, once again, proved to be a huge success at Manchester Central. A number of announcements were made during the event, with the health secretary naming the second wave of NHS digital pioneers, or ‘fast followers’, which follow the initial global digital e... read more >

last word

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad, president of the Association of the British Pharmaceutical Industry (ABPI), sits down with National Health Executive as part of our Last Word Q&A series. Would you talk us through your career in healthcare? My parents both worked in the NHS on the frontline. My mum was a GP, and my dad was a nephrologist in inner city L... more > more last word articles >

the scalpel's daily blog

Providers are delivering – and here’s how

09/10/2019Providers are delivering – and here’s how

It has been a challenging few years for healthcare providers, yet they have continued to deliver high quality care despite the conditions. Adam Brimelow, director of communications at NHS Providers, outlines just how providers are managing to deliver despite the financial squeeze.   It is inevitable that the NHS’ fun... more >
read more blog posts from 'the scalpel' >
332 304x150 NHE Callout banner.

comment

NHS England dementia director prescribes rugby for mental health and dementia patients

23/09/2019NHS England dementia director prescribes rugby for mental health and dementia patients

Reason to celebrate as NHS says watching rugby can be good for your mental health and wellbeing. As the best rugby players in the world repr... more >
Peter Kyle MP: It’s time to say thank you this Public Service Day

21/06/2019Peter Kyle MP: It’s time to say thank you this Public Service Day

Taking time to say thank you is one of the hidden pillars of a society. Being on the receiving end of some “thanks” can make communit... more >
Nurses named as least-appreciated public sector workers

13/06/2019Nurses named as least-appreciated public sector workers

Nurses have been named as the most under-appreciated public sector professionals as new research reveals how shockingly under-vauled our NHS, edu... more >
Helpforce to launch training programmes for NHS volunteers

10/06/2019Helpforce to launch training programmes for NHS volunteers

Kay Fawcett OBE, clinical advisor and education lead at Helpforce, and Lynn Twinn, talent development consultant, outline the new national traini... more >

health service focus

View all News

interviews

Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

24/10/2019Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

Today, speaking at the Royal College of General Practitioners (RCGP) annual conference, Matt Hancock highlighted what he believes to be the three... more >
NHS dreams come true for Teesside domestic

17/09/2019NHS dreams come true for Teesside domestic

Over 20 years ago, a Teesside hospital cleaner put down her mop and took steps towards her midwifery dreams. Lisa Payne has been delivering ... more >
How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

24/10/2018How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

A dedicated national social care service could be a potential solution to surging demand burdening acute health providers over the winter months,... more >
RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

24/10/2018RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

The president of the Royal College of Physicians (RCP) has told NHE that the college’s new headquarters based in Liverpool will become a hu... more >