Hull and East Yorkshire Hospitals NHS Trust Annual General Meeting Review of 2014/2015 Chris Long – Chief Executive.

Hull and East Yorkshire Hospitals NHS Trust Annual General Meeting

Review of 2014/2015Chris Long – Chief Executive

A year of significant change for the Trust…I arrived in September 2014 with some clear issues to address:

• Actions required following the CQC inspection• Performance against NHS constitution commitments

had slipped significantly• Concerns about the culture raised by

CQC/ACAS/Unions and staff survey• Lack of stability and cohesion at board level• Confusion over our long-term future – Foundation

Trust status seemed a long way off

To put this into context….• I was the third chief executive in five months• Lots of movement and unrest within the Executive team• Interim chairman in post due to leave in December• Media furore regarding governance – KPMG report• A bullying culture identified by ACAS• Lack of engagement with external partners• Financial landscape deteriorating rapidly (the forecast

remains extremely challenging)• And to top it all off, winter was coming and A&E was

moving into a Portacabin

Achieve your objectives and look after your men

Six clear objectives identified – one stood out as being critically important and urgent

Achieve delivery of key targets

Strengthen accountability arrangements

Deliver our financial plan

Improve our culture

Achieve quality and safety improvements

Develop a vision and plan for Five-year Forward View

52 3 41 6

Emergency DeptReferral to treatmentCancer targets52- week waits

Clear objectivesRoles and responsibilitiesPerformance management framework

Strategy agreed with the boardDeliver financial plan

Learning and developmentStaff satisfactionAnti-BullyingVolunteersInnovation and research

Quality and safety priorities Patient satisfactionReduce infectionsNever events

Secondary careTraumaCancerCardiac

Lots of slogansBut one struck a chord…..

The staff here are already Great• Spent time with porters, ED staff etc• Struck by their passion and commitment• Response to challenging circumstances is

humbling – last year was the toughest winter we’d ever experienced

• The Golden Hearts Awards nominations reminded us of how Great our staff are

• Lots of work and focus has been dedicated to reminding our staff how much we value them

Great staff - recruitment

Apprenticeships 90 to be recruited by Dec 2016

International recruitment110 nursing staff

Growing our own!Currently training our first cohort of Theatre Assistant Practitioners

Great staff - Recognition

The Cancer Survivorship Team shortlisted for a 2014 Macmillan Professionals Award in Team Excellence.

Chris Venton, Teacher/Trainer - nominated for a 2014 Women of Achievement Award in recognition of her work to support older people with dementia

Chief Nurse Information Officer, Steve Jessop -shortlisted for National Patient Safety and Care Awards 2014.

Two of our apprentices were shortlisted for regional awards.

Palliative Care Nurse Specialist, Maggie Simkiss was recognised with a 2014 ‘Henry Garnett Award’ by Macmillan Cancer Support

New values chosen by our staff

Our values will set the tone for a different culture

• A long-term objective but we have made progress

• Anti-bullying work has seen the appointment of Dr Makani Purva as Anti Bullying Tsar

• 2,000 staff undertaken Professionalism and Cultural Transformation (PaCT) training

• New staff charter in place• SALS established to give staff an outlet for

raising concerns• All new starters receive PaCT training and spend

their induction day focusing on expectations of them as HEY staff

Fixing the culture• Investment into nursing to address staffing issues and prevent

staff being moved around from ward to ward every day they came to work

• Clarity on objectives to enable all staff to connect their role to the vision and purpose of the Trust

• Briefings began in-year to engage all managers and ensure they are clear what is expected of them

• Leadership development work at an advanced stage of development

• The latest FFT results indicate a positive shift against all measures

Leadership• A new board is in place to

provide leadership and stability – permanent appointments to CMO & CNO

• Greater visibility and engagement with Executive ward and department visits

• Development of Clinical Leads through the Great Leaders programme and work underway to ensure continuous engagement and communication with this group

• Focus on developing our leaders will continue

Great Care – Improving the experience for Emergency care patients

• New £11m Emergency Department – one of the largest and best equipped in the country

• World class facilities• Designed and built in full

consultation with the teams who deliver the care to our patients

Great Care – Medicine transformation

• Transfer of medical wards to HRI • Opening of ward 500• Opening of Ambulatory Care

Unit/Elderly Admissions Unit/Medical Day Unit

• Improved relationships with Local Authorities/Ambulance Service/Mental Health and Community Services

Green shoots of recovery• Improved discharge• Reduction in delayed transfers of care• Shorter length of stay for many patients• Fewer medical outliers

NB: Recently the impact of this work has seen us improve against the four-hour target but more effort and work is required if this improvement is to be sustained and continue, particularly as we approach winter once again

Great Care - Innovation in treatment

New radiotherapy treatment for cancer patientsSABR (Stereotactic Ablative Radiotherapy) – a short course of high dose radiotherapy treatment which targets small tumours in the lungE-observationsStaff are using iPads and iPods to improve the process of recording patient information, such as their blood pressure, temperature and heart rateDa Vinci robotHull City Football Club owner, Assem Allam and his family, pledged the funds to buy the ‘Da Vinci’ robot – used for minimally invasive surgery

Great Care – pride in our servicesEndometriosisThe Endometriosis Specialist Centre, has earned accreditation from the British Society for Gynaecological Endoscopy for the second year running

Reducing fallsPhysiotherapists have been trialling the use of yellow wristbands to highlight those who are vulnerable to falls or who require help with mobility. Reductions in falls of more than a third were seen on Wards 8 and 80 at Hull Royal and Ward 19 at Castle Hill Hospital

EndoscopyFollowing a recent assessment by a panel of independent experts; the Joint Advisory Group (JAG) on Gastrointestinal Endoscopy has been given the highest possible rating of ‘A – Excellent’

Great Future - Looking forward…We continue to focus on our six objectives and ensure everyone is working in service of these1. Further improvements against our safety objectives: sepsis, dementia,

medicines management, infections etc2. Performance management framework, leadership development, cascade

of objectives through PDR3. Unprecedented financial challenge – savings of £27m again in 2015/20164. Ambition to perform alongside the top 20% of Trusts in the national staff

survey5. Meet our NHS Constitution Commitments6. Focus on delivering our services in partnership with the local health

economy