z CEO Report January 2024

National and system update

Industrial action
Junior doctors began their latest strike action on Wednesday at 7.00am and finished at 7.00am on Tuesday 9th January. At a national level, this latest action saw 113,779 inpatient and outpatient appointments rescheduled, and 25,446 staff were absent from work due to strikes at the peak of the action. Since strikes began, the cumulative total of acute inpatient and outpatient appointments rescheduled across the NHS is now 1,333,221. I would like to personally thank all of my colleagues at the Trust for working tirelessly to keep our patients safe.

Measles
The UK Health Security Agency (UKHSA) has warned that further outbreaks of measles could spread beyond the West Midlands unless urgent action is taken to increase Measles, Mumps and Rubella (MMR) vaccination uptake in areas at greatest risk.

As of 18 January, there have been 216 confirmed cases and 103 probable cases in the West Midlands since 1 October 2023 – the majority being in children aged under 10 years. There have also been outbreaks in other parts of England, including London. As a result, the UKHSA has declared a national incident. As a Trust we are implanting the latest UKHSA guidance to support preparedness for and management of suspected or confirmed measles cases in healthcare settings.

Fuller report
Following the Independent Inquiry into the David Fuller case, the Phase 1 Report was published on 28 November 2023. The inquiry was established to investigate how David Fuller was able to carry out unlawful actions in the mortuary of the Maidstone and Tonbridge Wells (M&TW) NHS Trust, and why they went, apparently, unnoticed for so many years. The report makes 17 recommendations all of which are relevant to all mortuary providers. The Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (BOB ICB) is working with providers of mortuary services, to gain assurance that all recommendations are being implemented. This assurance will be monitored through the BOB Population Health and Patient Experience Committee (PHPEC).

BOB ICB Primary Care Strategy
The BOB ICB has published its draft Primary Care Strategy which highlights our ambitions for the future of general practice, community pharmacy, optometry (eye care) and dentistry across BOB.

The draft strategy outlines three priorities to help deliver these ambitions:

to improve access so patients get the right support first time to manage their health and wellbeing
to develop proactive and personalised in the community care for patients with complex health needs
to prevent ill health by using and sharing data with our partners about the health needs of local communities.

To help deliver these priorities we are proposing to further develop the following services:

Non-complex same day care
Integrated Neighbourhood Teams
Cardiovascular Disease Prevention

You can find out more about the draft strategy and share your views about the plans here: The draft strategy will be an agenda item at the February Trust Board.

Outstanding care
My thanks to colleagues across all our acute and community sites working hard over the Christmas and New Year period to keep our patients, particularly some of the most vulnerable residents of our county, cared for.

Key performance data are reported in the Integrated Performance Report with supporting narrative. At Transformation Board earlier this month, the team updated on continued improvements to the Elective and Urgent & Emergency Care pathways. Whilst there have been improvements in the cancer pathway, the Trust is still performing below target and a deep dive is in progress to ensure this is back on track by the end of March 2024.

A Joint Area Targeted Inspection of the way the safeguarding partnership in Buckinghamshire works together in relation to the assessment of initial needs for children took place from Monday 22 to Wednesday 24 January 2024. Over the three days the inspection team visited our safeguarding team, emergency department, children and young peoples’ services and maternity department. The inspection will not result in a rating for the Trust or Buckinghamshire Council but will identify strengths and weaknesses in our partnership practice. A further update will be provided once we receive the final inspection report.

I am delighted to append to this report a letter from NHS Blood & Transplant (Appendix 1), advising that the number of donors and transplants has increased and returned to pre- pandemic levels, and commending our Trust on our contribution to this. The letter describes data for the first half of the financial year, and I would particularly draw the Board’s attention to the quality of care provided through these complex situations. My thanks to colleagues involved.

I am also very proud that Wycombe Hospital has been successfully accredited as an elective surgical hub delivering high standards in clinical and operational practice – the first within the BOB ICB.

The scheme, run by NHS England’s Getting It Right First Time (GIRFT) programme in collaboration with the Royal College of Surgeons of England, assesses hubs against a framework of standards to help hubs deliver faster access to prioritised care and surgical procedures such as cataract surgeries and hip replacements. It also seeks to assure patients about the high standards of clinical care. Wycombe Hospital is one of 31 hubs to date that have been accredited.

I am sure the Board will join me in congratulating our Research & Innovation team which has been successful in applying to be an NHS Clinical Entrepreneur Programme InSites Trust.

The programme is in the second year of its pilot, and we now join a group of 20 leading innovation trusts. We will also receive funding to support capability building, and I look forward to sharing further updates in due course.

I am pleased to announce that we have been shortlisted in the HSJ Partnership Awards in the Most Effective Contribution to Integrated Health and Care category for the Onward Care programme which has been developed and piloted in partnership with Sodexo. I am also

delighted to celebrate the outstanding work of some of our colleagues and volunteers. Dr Andy Tyerman, Consultant Clinical Neuropsychologist, has won the British Psychological Society M B Shapiro Award for clinical psychologists which is given to those who have achieved eminence in the profession. Trust volunteer and honorary chaplain, Dave Short, has been made a Member of the British Empire for his services to pastoral care and the community in Buckinghamshire.

Healthy communities
Partners across the Buckinghamshire place have identified the need to build healthier communities, improve population health and reduce health inequalities. Recognising the collaborative nature of this work, Buckinghamshire partners have agreed to develop a place wide strategy. The first strategy development session was held on 4 December 2023. The key outputs were the need:

for prevention and proactive care to feature more strongly in Buckinghamshire’s service offer (including citizens as assets and a systematic approach to working with the VCSE sector).
to add value in those services where patients are receiving care in the appropriate setting
to review governance and accountability arrangements to ensure accountability is shared and aligned; and
further develop an effective approach to providing care earlier in the pathway, in and out of hospital settings

Next steps will be to complete data collation and analysis and reconvene key partners in February to agree data analysis and confirm a focused set of key priority areas for integrated health and care in Buckinghamshire to then share and develop with wider partners. I look forward to updating on the outcome of this work in due course.

The Trust has been running a Homeless clinic since May 2022 engaging with two local homeless charities, Aylesbury Homeless Action Group (AHAG) and Wycombe Homeless Connection (WHC). Last month, led by Chief Medical Director Andrew McLaren, we held a workshop with representatives from the Trust, Oxford Health, Buckinghamshire Council, BOB ICB, Primary Care and Oxford University Hospitals to discuss how we can work closer together to support local homeless and vulnerable communities. We will continue to update the Board on this initiative.

Great place to work
It was a pleasure to visit all of our Trust sites alongside my Executive colleagues in the days preceding Christmas, to spread some festive cheer and say a personal thank you.

In November last year, we said we were going to change how we support working flexibly at the Trust. How we manage annual and other leave is an important part of these

changes. We are pleased that we have launched a new policy which aims is to provide support to all colleagues, recognising different working patterns and places, different life events and different stages of our working lives.

We are also working hard to improve the environment for our colleagues, ensuring they have comfortable spaces to take a well earnt break. As part of this, I am pleased that we have reopened the Windsor Dining room at Wycombe with further refreshment areas openingsoon at Stoke Mandeville and Amersham hospitals.

Finally, on behalf of the Board I would like to take this opportunity to say a special thank you to two colleagues.

Dr Sarah Lewis will be attending her final Board meeting this month in her role as Board Affiliate, which she has undertaken over the last year in addition to her clinical responsibilities. Sarah has made a valuable contribution to our discussions, and we wish her continued success in her career with the Trust.

Ali Williams, our Chief Commercial Officer, will be leaving the Trust at the end of January to take up a position in Scotland. During her time at the Trust, Ali has been instrumental in establishing a thriving commercial function and led on some of the most critical changes to our sometimes problematic estate, from ensuring we had sufficient piped oxygen at Stoke Mandeville Hospital at the height of the COVID-19 pandemic, to modernised agile working spaces across our sites. One of Ali’s most memorable legacies will be an energy plant at Wycombe which will have the potential to power new buildings on that site at net zero.

Charmaine Hope will be joining us from Oxford University Hospitals NHS Foundation Trust as Chief Estates & Facilities Officer. where she has been Director of Facilities, Estates and Capital Management. Amongst many highlights in this role, Charmaine led on delivering an award-winning 48-bed critical care new building. We will be delighted to have her experience and expertise in our organisation.

Please see PDF to view the CEO’s report appendices:

Appendix 1 – Letter from NHS Blood & Transplant
Appendix 2 – Elective Surgical Hub Accreditation letter
Appendix 3 – CARE Value awards
Appendix 4 – Executive Management Committee and Transformation Board