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t CEO report: May 2024

Chief Executive’s Report – May 2024

1.0       National and system update

1.1       The Integrated Blood Inquiry Report was published on Monday 20 May 2024 and NHS England issued its response and a public apology on the same day. Our thoughts are with those affected and we would reiterate the advice to any members of the public who may have questions or concerns relating to infected blood to access the online resource that has been set up. We are also reinforcing the support available from our Health & Wellbeing team for our colleagues.

1.2       The Integrated Care System’s financial plan submission at the beginning of May outlined a £92m deficit, of which the Trust’s position was a £28m deficit. This deficit position includes absorbing two years’ worth of growth and inflationary pressures plus a reduction in income of around £19m. This is in line with the Integrated Care Board’s approach of reducing income into the secondary care providers to fund other system pressures; this especially impacts the two district general hospital organisations in the system, who are more reliant on ICB income as a percentage of total income than other providers. To meet a breakeven position with this income redistribution method would require an in year direct cost reduction for the organisation of about 12%. Since submission, the system has been allocated a control total of no more than a £60m deficit. Options to close this £32m gap are being worked through across the system and will result in a more challenging deficit target for the Trust. The Chief Financial Officer will update on progress later during his report.

1.3       The Acute Provider Collaborative Board is now established and had its first formal meeting this month, chaired by our Trust Chair, David Highton. The Board brings together the three providers of acute hospital services within the Buckinghamshire, Oxfordshire & Berkshire West Integrated Care System to improve the experience and services for patients and find more efficient ways of working where systems and processes are shared across trusts. Further updates will be shared with the Trust Board in the next quarterly Place & System Briefing in July.

1.4       Earlier this month, partners from across Buckinghamshire came together for the third time to further develop our proposed Health & Care Strategy for the county. My thanks to everyone who gave up their time to bring their perspectives and expertise to the day. We look forward to engaging with the public in coming months and sharing further details with the Board in due course.

1.5       Finally, we continue to manage some challenging aspects of our ageing estate: in Wycombe Hospital we have experienced some issues with our hot water supply. My thanks to colleagues for their patience and flexibility while a temporary solution has been put in place to ensure the continued safe use of water.

2.0       Outstanding care

2.1       Key performance data are presented in the Integrated Performance Report with supporting narrative. The report has been restructured to focus the Board’s attention on progress against delivery of the Trust objectives this year, with contributing or related metrics grouped accordingly. Earlier this month, the Executive Management Committee discussed these data, in particular recognising the increasing number of patients on our waiting lists and the poor experience this provides those under our care.

2.2       Following receipt of national performance data for the end of March 2024, we have been able to confirm a number of improvements across key measures, and I have enclosed an infographic that summaries the achievements. These all reflect significant hard work and innovation by lots of teams, and my thanks for these efforts. Thank you also to the many patients who have been waiting for appointments for their patience – as these data show, reducing our waiting times is a priority for the organisation and we have been putting in place sustainable changes which should continue to improve patient experience.

2.3       Together with colleagues from the Buckinghamshire, Oxfordshire & Berkshire West Integrated Care Board, we met with the NHS England regional team to review our performance over 2023/24. The presentation we gave highlighted our improvements, delivery of our financial plan, and key activities with partners in the Integrated Care System and more locally in Buckinghamshire (‘Place’). I have attached these slides in Appendix 1.

2.4       This month we also held another inspiring Research & Innovation Conference, and our amazing colleagues making improvements to their services through our annual Quality Improvement and Clinical Audit Conference.

3.0       Healthy communities

3.1       Our Amersham Skin Cancer Centre was officially opened this month by Trust Chair, David Highton. The Centre has been set up primarily for patients with skin cancer, though patients with a variety of skin conditions will also be seen and treated there. There is also a same day ‘see-and-treat service’ which offers patients the opportunity to have an assessment and surgery if required in a single visit.

3.2       In an effort to tackle undiagnosed hypertension, we have made a commitment to offer our patients blood pressure checks whilst they are waiting to go in for appointments: the breast care team is championing this initiative and has installed a blood pressure monitor in the waiting area of the Breast Unit at Wycombe Hospital. Members of the public can already check their blood pressure numbers at Health on the High St in Unit 33 of Friars Square, Aylesbury.

3.3       It was fantastic to spend an enlightening morning with our children and young people’s therapy teams based in Amersham Hospital. It is always humbling to witness our clinical teams at work, and a particular privilege to see and hear how this team is supporting both schools and the youngest members of the population we serve.

4.0       Great place to work

4.1       NHS England has contacted all trusts asking them to consider how they can be ‘Improving the working lives of doctors in training’. The team is currently reviewing these in detail and will be sharing a report to Strategic People Committee in July.

4.2       This month we have also been recognising and celebrating lots of national awareness days. For Mental Health Awareness Week this year’s theme of moving more for your mental health. Our fantastic Health & Wellbeing team has put on a number of activities for colleagues to take part in throughout the week in addition to their usual offering, and I was fortunate to spend some time with them and the Occupational Health team, whose expertise and insights I continue to find humbling.

4.3       It was also Equality, Diversity & Human Rights Week 2024 and we supported and promoted the work of the NHS Confederation’s three diverse leadership networks: Health and Care Women Leaders Network, Health and Care LGBTQ+ Leaders Network, and the Black & Minority Ethnic Leadership Network.

4.4       In recognition of International Day of the Midwife and International Nurses’ Day, our 4th Annual Courage of Compassion conference took place and once again we were honoured to welcome esteemed external speakers to inspire our nursing and midwifery teams. I was also delighted to spend time earlier this month with our community midwifery colleagues based at Wycombe Hospital, see their expertise in practice first hand, and discuss their thoughts about their service with them.

4.5       Several of our nursing colleagues were honoured to be invited to the 59th Florence Nightingale Commemoration Service held at Westminster Abbey on Wednesday 15 May. We were privileged that our Trust and wonderful nursing colleagues were represented at this special event.

4.6       I was extremely fortunate to be invited to 11 Downing St, London earlier this month with the team from Scannappeal for the launch of the William Baxter Memorial Fund which has been set up to continue William’s legacy and reflect his passion for innovation. More details are available on the Scannappeal website here.

4.7       This month, Bridget O’Kelly (Chief People Officer) and I have been meeting about 20 of our teams across the organisation to discuss their results from the National Staff Survey to see what we can learn from pockets of excellence and best practice in engagement and improvement. My thanks to colleagues for their time and input.

4.8       Finally, I am sure the Board will join me in extending our enormous thanks to Hannah Hornby for her thoughtful and insightful contributions to the Board, and her joint leadership of the Trainee Leadership Board during her tenure as Board Affiliate. We wish her all the best in her future endeavours.

Appendices