e CEO Report November 2023

National and system update

At the start of November, we received guidance from NHS England about managing the financial position and performance for the remainder of this financial year in light of the challenges created by industrial action. On 22nd November we held an extraordinary board to review and approve our plans, which will be referenced later in the agenda.

Outstanding care

Key performance data are reported in the Integrated Performance Report with supporting narrative. At Transformation Board earlier this month, senior leaders discussed in detail the challenges with waiting times in our Emergency Department (ED), acknowledging that whilst a lot of hard work has gone in to setting up processes and pathways to triage patients attending ED to access the most appropriate form of care, there is work now to do to ensure these are all functioning coherently in what is one of the most complex services in the Trust.

Colleagues also discussed cancer performance, and our position against the faster diagnosis standard. Plans are in place to improve this over the coming months, particularly in dermatology where we are currently experiencing the largest challenge. In diagnostics we have seen an improvement in endoscopy, and a mobile MRI unit is now operating 7 days a week at the Stoke Mandeville site to help see more patients waiting for this diagnostic test as quickly as possible.

We noted the consistent delivery on a number of people metrics. We are also seeing continued progress on some of our quality metrics (including HSMR, and medically optimised for discharge). Our Hospital at Home service currently has 112 beds open and is on track to hit the planned trajectory, currently at 81% of capacity. More specialties are coming online, including heart failure and paediatrics.

We are also on track to hit the target we set at the start of this financial year in terms of clinical accreditations, and I was pleased to participate in two earlier this month. I would urge my Board colleagues to do so as well, if not already.

Our Research & Innovation team are working with the cardiac research team to support our participation in a lipid optimisation study, which is expected to impact c.2,000 patients over the next six months. Elevated levels of low-density lipoprotein cholesterol (LDL-C) are associated with increased risk of coronary heart disease and stroke. This study aims to identify patients through the NHS shared care record who require optimisation of their secondary prevention lipid-lowering medications and offer treatment to rapidly reduce their levels of LDL-C such as Inclisiran, a novel lipid-lowering therapy.

The Bucks Family Nurse Partnership held their Annual Review this month. This is a vital service for some of the most vulnerable members of our community, and it was interesting to see that they have experienced a 25% increase in demand in the last year.

Congratulations to our children’s teams who have been successful in winning two bids for services: children’s therapies, and the Healthy Child programme. This reflects a significant amount of hard work and I am grateful to the teams, as well as supporting corporate colleagues, for their efforts in recent weeks. We are really pleased to be able to continue delivering these vital services for children in Buckinghamshire, allowing us to work within our integrated Trust to coordinate positive outcomes for this cohort of our community.

Healthy communities

The Trust is supporting the council’s ongoing Community Action Days which are taking part in the 10 priority wards identified in the Opportunity Bucks levelling up programme. This gives us the opportunity to reach residents who may not usually access our services. Over 800 people visited our Research & Innovation and health visitor stands at the Community Action Day in Aylesbury which took place in October, allowing us to showcase the Trust’s services and raise awareness of our first health on the high street venue at Unit 33 in Friars Square shopping centre.

On Saturday 4th November our Resuscitation Service completed 24 hours of uninterrupted chest compressions in a Basic Life Support marathon. Inspired by the global initiative, Restart a Heart Day, the marathon was intended to raise awareness of this life saving skill and fundraise for community equipment. In just 24 hours, 420 volunteers completed over 150,000 chest compressions. From 16 October for six weeks, the team are aiming to train 1,800 people across the local community. Congratulations to the team for this initiative and for spreading such an important message: two hands can make a difference.

I have also previously highlighted the growing success of our schools engagement team and our BrigHT Futures at BHT programme, and I am delighted to share a video showcasing our Teachers Engagement Project. This was set up to give local teachers and careers advisors the chance to see the range of careers available in healthcare, speak directly with clinical and non-clinical colleagues, and see how the skills and curriculum that students learn at school could support them in a future healthcare career. It’s also an opportunity to share the range of opportunities we have to offer young people such as apprenticeships.

We were also invited to present at a national briefing organised by the Careers and Enterprise Company (CEC), alongside organisations including the BBC, UK Space Agency, and Federation of Small Businesses, to discuss new employer standards for careers education. In partnership with the Bucks Skills Hub, we participated in a pilot run by the CEC to apply its nine standards for career education, which includes promises to ‘provide meaningful opportunities’ and ‘raise awareness of pathways into work’ to support young people in their next steps beyond education.

Great place to work

Two of our colleagues were privileged to attend the recent celebrations at Buckingham Palace for His Majesty the King’s 75th Birthday and 75 years of the NHS: Asha Mathew (Advanced Nurse practitioner in Haematology) and Arlene Bautista (Head of Clinical Education and Professional Development) represented our Trust for their work in supporting internationally educated nurses settle in to working with us and living in Buckinghamshire.

The National Staff Survey closes on Friday 24 November 2023. I described in my last CEO Report how important data from this survey are in understanding how colleagues feel about working at BHT, and what we can do to improve their experience. I am delighted to append to this report a letter we have received commending improvement across all seven elements of the NHS People Promise in last year’s data. Our Chief People Officer, Bridget O’Kelly, was also invited to attend the Chief Nursing Officers’ Conference to share some of our approaches and findings.

Earlier this month we marked Remembrance Day with services on each of our three largest sites, with the service at Stoke Mandeville Hospital live-streamed for colleagues joining remotely. My thanks to colleagues who organised and coordinated these services, which form a sobering and important time in the year to reflect on sacrifices made, both past and present.

Finally, I was pleased to spend time with some of our peer vaccinators this month, as our flu and COVID-19 vaccination campaign continues.