z CEO report January 2025
1.0 National and system update
1.1 I will start this report by acknowledging the challenging pressures that have been experienced by the NHS across the country, with a number of trusts declaring critical incidents earlier this month. At BHT we were not immune to these challenges, and I am grateful to clinical, operational and support services colleagues for their commendable hard work in, at times, difficult circumstances. Although we still have more to do to provide high quality care in the timeliness that we aspire to and our patients rightly expect, our performance has on the whole been an improvement on previous years, which is testament to the robustness of our winter plan and preparedness.
1.2 On 6 January 2025, the Department of Health & Social Care and NHS England issued guidance titled ‘Reforming Elective Care for Patients’ in which it sets out short- and longer-term commitments to improve how elective care is managed, and through doing so, meet the constitutional standard that 92% of patients should wait no longer than 18 weeks from referral to treatment by March 2029. The commitments include empowering patients, reforming delivery, delivering care in the right place, and aligning funding, performance oversight and delivery standards with a series of targets and milestones to 2029. We welcome these changes and look forward to working in line with this guidance to further reduce the length of time our patients wait for their appointments. Please see attached gap analysis assessment from Raghuv Bhasin (Chief Operating Officer) and his team (Appendix 1).
1.3 Work continues on planning for 2025/26, whilst we await publication of the national planning guidance. We have been asked by the Integrated Care Board to present all options for submitting a break-even plan at organisational level for a preliminary submission at the end of January. A potential financial and performance assessment of this will be discussed later in the Board meeting.
1.4 The Acute Provider Collaborative between the three trusts in the BOB ICS providing acute healthcare continues to work towards identifying opportunities to work more collaboratively to improve the experience of patients in Buckinghamshire, Oxfordshire and Berkshire West, and the following slide summarises the current status of the main programmes of work:
The BOB Integrated Care Board has updated its Place-based working arrangements, with senior executive sponsors for each: Rachael Corser (Chief Nursing Officer) for Buckinghamshire, Matthew Tait (Chief Delivery Officer) for Oxfordshire, and Dr Ben Riley (Chief Medical Officer) for Berkshire West. Dan Leveson, previously Place Director for Oxfordshire, has been appointed Director of Place and Communities. Formerly part of BHT’s strategy team, we look forward to working closely with Dan again in this capacity.
1.6 Congratulations to Mr Andrew McLaren (Chief Medical Officer) who has been elected as co-Chair for the NHS Providers Medical & Nursing Directors Network.
2.0 Outstanding care
2.1 Key performance data up to the month of December are presented in the Integrated Performance Report with supporting narrative. Regarding delivery of our breakthrough objectives, our corporate nursing team have advised plans are in place to get back to trajectory for clinical accreditations, and colleagues are working hard to implement the necessary processes to capture all the outpatient blood pressure measurements being taken. The Board will note the current challenges to delivering the 28-day Faster Diagnosis Standard, and 62-day performance target and the recovery plans and oversight in place to drive improvements on these for our patients. Raghuv Bhasin (Chief Operating Officer) will update further under this item.
2.2 The Board will recall a previous update regarding the national implementation of Martha’s Rule, named after Martha Mills who died age 13 after developing sepsis in hospital, and intended to ensure the concerns of the patient and those who them best are listened to and acted upon. Stoke Mandeville Hospital is one of 143 pilot sites and earlier this month Call 4 Concern© was rolled out across most of our adult inpatient wards. This is a patient safety service which enables patients, families, and carers to telephone our Critical Care Outreach team if they are concerned about the care they or their loved one is receiving, and they do not feel the team caring for them has recognised the change. Information about this service is being made available on the wards and can also be read on our website here.
2.3 I have previously mentioned the opening of our Skin Centre in Amersham Hospital a few months ago, and it was a privilege to recently observe their same-day clinic in action, with a patient receiving plastics reconstruction one afternoon, following Mohs surgery that very morning to remove a skin lesion. Several of our services are looking at how we can structure how we deliver outpatient healthcare in this way, to give our patients a better experience and minimise the number of times they need to attend our sites.
2.4 At Month 9, the Trust is reporting a deficit of £5.1m year-to-date, in line with plan, and is on track to hit the planned full year £0.7m deficit plan subject to receipt of clinical income for activity delivered. The Trust has so far delivered £19.0m of it’s £36.1m capital programme for the financial year. Jon Evans (Chief Financial Officer) will update more through the Month 9 Finance Report.
3.0 Healthy communities
3.1 Congratulations to our midwifery team who have been successful in their bid for a UK-Zimbabwe Health Partnership Pilot Grant Award from Global Health Partnerships, for a project looking to improve maternal and neonatal morbidity and mortality at Luisa Guidotti Hospital and the surrounding area in Zimbabwe. One of our internationally educated midwives is from this region and this partnership is a fantastic opportunity to help improve the outcomes for women, children and families in this community.
3.2 Our clinical operations leads have been out and about in Buckinghamshire over recent weeks, visiting primary care centres across the county to get a better understanding of our respective challenges and opportunities to improve the experience of healthcare for our residents as we work together towards developing Integrated Neighbourhood Teams. It was a pleasure to join one of these visits to Poplar Grove, Aylesbury, part of the Central Maple primary care network. My thanks to our partners for hosting us.
3.3 The next Opportunity Bucks Community Action Days are coming up in February – these are fantastic days organised by Buckinghamshire Council and involving lots of partner organisations from across the county, including heath and BHT. I look forward to seeing and hearing from lots of residents at these important events
3.4 Healthwatch Bucks are holding their next roadshow from the end of February into early March, keen to hear from members of the public about their experiences of all aspects of health and social care services in Buckinghamshire.
4.0 Great place to work
4.1 In the penultimate week of December, members of the Board visited all departments across both our hospital and community sites to extend our gratitude and best wishes for the festive season. As always, it was a privilege to be able to spend time seeing colleagues and taking the time to thank them for their hard work.
4.2 I was pleased to join colleagues at the first of our Managers’ Inductions at the start of this month. These are really important sessions to make sure that those with line manager responsibilities have the necessary training and information to lead and support their teams as effectively as possible from when they first join us at BHT.
4.3 Finally, this is the last Board meeting for Tom Roche, Non-Executive Director (NED). Tom joined us in 2017, first as an Associate NED and member of Strategic Workforce Committee and attendee of Finance & Business Performance Committee. In his tenure as a Non-Executive Director, Tom has championed our People priorities through his chairmanship of Strategic People Committee and most recently his passionate advocacy for organ donation as Chair of Organ Donation Committee. Tom has always brought professional rigour and enthusiasm to the Board, and we are grateful for it. Such is his commitment to the Trust and improving the experience of local residents, I know Tom is sad that his tenure with us has come to an end. I am sure the Board will join me in wishing him the very best.
Appendices – can be found in the PDF download document
- Appendix 1 – Reforming elective care for patients gap analysis
- Appendix 2 – CARE value awards
- Appendix 3 – Executive Management Committee & Transformation Board