This week's leadership message comes from Chair Sarah Boulton

Sarah Boulton

You will have seen that Clive Lewis MP revealed in Parliament last week that a whistleblower from our Trust had suggested that there were 20 deaths due to delays over the festive period. A number of other MPs made interventions, and the media made various claims about harm to patients. Some saw it as an indication that we, as an individual organisation, had let patients down while others saw it as a strong sign of the pressure the whole system is under.

It has been uncomfortable to be in the spotlight of the media, politicians and regulators. It has been very busy, as we have had to respond to information requests, further analysis, attend meetings at short notice - all in a short space of time. There have been various statements and allegations made, so I thought it would be helpful to tell you what we think is happening and what we are doing about it.

What we understand is that someone from our Trust passed on a list our clinical team had compiled, containing the names and brief details of patients who had experienced delays in the care we were able to provide for them. Various news outlets now have this list and have tweeted, published and headlined some of the details of the individual cases that you will have seen reported. The list was compiled as part of our usual incident reporting and management process prior to further deeper analysis and investigation to understand if the delay experienced had caused any harm to the patient. The list was at a very early stage of the process, with no conclusions drawn as to the outcome for the patient at that stage.

What we also know is that the festive period was, as always, incredibly busy. At our board meeting yesterday we heard directly from people in one of our Patient Safety Intervention Teams. We heard just what care is like for those patients stuck in a queue outside and inside a hospital, waiting to be handed over to the care of the hospital. And we heard first hand about the stress and pressure this has on you. I visited Bedford EOC over this busy period, just before it was locked down, and I saw the immense volume of calls and incidents our call handlers, dispatchers, team leaders and managers are dealing with. And I also saw how effectively the ECAT team provide clinical support and advice and how they manage the clinical risk in all those waiting calls that have to be stacked as they await resource to become available. Incredibly we dealt with 50,000 calls in 15 days, and indeed received 4,800 in the 24hours between 31st December and 1st January. That is an amazing achievement by you.

We also heard at the board yesterday that in preparation for the winter period we put on an average of 20% extra resources, by using private ambulance, agency and overtime when it was appropriate and available. And, in moving to REAP 4, further resources were released to help with the increase in demand. Executive director colleagues were working right across the festive period and were available every day to contribute to and support the operational teams. In spite of all this, unfortunately, the combined impact of high call demand and high levels of hospital handover delays meant that we were not able to respond to some of our lower acuity patients nearly as quickly as we would have liked, for which I am very sorry as I know you will be. 

Probably just like you, we read in the press that there was to be a risk summit, variously described as an independent investigation, an inquiry, a review and so forth. We have now heard first hand that what is actually going to happen is a review of urgent and emergency care in the East of England for the festive period so we can learn lessons, led by NHS England. We will take forward any actions that emerge from this and share those lessons with you.

While it has been uncomfortable to be under the cosh in the way we have been for the last few days, we need to continue to provide assurance and confidence to our stakeholders that we are running our Trust in a way that serves patients to the best of our ability. And to do that we have to continue to be open, honest and share all the information and evidence we have about what we have done and why. In that spirit, if you have anything that you think we need to know, particularly around patient safety, please do pass it on. You can do this through your line manager, or directly through Datix. Or of you would prefer to raise it confidentially contact Simon or Anna in the Freedom to Speak Up team at Eoeasnt.f2su@nhs.net. They have established a strong track record in dealing with the concerns you raise.

Finally can I thank you all for the incredible work you have done over the festive period, in the face of so much pressure, and all the work you continue to do to ensure our patients get great care. I am immensely proud of you and what you have achieved.

Published 25th January, 2018

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