WeAreEEAST Briefing 30th December 2020

WeAreEEAST Briefing, Wednesday 30th December with Dr Tom Davis, Acting CEO and Marcus Bailey, Chief Operating Officer.

Good afternoon and thank you to everyone for joining me this afternoon for the Executive Q&A session. I hope everyone was able to enjoy a merry Christmas with family and unfortunately this year, probably no friends. But as we will hear about, it has been a very busy time of year and I hope people were able to get down time where they were able to, and for all the people that helped support the organisation and our work, a big thank you.

As you’ll all know hopefully by now, my name is Tom Davis, I’m the Acting Chief Executive, and today’s session, like all sessions, is for you to ask questions of myself, and I’m joined by Marcus Bailey, our Chief Operating Officer, today as well. If you have questions please put them in to the Q&A box. We will try and answer them as efficiently and effectively as we can.

So, as we are going to hear from Marcus, it’s been a really busy time for the health service, and I’m sure you don’t need to wait for Marcus to give you that information because it is very visible across the news at the moment. There is some good news today, and I’m sure you’ll all have seen that the second vaccine, the Astra Zeneca Oxford vaccine, has been cleared for use today, and we will be hearing from the regional team and our own internal team about plans for staff vaccinations over the next couple of days, and we’ll hopefully be able to share that with you. It looks like the Astra Zeneca vaccine will be available from the beginning of January, or the 4th, 5th, 6th of January, and the national team are just identifying the priority order of health staff amongst the population.

So, some really good news amongst the challenges that we will hear about from Marcus, but before I go to Marcus, just finally from me before I come back later, is to say that it has been a challenge, but there has been significant planning done by the organisation. I’ve witnessed myself in the role that I took over the last four or five days as the Executive Lead, great teamwork across the organisation, and effective delegation and escalation. All of that has been fundamental in keeping the organisation resilient and safe for our patients over the last couple of days.

So, I’ll turn to Marcus to give us some further detail on the performance and operational issues, then happy to take some questions after. Marcus.

Thanks Tom, and welcome and afternoon everybody. As Tom said, a really different Winter, and a really different Christmas period this year. Not only personally for all of us in the sense of what it would normally be like, but in terms of matching Covid, experiencing Covid, and really, the second wave as we would call it, really really affecting people. We are seeing some really sick people. But, also affecting you as individuals, and therefore then combining together to cause some real real challenges.

We have started to see within us as a Trust, we’ve started to see that particularly on the London borders, and in the news today you will see they’re running with the story in Mid and South Essex through their local resilience forum declaring a Major Incident really because the pressure, and I guess they use the term saturations, and kind of really just being full capacity wise, a number of challenges.

So, we did a lot of learning from phase one, and I think we’ve probably tested more now in this phase, because we’ve had to because it has now become more prominent and having a greater impact. The two biggest areas, as I said, one will be about staffing and about you being well and being able to attend work, the other bit is around patients and the demand, and also how patients are, and we are seeing some sick patients particularly… it’s a respiratory impact, so we’re seeing patients requiring non invasive ventilation and oxygen requirements. And that in itself has been another learning over the last 48 hours of where we are seeing some hospitals really struggle with high flow oxygen capacity just to maintain.

So, all of these, as we have contingency plans that Tom mentioned, the ability for staffing, and increasing staffing. Thinking back to where we were this time last year to where we are now, it’s a very different place as an organisation around our ability to be more resilient. But also the challenges keep coming, we also had flooding, we’ve also got adverse weather on the way. So, actually our ability to prep and plan.

I want to say thank you particularly to those staff who worked Christmas, and for those staff who worked Christmas and went into London. Something we’ve never really tried and tested for. Most mutual aid has been based around a big incident, so the London bombings or things like that, where it’s a very defined period, a very defined ask. This was about providing care to patients.

Myself and Tom were around all over Christmas on call or in the building doing a number of things, but risk assessment and managing the risk of the organisation was again, something in my 20 years here is probably one of the most challenging times that we’ve had to try and get all of this right with so many things. But, again, without you, without everything you’ve done, and actually whether you’re on front line, PTS, control rooms, in all of the support services, without everyone we would not have been in a position to deliver our winter plan.

It’s still going, if you look outside it’s getting colder, Winter is not over, and we have New Years. It will be a very different new year this year, it will not be what we would expect traditionally from people going out. But I think what we will see is we will see the effects of Covid now running in to the first two to three weeks of January. We know regionally they are preparing for that with regards to intensive care facilities, increasing those beds as well.

I know we’ve had a couple of people ask questions are they opening things like the Nightingale Hospital again, so they are looking at it. I think the reality here, and we see this in hospitals, and for those of you who have queued in patient handover, staffing is a real challenge for everybody. Staffing has been a real challenge because of absence, not because of people aren’t wanting to come in to work but actually because of isolation or symptomatic, then than causes a real problem. In order to increase any surge capacity generally it’s about people.

My other thanks goes to all of you who have adapted and adopted your working practices. We know it is really difficult, and we know that going from making a decision in optimal conditions to making decisions in more challenging times, it feels really scary actually. It feels really difficult because you’re asking perhaps something that we don’t routinely do, to think about wider risk.

Our control rooms and our control room clinicians and our despatch teams have absolutely shown that, with regards to how they keep more than 100 patients safe, and in face we reached over 250 patients awaiting an emergency response. Now, for us we have experienced that in the past, but not recently. But we were able to do that in a process that was calm and controlled. And that’s a real testimony for us as clinicians and for people to really start to look at managing that risk.

It’s always really horrible in terms of where we provide poor patient experience, but our whole back stop here for everything has always been about making it safe for everybody, looking after people. We continue to learn, and we’ve put a number of actions in particularly around London and the mutual aide. We’ve also today looked to see what we can do in terms of welfare, particularly around where we will have longer delays within hospital handovers of patients, and we are trying a number of things, particularly with some of the work that we are doing with our regional teams and also providers. We’ve been on multiple calls last night and again over Christmas and this morning, really trying to look at different ways of doing things, and all of those are really important. Just to really try and do something that is different. If we keep doing what we’ve done we will stay doing that, and we really don’t.

The next bit for us now is that we’ll focus on in to January, and we know that January will be challenging, we know it will be very difficult, and we know that the planning and the preparation has to continue. I thank you for your participation for those that do lateral flow testing again, really important about keeping us all safe, about keeping yourself safe.

I reflect, and when I’ve done a couple of these sessions before, I’ve spoken about really thinking that we’ve now had 14 months of just quite a lot of pressure in terms of looking after patients. And its’s really difficult because there isn’t a magic wand to make it all better overnight. But I think, for us, keep doing what we’re good at, which is looking after patients, supporting and looking after each other, taking the necessary precautions and being protected with regards to PPE, thinking about that social distancing. And also, using the time, even though we may be in tier 4, and everyone feels they’re in tier 4 and can’t necessarily do as much as you could do before, is still trying to get some time out to look after yourself as well.

We know this time of year can be challenging anyway, and we really do know that, and we have a number of support mechanisms, talking through to occupational health, employee assistance program, your line manager. They’re really important still, and the ability just to have conversation, the ability to be able to talk and share, the ability to reflect and say how you feel, and they also really, really important as well.

So, again, I will hand back to Tom, but just to say thank you so much for everything so far, and we will keep going as we always do, but I thank you.

I also just want to take, and I always feel like I’m a party pooper sometimes when I say things like this, but it feels like I’m into some of the parish notices at the moment. But I do just want to remind people of the use of social media. Social media is a really powerful tool, it’s really good, it connects with people in a different way. I just ask people to be really mindful of what they post on social media. We do have a professional responsibility for patients and the organisation. There’s a lot of stuff circulating yesterday, and I’m not asking people not to talk about stuff, but I think you have to do it in a professional and respectful way.

If you’re not sure please have a chat or please have a look at the social media policy. Because I think for us, it’s about how we control messaging, how we take professional responsibility to, in effect, raise issues and concerns, but do it in a way that enables a good discussion. And from our point of view, we will do, and from the comms team putting out media posts as well, we will do lots of things. We never shy away from hospital handover delays, we do not say things aren’t bad, but we do them in a respectful way that allows us to work with colleagues and partners as well. So that’s my parish notice party pooper one that I’ve done on that one, but really important for us to remind.

We’ve had one more question which is can the call handler script about relatives wearing masks… so we have talked about this, and I will go back and just ask the question nationally, the thought process was a) in an emergency situation it’s not always easy, people do panic, the second bit is the best way to control it is actually for us to wear the PPE, not the individual actually, because it is directly within our control as well. And for every question that we ask, and everything – it may seem one question – but every question that we add in to the call handling script is another question that either they have to give manually because it won’t be mandated at the moment, or it takes away… so it’s all around the time it takes to do things and get round to things like CPR etc. So, I think my thoughts and my advice at the moment is that we continue with us controlling the PPE level 2, because that’s the safest thing, and that’s absolutely within our gift, in order to do. But I will ask that question to see about the scripting on that.

I’ve got no further questions, so I’ll just do my final bit in case any more come in. But from myself to all of you who have taken the time to join us, genuinely thank you for doing that. Thank you for continuing to engage and ask the questions. I know in the new year, once we are trying to get through these two weeks, and we assess what January will look like, we’re going to move into an Executive Q&A update session so we can start to talk about the so what question from the harassment survey, start to paint a picture of what we’re doing. Because I think we have spoken a lot in exec and to others about how it has to feel believable, it has to feel real, you have to notice something, and that’s the thing that we really want to start talking to you about, the bits that you will start to notice at a local level. And, for us, trying to show that connecting the dots, the road map and what does that mean, and really, really looking forward.

That for us is really important to do as well. It’s also a bit, for us, about the trust and confidence, about the relationship that we build together as a collective, and from the openness and the transparency that I hope you feel we are showing from an Exec team perspective, because that is how we do our business. I know it doesn’t always feel like it, but we’re always happy to answer questions to the best of our ability, to be able to talk about what we can talk about, and that becomes really important.

So, I’ve got no further questions, so it just leaves me to say thank you again, for everything. I wish you all, as best as we can, at least a very safe new year, and I think we will all be glad that 2021, unless there’s a plague of locusts coming over the hill that I haven’t quite accounted for, I’m really hoping that we’ll have a very different 2021, for us just, personally and professional, for our own resilience and sanity as well. But thank you, please stay safe, and I will speak to you again very soon.

Published 31st December 2020