We Are EEAST Briefing - 23rd December 2020

WeAreEEAST Briefing, Wednesday 23rd December - Dr Tom Davis, Acting CEO and Marcus Bailey, Chief Operating Officer

Good afternoon and thank you again for joining me on today’s Executive Q&A session. My name is Tom Davis, I’m the Acting Chief Executive at the moment. As with all these events, please feel free to ask your questions in the question-and-answer box, and we will endeavour to answers those in the live event, and if not, send a response to the individual or otherwise afterwards.

I would start by saying I was hoping that this week’s message would be a little bit more light hearted and positive, but the events of the weekend, and the escalation across the country and the rest of the world with the pandemic has put a little bit of that festive cheer on hold.

I’m joined today by Marcus, our Chief Operating Officer, and reflecting the pressures that the system is under, I’m going to have to leave you at 3 o’clock to join a national escalation call for the ambulance sector, so hopefully I will get through as many questions as I can, but the Marcus will be with you for the full session to answer further.

So, I think one of the things I’m very keen to focus on is about how we look after ourselves as people and as human beings. I’m hoping that many of you will get some rest over the coming weeks, and be able to enjoy, in the context of being able to enjoy, both a rest and Christmas with your loved ones and dear ones.

I know that Saturday’s Coronavirus update was a blow to everyone, but there are positives, and the vaccine is on it’s way, and we have achieved a huge amount for both keeping ourselves and our communities and our patients safe over the last year. But please do look after your own wellbeing and that of your colleagues. It’s stressful at work and it’s stressful at home, and there is support available, and all the details for that are on our Need to Know site, and through conversations with your colleagues and your management teams.

Before I pass over to Marcus, I just wanted to focus on one aspect that I’m very passionate about, and that is the wearing of correct PPE. Not in clinical areas necessarily, where we know we do a good job in the main, but in all other areas, in non-clinical areas. I’m really keen that we see the importance of wearing masks in our vehicles when we’re sharing lifts, in our vehicles at work, but also in our stations and in our interactions across the organisation through this time. So, we will see over the next few days a focus on mask wearing and correct PPE wearing in all circumstances. This is because the risk is increasing, the risk to ourselves, the risk to our colleagues, the risk to our communities, and the risks to our families as well as our patients. So, please, I would encourage you to look out for those communications, and if you aren’t in a mask yourself, or your colleagues aren’t in a mask, politely ask why, to ensure your safety and your colleagues safety is paramount.

So I’m going to pass over to Marcus, to just articulate some of the things that we are doing as an organisation in response to changes over the weekend, and then when I come back afterwards I’ve got a few positives to look forward to in 2021. So, Marcus, I’ll hand over to you, thank you.

Thanks Tom, and good afternoon everyone, again thank you for joining. So yea, look it is really busy. I have said on some of the previous sessions that I’ve been involved in that we are now on month 14 of a really pressurised ambulance service. Probably more so than we have seen in a number of years moving from Winter Covid, Summer Covid and now in to Winter and Covid, and some would even dare argue that Winter isn’t truly amongst us at this moment in time because of the weather. It’s also while we’ve experienced Covid for a number of months, actually still also different. It’s different because we have seen different changes in terms of tiering and lockdown, we’ve restrictions eased then come back on. We’re now seeing, I think, the effect of, I guess, pressure within systems, pressure within hospitals. And so for most organisations, and we are no different, whether in health and social care, is the impact of how that is for you as individuals, i.e the impact to our ability to have you at work in the workplace, and for you to be protected and looked after as well. And that means for us, and we see it particularly in some of the London hospitals, the affect of being able to have sufficient staffing.

Now, we’ve had a number of contingency plans in place, and they have been enacted in order for us to maintain, I guess, our response to patients. But importantly, when we look at response to patients, its also in areas to make sure that we look to reduce the amount of late finishes, make sure we look to get rest brakes, and there’s and number of reasons when we talk about this. It’s not just about our response time, it is a whole collective set of actions in order to support and to do that.

We know fully well that we have a legal duty in terms of keeping you safe, and yourselves have that shared responsibility in terms of, and as Tom was saying, the ability to talk to and speak with your colleagues related to any concern or areas for improvement and support as well. We are doing well, and I know that it doesn’t feel like it, but we are doing well in terms of the lateral flow testing, about the testing arrangements. We know that vaccination will come online after Christmas, that is our latest information in to January. And we know that the changing of the prioritisation, we probably learn and understand about as much in short flow from the news itself, i.e the timing’s very short and we respond very quickly to really understand what those look like as well.

In terms of Covid and the impact, and I can see a couple of questions that have come in to the chat box as well, is we do constantly review, and we have to constantly review information. And there’s a balance between everything here, which is how do we maintain, in effect we are essential work, so what we do as an organisation, we are essential work. PPE, we know PPE has been shown, particularly in high-risk areas, so they’ve done a review particularly in hospitals, where they were looking at the high risk areas where PPE is used and the conversion of that in to staffing concerns, is low, i.e if the correct PPE is worn, and is worn effectively, and social distancing and hand washing and all of those things are followed, then actually the rate of transmission is lower. Where we don’t, and in what they described as general ward level care, then that becomes the balance.

Now, from our point of view, we are constantly reviewing our Covid safe practice, and I think from Tom’s description, and I would support that, we can write as many instructions as we want, we can write as many posters as we want, but actually it’s something we need to look to do ourselves. I can only say, whatever we think, Covid is very real, and Covid is very present, and that isn’t to insult people. But when we look at adherence to PPE, I think sometimes we look directly at that being around clinical areas. Actually, the ability to wear appropriate protection and to follow appropriate guidance follows clinical and non-clinical areas, as that’s where the Covid secure element comes in as well. And that’s just asking us to think about how do we maintain that, and how do we really focus supporting each other in that.

Because it is a long haul, and it doesn’t matter if the vaccine actually starts in January or not, the reality is that this will not be over by the end of January, and we know that actually this will roll in to 2021, and therefore our new ways of working, and our new normal as we would describe it, is going to here forever really in terms of some of it, until we really understand. Now we know that brings with it a number of challenges.

I think we also learn and we also look within that, and again I’m conscious of the question in the chat which is really good, is when you start to get the tiering, what does that mean in how we modify and how we look at our business? And it is difficult and there’s the balance , and I guess I share with you some of the decision making and the balances that we go through, is how we afford and how we look at appropriate level of protection, restrictions and guidance, and how do we also make sure we remain agile and flexible enough in that to make sure that we can respond to increase in demand, how do we respond to support colleagues. There’s a whole thing in there about how do we risk assess, how do we look through our business continuity plans in order to make a judgement of how do we make essential service judgements, how do we put in protection and guidance.

 I think the commonality out of all of those, and time and time again this comes back to actually social distancing, hand washing, use of appropriate protection, whether with a patient or without a patient, appropriate cleaning, appropriate decontamination. Out of all of the guidance we’ve ever had, that is always the consistent message, always the consistent message. That is a continuous level of practice regardless of tiering, because obviously tiering in terms of restrictions is designed to bring the R rate, or the infection level, down. We do provide the level 2 water repellent masks, and looking level 3 PPE, the protection is more than cloth masks and cleaning etc. So all of those really do look in to that as well.

So I think I just reiterate and summarise for that with Tom, the other bit just in case anyone had forgotten, we also leave the EU very shortly, and you’ll have seen by the Covid may have caused lorries to have been stacked up at Dover, we’ve also seen some of that around Felixstowe, some of that around Harwich as well. The reality within all of those, it is a very clear and present effect in reality of a trial run of what it could be like in terms of customs.

Now, from our point of view, we have established plans now from Brexit and from leaving the EU. We have been able to tabletop and test some of those, and initially from our point of view, the ability to get everything we need to, we are not anticipating any challenges what so ever. As the weeks progress, we will then see if that has an impact, but we have a number of plans within those, so we will update as we do, every time there is something that we believe you need to know, but I think from a planning perspective we are as prepared as we can be, with the information that we have along that now. So Tom, thank you, I’m going to hand back to yourself.

Thanks Marcus, before I mention some of the things to look to for 2021, I just want to really link the mask and PPE issue to what we have been saying about our culture. We have been asking people to Speak Up, to Speak Out and to Stop It, and it is no different with our use of PPE. I think if we all work together, we will keep each other, and our patients and our colleagues and our families safe. Clearly, these are unprecedented times, but there are some simple measures that have been in place for a long time, that if complied with, and I’m talking every level of the organisation here, I expect my management teams to be setting an example, and I expect everyone to be thinking for themselves as healthcare professionals, in how they conduct their self-protection with the equipment.

But if you feel that people aren’t compliant and therefore you are not safe, then please speak up, and be heard by those that you speak up to. If you see others around you not complying, please speak out and either work with them or those around you if you don’t feel able to speak directly to them so that we can help support each other in doing the right thing. And I think that if you are a healthcare professional, especially those of us with a registration, and you can honestly look at yourself and believe that you are doing the right thing, then fantastic. But if you are a healthcare professional with or without a registration, and when you have a good look at your practice you believe that you could do things better, then please stop doing it wrong, and do it right for your sake, if not for anyone else’s sake.

So as I said, I have mentioned some good news stories, and then I will pick up the second question. So some good news for 2021 I hope, firstly is that we have spoken briefly in some of these sessions but also I have received a number of emails to the Chief Executive inbox, about how we’re going to recognise the work that staff have done in this unprecedented year.

John Syson, Director of HR, is leading on a piece of work which we hope to bring to you in January, which will look to refresh our recognition and reward scheme for staff, but in particular in the light of the last year and the pandemic. I know that other Trust’s have already made moves to do this, and it is not that we don’t have that intention, but I hope that everyone has been aware, there have been multiple pressures on this organisation, and we want to get this right. We want to involve staff in choosing what the right recognition and reward might look like, and that’s what I’ve asked John to do in to the new year.

We’ve also continued to invest, and a couple of week’s ago we spoke about the Electronic Patient Care Record, which project will commence in the new year. But we have also signed of 2 million pounds worth of investment in buildings, as well as with IT and other projects. This investment is to help improve the day-to-day experience of our staff and therefore the benefit to our patients and our communities, and we will continue to share more details as we go into the new year.

I’ll just pick up the question, so ‘staff are unlikely to wear PPE if it increases rather than diminishes their risk of cross infection. I and other staff have repeatedly raised the issue through Datix system and direct message to the Exec team about the flimsy not fit for purpose plastic aprons that were issued. They blow up over head and face even with the slightest breeze and a description of one contact with 17 times that happened, and that then increases risk of cross infection’. I know from the work that I did with the Infection Control Team and the national team, that this has been an issue that has been raised, and solutions have been sought.

I think I am more than happy to go back to the team and ask them to review that, but the stores and the PPE stock that we use is following all national guidance and it is done with safety in mind. So, I think there is two things here. One is I’m assured that we are following national guidance, and two is I can follow this up because it is not necessarily an issue that I thought was ongoing, I can follow it up to ensure that we have done everything that we can do, and that is the important thing, that as an organisation we acknowledge these concerns and that we are able to demonstrate that we’re doing everything that we can do, as some of these challenges unfortunately have no simple solution.

So, as we look for any further questions, and please if you feel that you don’t want to ask a question in the live event then the OCE email account is regularly reviewed and we try and respond on a timely basis to people as they raise their questions to me and any of the other Exec Director team. So, we’ll just pause for any further questions.

So, just to reiterate, the challenges are being thrown at us all the time as a healthcare service. The pandemic doesn’t see dates, it doesn’t see timelines, and we know from our knowledge of any virus, viruses are able to do what we have seen over the last couple of days, and that is adapt to the environment as much as we adapt to the environment as humans. It has been a tough year, and for this organisation it has been tough for more reasons that many, and that in itself creates stress both at work and for people at home.

It is important that you spend any time you can with your family and friends, even at this time where the restrictions are in place. Please look after yourselves and those you rely on for support outside of work, but also, as I’ve said, please support each other in work in keeping safe. Think about how you are using the protective equipment both in clinical and non-clinical environments. Think about how your colleagues are using it, and help each other in doing the right thing for yourselves, your communities and your patients.

Above all, I’d like to thank everyone for their hard work this year, responding positively to the changes that we have had to make in the circumstances that we find ourselves. As I’ve said, if you can, take some time to relax with friends and family, but in everything that you do, please stay safe. And on that note I wish everyone a Merry Christmas.

 Published 24th December 2020