We Are EEAST Briefing - 3rd December

WeAreEEAST Briefing, Thursday 3rd December – Marcus Bailey, COO and John Syson, Interim Director of Workforce 

We’ve just come from a session this morning with our regulators, NHS England, NHS Improvement, the Care Quality Commission (CQC) and other stakeholders whether it be Healthwatch, whether it be some of our Clinical Commissioning Group (CCG), College of Paramedics, UNISON. The meeting was around our oversight and assurance group which is the monitoring group and the group that we would work with in relation to us being in special measures. Today we were able to go through a range of areas particularly on progress and around completing the harassment survey and very much abut how we are then going to look at and use those findings. But I won’t go in to too much detail I’ll save it for John to have a conversation with you and let you know what those next steps might look like.

The other bit was also around some of the assurances around making sure that we have our processes in place, that we’ve reviewed those and the big bit for us now is moving on to the ‘so what’ questions. We’re doing all of these things but what does that actually mean. I know for those of you who have joined us in previous sessions we have had some good questions, good conversations about ‘so what’ in the context of, ‘well you’ve done this, we’ve got this problem so what does it mean, what does it look like, what does the future hold for us.’ We took a lot of time in the last session around the values and behaviours and you can see by our background that whole bit coming together in terms of teamwork and respect, two really important ones, and then the role modelling of behaviours that goes with that.

We’re also able to do some deep dive elements in terms of some of the complaints, we’re also talking through our assurance of Private Ambulance Services (PAS) and also that linkage with regards to safeguarding and casework and case management. I think, for me, I would say thank you to the people who have come forward to share experiences, thank you to the people who’ve been brave enough to say that they need some help, to raise issues, and also to support in offering assistance and sharing of views as well. We know there’s work to do and we know the journey but, actually for me, we’re seeing real willingness to move from an element of anger into ‘what can we do to solve the problem.’ I think we all say that working for EEAST is good, people like working for us, I like working for us, but it’s about how do we support each other in that and I guess my take away from  having conversations with people over the last few weeks has really been about how do we build that trust and how do we have an adult relationship across the whole organisation, built on respect and a set of behaviours that support each other, and ensuring we take action where required. One case of harassment is one case too may for us in this organisation and therefore we have to be routinely working out how do we work our way through and how do we really get that support in there, and that’s the work in progress.

Now, I know some people may feel, and this is always a bit strange and we’ve spoken about this as an exec team this week, you do a survey and the stuff we said we were going to do but then there’s anticipation about ‘what’s going to happen, what are you doing?’  The fact is that we are doing things in the background, you won’t necessarily see it yet, but we already have from a cultural perspective Steve Mason and his team. I know we keep speaking about Steve as a Cultural Director, but he isn’t on his own he has people and that’s the expertise that we want to give us capacity and capability. It’s very much about where we need to work with a group of individuals, a team or in fact a whole department, and already the team is in 14 different locations working and supporting, that’s even before we have completed the harassment survey. Why? Because already people have reached out, conversations are happening creating psychological safety, which is really just an environment where we’re really able to be open and honest regardless of role within the organisation, it’s about the ability for people to feedback, to have conversations, to reach out, to constructively check and challenge, because that’s a healthy organisation. That was discussed further at the Trust Board this week as well, which was really around quality management systems and, I’ve said this before, we sometimes get hung up on loads of complex speech and posh words, but actually it’s about creating an environment and a system that is able to support improvement, good quality conversations, how does it foster ideas and how does it continually learn. It’s something that we haven’t been good at because we’ve always had other priorities and now it’s about how we address that balance. I’ll pause there, thank you for listening and I’ll hand over to John.

Good afternoon and thank you Marcus for the summary of the OAG meeting this morning. A bit more on that, we had a large number of stakeholders in the virtual room with us and I think although support is absolutely there and we had some positive comments, there is a realisation, both within the Trust and without, that cultural change is a very elongated and long process. We won’t all come back in on Monday and be in a different environment. It’s about those incremental changes, whether that be people being able to make suggestions about how they can improve their own workplace or their own practice or whether it’s about people having the confidence to challenge when they see poor behaviour, whether it’s about speak up, basing our culture on respect and teamwork, whether it’s treating a patient, colleague or line manager with that respect.

It will be a long journey and us and the execs will make mistakes along the way, our managers will make mistakes, our trade union colleagues will make mistakes but it’s about starting off on that journey, wanting to learn and improve and make those tiny incremental improvements as we go along and that willingness to learn, which I think sometimes the organisation does really, really well when it comes to some of the clinical situations that we face. But expanding that across all areas and all elements of learning. I think Marcus is absolutely right, there is a huge amount of work going on and there have been some changes, the cultural director and his team have been going in pre-emptively working with teams to try and improve areas of the Trust and that will continue to happen. We have seen an increase in the number of people contacting the Freedom To Speak Up Guardian or the trade union reps or raise concerns and that’s a very important part of this process that we’re going through as an organisation that we have the confidence to raise concerns, ask questions and be listened to, even if we don’t get the answer we want, just be listened to. All of these things are part of the journey that we’re on. It was a very helpful meeting with our partners and stakeholders earlier on today and we continue to look to them for support and guidance. This is a long journey but one that other organisations have gone on before us and we are not unique, either in the ambulance service or the NHS with some of the problems that we’ve got or some of the solutions that we can put in to reduce and fix them. We are working with lots of organisations as well as people like NHSEI and the CQC to look to improve those things.

There are a couple of other updates I’ll run through for you. One of the things that has been happening as part of the Trust going into special measures as we did a couple of weeks ago, is increasing the capacity that we must manage the many challenges. We have two new Improvement Directors join or are joining us. Kate Hall has joined us this week, she is very new to the team. I will be meeting her myself for the first time this afternoon. She’s bringing a lot of experience of organisational transformation and leadership within challenged NHS organisations, so I think she’ll be a fantastic asset to the team. She will join Stroke Consultant, Sreeman Andole, who has already joined for a couple of exec meetings over the last couple of weeks. He will be taking up the role of Improvement Director Medical Director so he will be backfilling Dr Tom Davis as he is backfilling the CEO role. There’s going to be more information about them on NTK and I have no doubt they will participate in some of these sessions over the week and months to come. They also join Juliet Beal who joined us as Improvement Director for Nursing and Quality a couple of weeks ago. It’s been fantastic to work with some new faces on board and get their expertise of organisations in a similar position to ourselves.

I will leave Marcus to deal with winter planning efforts, but I will mention we are now in the final few days of the official flu campaign. It probably won’t come as a surprise to any of you that the COVID vaccination programme will be rolled out in earnest over the coming weeks and to facilitate that focus, all trusts are being asked to wrap up their flu campaigns as quickly as possible. We are still looking into whether we can provide flu vaccinations and how we might do that throughout the winter but the large scale clinics will be coming to an end tomorrow so if you are near a clinic please look on NTK to see where they are running and if you haven’t had your flu jab yet please do so. There’s one final chance to be entered into the draw for the second set of M&S vouchers we have, which people who have had the jab with us, or if you’ve had it at Boots or your GP just fill in the form on NTK to let us know you’ve had it, will be entered into.  I’ll leave it there and ask Marcus to pick up around winter planning and patient care and some exciting news around the technology associated with that.

Thanks John and you’ve rightly led us into some of the more practical bits. So, whilst we’ve also got the CQC actions, or we should say Trust actions as they belong to the Trust we can’t, nor should we, just focus on one thing. It would be a luxury sometimes, but we can’t because we have to look after you and we have to look after patients, that’s what we do as a Trust. Some good news from an investment position is that we have signed off and agreed Electronic Patient Care Records (EPCR) which we are rolling out, moving towards our commitment to issue frontline with iPads. We hope it will be a catalyst for two things, one is good capture of patient care records on a consistent basis but also, that ability for you to have mobile connectivity devices and that’s really important when it comes to communication, learning and CPD. The range is endless and with the linkage of the data means improved patient perspective for you, as an individual dashboard of what you need to do and where you are. The opportunity is endless as you are then a mobile organisation which is digitally enabled – which is really a posh way of saying we know what we can do, we can communicate and we can access things. That’s really important, the ability to do all of those really will help in terms of communication, a bit like Teams. We’re having these conversations now on Teams but 12 months ago the thought of doing an online webinar would probably take six months of planning and 15 people, whereas now we can do it and it opens up access to that. We are keen and committed to getting out and about but clearly this is a really good tool in making sure that we can see, hear, talk in terms of interaction with you as much as we can. 

Finally, there are a couple of things I want to thank you for. The first is an observation, I know it has been difficult when it comes to things like face coverings and face masks. It seems really difficult and challenging when people are wearing them or not, but in the last couple of weeks we have seen a good improvement in compliance and usage and I really do thank you for that. This is about protecting you, protecting everyone who works for us, protecting patients and your family and friends. I know as we exit lockdown into the tier system, we know this winter is likely to get busier quite quickly, although it has been ok at the moment and we are into December. We know one of the reasons the flu vaccination programme has been closed is because of the COVID vaccination and you have to have a gap between the two, so the idea is that we now move onto the mass vaccination. That’s a mammoth task in itself and we’ve got a team of people working through that in order to offer it as well. We will do some Q&A’s and frequently asked questions and I know we’ve already got one of the Government Deputy Chief Medical Officers giving some advice, because it is uncharted territory and there is a bit about being unsure about what’s going on so understandably there may be questions and we will look to answer those as much as possible.

The other thank you is to those of you in patient care and critical roles who have undertaken lateral flow testing, it’s really important for stopping asymptomatic spread. Just this morning I got the latest figures and we’ve had 2,274 tests completed and eight positive results from asymptomatic people, which is 0.32%, so a lot lower than some areas have seen. If we’re following COVID secure guidelines, facemasks, handwashing, social distancing as best as possible, the correct PPE and maintaining that in and out of work then this is a good way of protecting you and protecting colleagues. I think it’s also helped having conversations because when it’s a bit more real, when you know people who may have been asymptomatic, then it does spark a different conversation as well. We know we’ve got areas where we do have outbreaks and they’re being managed through the IPC team with clinical and operational support in order to make sure that we are supporting you within those as well. In terms of the mass vaccination programme there will be further details as soon as we are able to share, arrangements are being put in place. Please just keep an eye on Need To Know for further communications around this.

Published 7th December 2020