We Are EEAST Briefing Thursday 15th April 2021


This week's We Are EEAST Briefing comes from our Chief Operating Officer Marcus Bailey.

A couple of bits for reflection particularly around demand and Covid, of where we are. Again, I’m absolutely reiterating my thanks to you collectively. It doesn’t matter what role you do in the organisation, paid or volunteered, the effort and the focus to look after our patients has been phenomenal.

The progress with the CQC is the area that we have focused on in culture, and I guess my reflection over the last few weeks is something is not going to happen overnight, to see suddenly a magical spark and all of a sudden it’s different because this is about the way that we feel, the way we look, the way that we have conversations. The way that it is a safe environment to be in, a safe environment to speak up, and how we work together to do that. So, from that point of view, again another element of reflection.

Just for March, what we’ve seen as we moved forward, almost a nearly 10% increase, so as lockdown starts to change in a different, and I’m sure we will now see that throughout the rest of the year. It’s really great that we’re seeing the easing of Covid and the plans from the government really following through, but obviously that translates undoubtably to us for activity and that will be the first weekend that pubs and establishments will be open as well.

When you bring that down into reality, we are hear and treating around 11% of patients a day, which is probably 260-270 patients a day that are managed by hear and treat. We’re seeing around what equates to 100 patients an hour that we’re dealing with within A&E. We’re seeing PTS activity start to increase as well. We’re seeing some real positives in terms how we measure, because I think sometimes we can look at that around the experience we have of feedback and feeling really challenged.

Actually, we’re getting, when we look at March, one complaint for every ten compliments, and that’s really important because sometimes the lens and the view is always about what doesn’t go right as opposed to actually we get stuff right, we look after patients and we do stuff right. It doesn’t always go right in clinical terms, clinical medicine is high risk, we know that, but actually it’s about the approach that we have within that as well.

I’m going to take my shameless plug as I often do here to talk about Covid and Covid secure. I still can’t reiterate enough, the fact that just because the vaccine program is rolling out and doing well, we can’t stop the other measures of Covid around distancing, about hand washing, about face and space. It’s so, so important because actually the vaccinations is likely to support a reduction in the severity of symptoms, it won’t necessarily eradicate all of it, and we will have to learn to adapt and live with Covid as we move forward in our lives. For how long? Who actually knows, but in reality that’s where we are.

Thank you to everyone who has gone and got their first vaccine. I know some colleagues have not been able to get their first vaccine yet, some of the community hubs will be able to help, and also we are looking at opportunities for us to be able to run additional first vaccines internally as well. But I would ask you to make use of those community clinics, and also thank you and a reminder to have a chat with colleagues if they have had their second vaccine as well. It’s the second vaccine that really does allow us to move forward.

It is really difficult, and I’ve mentioned this before, I do get the Covid fatigue on some of this. We’ve been going for many months on Covid, well a year now on Covid, and also Winter. But I just again ask you to think about the correct level of PPE for situations. Some of our AGP breaches have very much been about the deteriorating patient, and these things do happen, and it’s difficult for everyone, and I say that there is no blame in that, it’s just we know it’s difficult. But we really are asking you to be able to see what we’re able to do and what we’re able to be within that. So ie trying to just remember that we need to maintain the PPE and the supportive measures that go through with that as well.

We will keep updating in terms of some of the Covid feedback and the government guidance that comes out as we try to understand the impact and that real balance between us as a healthcare provider, as an ambulance service, the impact to us as an ambulance service. And also, we are all people, we are all people in society, so actually the ability to go off and be with relatives, the ability to go out and enjoy a meal, the ability to go on some form of holiday for rest and relaxation. Actually, we are human, we need that social interaction.

The other flip side to that is recognising do you know what, its very different, its very strange to see people, to see people in person, and for some colleagues who we all work with, we may not have seen them in person, or friends or family, we won’t have seen them in person for a year, and that’s a very big thing related to that as well.

The other thing I just wanted to touch on was around culture. So, again, thank you all for those of you who done the pulse survey, we will be publishing the results next week from the January one. We had a long discussion about this at Exec this week, about that I know that people get a bit survey fatigued, it’s a difficult one because it’s the surveys that allow people to measure. As with anything, whether it be a quality improvement, whether it be the service we deliver, we tend to rate or survey so many things nowadays, and I think we need to understand what does that mean in relation to how we measure.

There is a big bit as we start to ease some of the restrictions, and when I talk about restrictions, some of the restrictions are absolutely about supporting and protecting, about not having as many visitors coming to stations, people being out and about, not because people don’t want to, but actually to stop that spread. The positivity is actually getting back out to have conversations because the feedback I’ve had when speaking with colleagues is what’s the point of doing a survey, will anyone listen.

I think through our Q&A’s that we’ve had every week, I’ve seen some of that progression of the ability to have conversations. It’s not always about giving the answers to say I can save every problem, but it is about the ability to have conversations and to be able to have a discussion and the ability to work through and deliver what we able to do.

The bit in that feedback that will come out is really the areas of what does it tell us, what have you told us, what does it look like, and also how do we solve some of that and making sure there is a solution. So, very much the journey that we have been on is getting to some of the root causes, understanding, supporting, the ability to speak up, feeling safe to speak out, dealing with some of our legacy case work and our legacy issues.

Root cause is really important. I had a long conversation with Steve Mason as our Culture Director about at what point is intervention, when do we start to do what I guess in my own head I perhaps have thought of as getting on with sorting some stuff out, and it’s really interesting when I’ve gone through over time my thoughts have changed to actually if we don’t get to the root cause, if we don’t really understand what your trying to achieve or to change or support with, then your intervention or the action that you may take may not address it, therefore you could put everyone on a course, there is nothing to say actually the course is the right course to address the right thing things, the right problems. The bit for me is the ability to have the conversations, that is one of the first bits actually, to talk about it, and actually to at that sense of understanding.

So, there’s that strong link, I think now if we tie those two bits together, is we will always and absolutely carry on with regards to keep turning over that stone and finding things out. Actually, for me it’s about speaking up, I would expect as people start to feel comfortable, people hear through word of mouth, they start to see something happen, they feel different, we may actually find that more and more things come out.

Now, actually, from that point of view, we really encourage that because the bravery to be able to speak up, and of course I can’t talk about the details because they are absolutely confidential, some of it even I don’t know because it’s through the Freedom to Speak Up route which is absolutely confidential. Some of it we’re asking the cultural team to support us with, and this is never about knowing individual cases, it’s about making sure we manage situations. But actually, when you start to build a bit further and forward, it’s about making sure we’ve got the basics right.

Effective and essential foundations is really going to be a focus for this year because we can have all the high voluted ideas in the world, the biggest shining strategy in the world, we can have flashing lights on billboards, but actually if we don’t get the foundations right, you’re never going to be able to build, you’re never going to get it right and you’re never going to do the bit that I guess the regulators externally and what people want to see is us succeed as a organisation. We have shown in areas such as our response to Covid, the work you’ve all done to support that, we can achieve. This is an organisation that can’t not do things, but it’s about making sure you have the sustaining foundations, and that for me is really, really important, about how we work together.

I took this job to make a difference to you, to the rest of our people, volunteers and our patients, and that’s always a real challenge of how do we balance all of those tensions and dilemmas, but actually that’s the commitment we have to have because from our point of view, from my point of view and Exec colleagues point of view, that’s where we know we need to make that difference. And we also know we have stuff to do as well, so I don’t think we sit here saying it’s all perfect when it’s not, and that would be such a naïve approach for us ever to think about it, and we had a really good honest conversation at the Trust board, and the Trust board is made up of our Executive Directors and our Non-Executive Directors, we really look to act as company Directors and subject matter specialists in order to govern and assure the organisation, and that’s really, really important.

One really interesting conversation, which was about did we know that we were heading towards special measures – discuss, and that’s really quite a, depending on which way you approach the answer, that’s quite a wide ranging question, but really, really important because it asks us to think about how we do what we do. How do we find out, how do we know, how do we act, how do we prioritise, how do we make it a priority in the sense of dealing with it, how do we raise those, and that becomes really, really important.

On to another important bit before I pause and take a breath, John Syson who is our Director of Workforce has decided to take opportunities up outside of the Trust, so will be leaving us. In order to support that transition and to assist us we have appointed an Interim HR Director, Bob Champion, and he has joined us now to do that handover with John. It is very much a personal choice for John and from my point of view and the rest of the Exec colleagues, John has been with us through some of the most challenging times I have ever known in my twenty odd years within this ambulance service, and he goes very much our best wishes for the future and thanks for the support and guidance that he has given us.

We know that in this week particularly when we talk about our values of teamwork and respect is very much about the support and stability of our HR colleagues who have been through a number of changes themselves in leadership, so even if you talk about global leadership, it’s very much how we manage and support that as well. So, we are sad to say goodbye to John but we welcome Bob to the Executive team as well.

 Published 19th April 2021