We Are EEAST Briefing - Thursday 6th May 2021


This week's We Are EEAST Briefing comes from our Trust Chair Nicola Scrivings, and our Chief Operating Officer Marcus Bailey.

Dr Tom has been an absolute anchor for the leadership of the Trust. He really stepped in and stepped up to the challenge of being Interim CEO in such a calm and resolute way, so I really wanted to thank him for everything that he has done, so far actually, because he really grasped the challenge of meeting the ambition of our change program and supported our team members to deliver such consistent solid results during the pandemic and supported many people in the change journey, and I’d like to thank you all for working so positively as well during the last few months.

But it’s really important that we continue to build on our improvement program, and also the great steps we’ve taken in terms of consolidating our performance, and it’s fundamental that we do have stable leadership to be able to help us to do that. Earlier today we did announce that we have a new Chief Executive that is going to join us in the autumn. We haven’t got the precise date yet, but sometime August/September, and that in entirely consistent with the plan that we laid out in January.

So, today we have announced the appointment of Tom Abell who is currently the Deputy Chief Executive Officer of Mid and South Essex Foundation Trust, which means that he’s got a background in our region. He was born in Norfolk actually, so knows the region really well. He’s got a long history in the NHS so knows the challenges of both our Trust and also around the system and challenges that we all share in terms of delivering patient care.

He has led large scale teams, he’s had large scale leadership roles, and he’s also been very experienced as an accountable officer previously for CCG also within our patch, in Basildon and Brentwood. But what’s most striking about him is the absolute passion for delivering services to communities and doing that in partnership with colleagues.

I would recommend to all of you that he has given us a letter which went out on the staff briefing this morning through the link, and when I ask him about what he would like me to say his arrival here in EEAST, the thing he has asked me to say is please read the letter that he has provided. It’s his words and it is his passion and belief that is within there, and his commitment to work together with everybody to make EEAST the best place for patients, staff and communities.

So, this is a really exciting time for us, of change, looking forward to September, and I’m really really pleased to say that Dr Tom Davis will stay as our Interim CEO until that point. It’s very important that he does stay because of the continuity, consistency. There’s still a lot of challenges in front of us that we need to wrestle with, all of the commitments that we have made around our cultural improvement program, invested in certain new technologies and new systems that we need to deliver against all of those as per our plan, and Tom will lead us through that along with the Executive Team.

Marcus is also on the call today so if you have any detailed questions about anything that we are doing more broadly then he’ll be very happy to answer them. I think that is all I have to say at the moment about Tom Abell starting with us in the Autumn and I’m very happy to pause there and answer any questions that people might have.

I’ll pass over to Marcus and he might just pick up and give you the latest on our oversight meeting today.

Thanks everybody and good afternoon. So, really I guess picking up from Nicola’s comment, nothing stops, and I think that’s really important to say. None of us are going to sit around for the next six months and wait for a different Tom to come in and join us. Why? Because the pace and the urgency says we can’t stop, nor would we want to stop actually as a senior team. And I know one of the comments that has come in, and I was going to touch on that around engagement, and your absolutely right, the value of engagement.

There’s two areas, one is doing the engagement and listening, really making sure that in reality the Board, senior leaders, that we are really in touch and on the ground so that we get live feedback. We talk about it in evidence terms about triangulation, so about having conversations allows us a) to be known, but importantly, it allows us to test, to communicate, to talk through.

We are planning as lockdown eases in the sense of the government roll out plan, from 17th May and the 21st June, the incremental ability to be out and about. We have already started to see some of the leadership team out already, applying Covid secure measures, and we’re also asking in the areas particularly around the General Managers and Assistant General Managers and departmental leads to start having the conversations.

It comes back to, and a plug for the communications survey that was put out there, because we talk about communication and we talk about engagement, but making sure that we have a range of ways really, to be able to reach out, to be able to communicate. Whether it be personally, because actually we do have individual meetings with people who come forward and would like to speak to us, to more collective and group meetings. But also then about how and what we do with that information.

Linking to some of the cultural work and some of the feedback we have spoken about when we have been doing some of these sessions before, particularly about how we need to be showing to not just listen but to do something with the listening. If not, people get fed up of telling us because it’s a ‘we’ve already told you’ scenario, and that’s really important, to make sure that our systems and processes allow change to happen, and we do that in a way that is very open.

I’m hoping people will feel, when we’ve been on these sessions, we are here to answer questions. We will be as open and transparent in the way that we approach these, to be very genuine. Because actually that is how we approach our work, and that is how we approach almost every day that we come here, and every task that we have, because we passionately want to make it better, make it different, and support you. Our job, and I reiterate it from my point of view and the Exec team, is simple and you say it quick, which is looking after our people and our patients, that is why we’re here. Within there is a number of complexities and also dealing with a number of those legacy areas as well.

The other bit I just wanted to talk about today, was really around some of the where we go next steps in the cultural journey of the organisation. We know that the last six months, and Nicola leading from a Board perspective with all of us, this ability to react and respond to the immediacy of the concern, the ability to encourage Freedom to Speak Up, the ability to put rapid support, rapid intervention, rapid assistance in there, has been a real focus, because that was the bit that needed to happen. It was the bit that needed to make a difference to people who are and were in difficult situations. That continues and we absolutely ask people to be able to come forward to speak up and speak out, because that’s really important.

But it’s also now time to start looking at what the future looks like in terms of addressing the root cause. Steve Mason as Cultural Director would always say to us in meetings that it is about making sure that we really get to the bottom of this, we make sure that we start to deal with the root cause and why. If not, a) it may not mean anything, and b) you might not actually be dealing with the thing that makes the difference. You can deal with a concern, but unless you understand it, are you really addressing it properly in totality and delivering you that as well.

I use a really prude example, which is we could put everyone on a course saying ‘please do better’. The reality is if it is not the right content, the right approach, the right meaning, actually it won’t make a difference, and that’s why we design any of these. But I think today we’re able to share at high level with our regulators and our colleagues through our Oversight and Assurance Forum that happens in special measures, the kind of themes that we believe make a difference.

Now, the themes that make a difference are based on the feedback that you have been able to give us, both in terms of surveys, our external stakeholders, the conversations we have with people, importantly the voice that individuals have given to the Cultural Steering Group through Freedom to Speak Up, the advocacy that comes in there, our learned experience, our historic case work. Every day that we progress, we will learn and learn more, but actually it does come back with some key triangulated themes. And those themes are stuff that is really important, we class them the, or I’ve dubbed them myself, as essential foundations that we really need to get in place.

So it doesn’t matter how fancy, how futuristic we want to be, if we don’t get some of these right, and we don’t take time to repair them moving the Trust forward, the commitment, and it links back to the conversation and engagement piece, we need to do both. We need to be able to listen but also do something with it. Actually the bit here about building relationships, working with you to build trust, for us all to take some of that personal responsibility.

I’ll give you some examples, I come to work and I take a level of personal responsibility in the job that I do, the personal responsibility in the way that I act and behave. But more globally, coming together to do that, but also dealing with the areas that we need to.

I know that the feedback is that some of those things that we’ve never quite got over the line that have made a sustained difference such as end of shift overruns and also rest breaks. We know that, to be fair, taking this tole, they are an achilles heel for me to try and make it better for you as much as they are for you who have lived them and have late finishes and have disturbed and disrupted rest breaks. So the answer is actually if I don’t have all the answers and you don’t have all the answers, how can we work together to come up with some answers and be very open to trying new things.

We’re going to start some work with Unison in terms of some joint work on a number of themes, so that we can be very open, very transparent, in what is driving and what needs to happen with regards to why we are doing things, what’s driving us, what our external people saying, how do we benchmark with regards to other ambulance trusts, how do we make a difference for yourselves in the workplace. Ultimately, I genuinely say this and I believe in this, it is our people and our patients, you are our people, in fact we’re all our people, it’s how do we look after each other.

The other bit that struck me in the sense of why we look at underpinning bits around leadership development and supporting capability, capacity, looking at how we use quality improvement methodology, how do we take it forward. It is also about behaviours and civility in the workplace, and that’s a really interesting bit that has come out from some of the cultural work. Because we can talk culture, and I know some of the feedback when I’ve been speaking with people is give me a definition, what do you mean by culture, because this can seem really theoretical, or can seem really intense. In reality, we’re talking about what happens and how it happens every day. That’s my really simplistic, uneducated non-academic take on it. It’s how we do and how we live and how we work in this organisation on a daily basis, how we treat each other, and how we share in a way that’s respectful, that is civil.

I’m very happy to have very open conversations with people and I’m very happy to share with all of those, the bit is how we deal with all of those. People can tell me I’m wrong, I’m very happy to have conversations in the sense that if we don’t feel we have got it right we will talk through those. But again, with all of those, it’s how we do it. And you may notice this in colleagues and conversations and the approaches for anyone, you start getting the eye rolling, the tutting, the talking over people, and all of those are signs on incivility.

And actually, if you think about it now and examples that I gave last week and the time before when I was doing this session, is some of these things are happening right here, right now. Right here, right now we’ve still got that challenge whether it be inappropriate comments against colleagues, whether it be inappropriate behaviour, the banter, conversation about what’s acceptable. I was speaking with a colleague this morning, reminiscing almost in terms of being here 20 years plus, thinking about actually how society, and I guess for me, reflecting what may have been acceptable 20 years ago and how society now moves forward and judges the acceptance of something within the workplace, and how we move forward to re-baseline, rebalance and rethink about what is appropriate.

I can’t but think back to some of the stuff in the news and we spoke about being safe at work in a variety of things. If you think back to the Sarah Everard case and the public demarcation now and the rebalancing of what is acceptable about safety for women in society. You look at the concern about the PCSO who was tragically found deceased, and you start to look at that and the conversations around areas particularly say the Equality and Human Right’s Commission, and those are the kinds of things that we need to be able to do as well.

Thank you for allowing to share some thoughts and tie those back together again.

Thank you very much Marcus for such an open discussion about some of the challenges that we’ve got and just saying what it feels like in the types of areas that we have challenges in.

I just wanted to just loop back to the appointment of the new Chief Executive, because when we go through these processes, right foremost and front of mind is about a values fit, and about what are the values that we are trying to drive, introduce and encourage within the way that we talk and work and be with each other. Tom Abell is absolutely consistent with everything we are trying to achieve for each other in the Trust at the moment. So everything, very eloquently spoken there Marcus, everything will continue, and will continued and be reconfirmed and we can be reassured that some of the themes that we are leading on will continue as we can’t chop and change.

I thought I would just mention about the meeting that we enjoyed this afternoon. Just for all colleagues information that we are very much held to account on our promises and commitments around our improvement activity. So we have a wide ranging meeting with many regulators and stakeholders once a month, which happened today. There’s probably about 40 or 50 people on the call, and we provide a large amount of data and information, and we also talk about our progress and where we’re putting our focus and priorities.

I just wanted to update in so far as it was a positive meeting. We were able to demonstrate that we’ve made some changes and some progress, but we were also very open about the scale of the challenge and how we need to move faster or deeper in certain areas.

The one thing that I just wanted to share with colleagues is that one of our colleagues, Barbara Shreeve, who is a Paramedic in Loughton I believe, is a co-chair of our All Women of EEAST staff led network spoke to the group, and it was fantastic to hear from her perspective, uncoached and unstructured, in terms of how the staff led groups which focus on diversity are making some difference. Again, we’ve got further to go in terms of publicising and supporting and making sure the groups themselves have the resources and support to be able to deliver on their own agenda.

But nevertheless, this wide ranging group of people from the HEE, from the CQC obviously, from NHSE/I, from other groups, Health watch for example, and the CCG’s really valued hearing from our staff and they asked actually if we could do more of that, because to them that is the whole purpose of our improvement journey, that we’re making life different deep in the organisation for staff, but also for patients. So, overall, a positive meeting, we’ve moved forward, but recognise that there is more to do and lots of priorities that we just need to make sure we get in the right order with the right focus to go through what could be a busy summer. So, that I guess would be the last thing I would close on.

Thanks Nicola, I was just going to pick a little bit on the theme about the openness, and the openness works both ways in terms of regulator wise. I wouldn’t want anyone to think that when we go to our regulatory meetings we sit there with a painted brush saying look at the best picture that we can paint and everything is perfect. I think we are very open and respectful in that, particularly around being open where we haven’t got it right as well.

So, look, I don’t sit here in the last six months since the CQC report, or over the last two years in respect of it, saying we’ve got absolutely everything right. Even now, there is a bit here for me, we really really know that we don’t always get right. I think if we have a fear of failure we don’t necessarily deal with those or acknowledge those.

What I mean by that is that you have to try and get it right more often than you get it wrong, because clearly that is important, but actually if we are I guess arrogant to think that we can always get it right or we can’t take on people’s views, then that’s one of the really big changes actually, the ability to be able to reflect, to be open, to learn, to encourage people. Because, actually, if you encourage people to come forward when they haven’t got it right, then that’s a bit cultural change.

Because it’s not about being punitive, it’s about being very open, and we are trying to role model that as well. I will take responsibility for stuff, look I haven’t got it right, and I have to be very open with that. Does it worry me? Of course it worries me, because actually you always want to come to work to do a good job, but you learn from it and you do something different with it next time. And they are the types of things we share with the regulators as well. Why? Because again, importantly, we want them to come and speak to you, our CCG colleagues will come and speak with you, you will be more spoken to than any time before.

So actually we’re not asking you to do anything other than be truthful, and that’s really important when it comes to how are things, hence the reason why we want to speak to you as well, because we want to change things if it’s not right, and if we are doing things, we need to know that because if it’s not quite right and we need to modify it, then that’s exactly what we need to do and we need to learn from that, and that’s the ability and the partnership to be able to do it.

Published 12th May 2021