This month has definitely had its challenges from a prolonged period of industrial action by junior doctors and consultants to an increased pressure on our Emergency Department from those with complex mental health needs. We have also seen though some really encouraging system wide work and marked the NHS’ 75th birthday milestone.
On 5 July we took the urgent decision to temporarily suspend the use of Entonox in our maternity unit at East Surrey Hospital for the safety of our colleagues who may have had extended exposure due to issues with ventilation. Work to rectify the issues identified through recent testing is underway, and we hope to have the equipment in place to make Entonox available again as soon as possible. Homebirths, dental and surgical services who also use Entonox were unaffected, and we issued some clear communications to both staff and the public to help manage the issue in the interim. We will continue to keep our patients and colleagues updated.
Achieving our targets
We finished the month of July with some impressive emergency and urgent care results, with 91% of patients attending our emergency department being seen, treated and either discharged or admitted within four hours of arrival on Sunday 30th July. It was a clear reminder that the work we are doing in this area and to increase flow around our hospital is positive, and that difficult periods don’t need to define the rest of our month or our year.
In recent weeks and months, we have seen a significant rise in the number of patients attending ED with acute mental health conditions that require treatment and care from mental health professionals in a more appropriate care setting – with some ultimately requiring admission to an inpatient mental health facility. This increase in ED attendances reflects the significant increase in demand that our mental health partners are also experiencing which is exceeding their capacity.
To help ensure these patients are getting the right care in the right care environment, we have been working closely with our partners on how we can get patients the support they need sooner and ease the pressures on our colleagues in ED and on the wards. We have agreed a set of actions with our acute and mental health trust partners, as well as our SECAmb and Surrey and Sussex ICS leads, on how we will address this as a system. These include ways we can ensure those who would benefit most from community support know where to go, and looking at how planned discharges from ED’s can be supported by urgent community re-assessment. These will take time to properly develop and assess, but this remains a core system priority.
New Community Diagnostics Centre
Last week we announced plans for a new Community Diagnostics Centre (CDC) at Crawley Hospital to reduce waiting times for vital tests and checks and increase local access to diagnostic testing. The new centre, which we are working on closely with our system partners at NHS Sussex, has been funded by NHS England and is planned to open in 2024. Once fully up and running, the hub will offer patients a 12-hour service, six days a week, and will mean within the first 12 months, 30% more patients who need a diagnostic test and live in Crawley will be able to receive one locally. This percentage will increase each year and will mean around 16,000 fewer patient journeys to East Surrey Hospital over the next five years. To help patients benefit from the new service sooner, we will be increasing the availability of diagnostic testing at Crawley Hospital in the coming months.
Trust Provider Collaborative committee in common
In July’s Board we discussed our work within the Surrey Trust Provider Collaborative – which works on transforming services for the local population to ensure we’re making the best of all available resources. We took the decision to join the new Surrey Trust Provider Collaborative committee in common, which will formally take this work forward. The committee will focus on a number of priority areas which are better addressed together, these include reducing elective waiting times, looking at how we best treat stroke, cancer and maternity patients, and how we can ensure that those with acute mental illness receive the right clinical support at the right time. I look forward to seeing how this work progresses in the coming months.
In the last two months we have seen 10 days of industrial action from junior doctors and our consultants as a result of their ongoing pay dispute with Government – with the number of junior doctors on strike nationally peaking at 20,342 in July, compared to 24,407 last month. In England over the five days of action 101,977 inpatient and outpatient appointments were cancelled, compared to 106,120 during last month’s three-day action. While we understand they won’t have taken the decision to strike lightly, at SASH there’s no doubt that this extended strike period put significant pressure on our services and those working. We prepared with as much mitigation planning as possible and proactively worked in business continuity throughout the 10-day period in order to minimise disruption. We stepped up our communications approach with stronger public messaging to try and ease pressures on our emergency department who were still seeing high levels of attendances from those who could have been treated elsewhere – such as a minor injury clinic or urgent treatment centre.
On 5 July we marked the 75th birthday of the NHS, which has come a long way since 1948 - forging its place as a pioneer in global healthcare and now treating over a million people a day. From delivering the world’s first test tube baby as a result of IVF in 1978 to carrying out the first keyhole nephrectomy in Europe right here at East Surrey Hospital in 2008 – revolutionising care has always been at the forefront. None of these achievements would have been possible without our staff, volunteers and partners, who have always been at the heart of our health service. The NHS is an institution that saves and improves lives and touches everyone from each corner of our country and each walk of life, for me, despite the challenges, it will always be a privilege. To mark 75 years of the NHS five SASH colleagues were nominated to attend the national service of commemoration on behalf of our trust at Westminster Abbey alongside the Duke and Duchess of Edinburgh. You can read more about this on our website.
Making the best of our workforce
In July we appointed a new Chief of Women and Children and a new Director of Midwifery – both will be a very welcome additions to such a vital division for local children, families and expectant parents. We have also appointed an Associate Chief Nurse for Workforce to help ensure we are using our nursing and midwifery workforce as effectively as possible. This includes oversight of national safer staffing requirements, as well as recruitment and retention strategies for Nurses, Midwifes and Allied Health Professionals.