Agenda item 9 Chief Executive s Report Public Board 29 March 2018 Presented for: Presented by: Author: Previous Committees: Information and discussion Julian Hartley, Chief Executive Julian Hartley, Chief Executive NONE Trust Goals The best for patient safety, quality and experience The best place to work A centre for excellence for research, education and innovation Seamless integrated care across organisational boundaries Financial sustainability Key points 1. To provide an update on news across the Trust and the actions and activity of the Chief Executive since the last Board meeting 2. To ratify the delegated authority for the appointment of consultants Discussion and information Approval 1
Agenda item 9 1. Urgent Care Our services continue to operate under significant pressure due to urgent care demand leading to high levels of bed occupancy and unfortunately the need to care for some patients in undesignated bed areas at times of peak demand. We continue to do everything possible as an organisation and with our partners to mitigate these pressures and ensure safe and effective care for our patients. Last month we took part in a Multi-Agency Discharge Event (MADE) at St James s Hospital, which was led by NHS Improvement. This brought together senior clinical and operational staff from across the Leeds health system to support improved patient flow, recognise and unblock delays both internal and external, whilst looking at improving and simplifying complex discharge processes. Over two days, representatives from a number of organisations and agencies came together to work with designated ward teams on the St James s site. These included teams from LTHT, Leeds Community Healthcare Trust, Leeds and York Partnership Foundation Trust and Adult Social Care. They were able to consider the care pathways for each patient in the clinical area by attending the board round, utilising the combined expertise and knowledge of everyone present to advise and assist the ward teams. Eight teams of multi-agency and multi-professional members worked collaboratively with an aim of improving the timeliness of interventions and reducing delays. They demonstrated a real desire to simplify and improve current systems. We are now working with our partners to take forward actions to address the themes from the MADE event which included the proportion of patients who had been in hospital for 21 days or more. 2. Staff survey results I m delighted that our 2017 staff survey results have demonstrated significant improvements building on our excellent progress since 2012. This year we have 13 key findings in the top 20% of Trusts nationally and only one key finding in the bottom 20% of Trusts nationally, this compares with our 2012 results which showed only one key finding in the top 20% of Trusts and 18 key findings in the bottom 20% of Trusts. Our staff engagement score has again improved to 3.85 which is really important given the strong correlation between staff engagement and the quality of care that patients receive. These results are a significant validation of the Leeds Way and reflect the fantastic work of our clinical service units and their staff. 3. Corporate Objectives 18/19 We have recently reviewed and refreshed our corporate objectives to ensure that they reflect the progress we have made as an organisation and our strategic direction. Our objectives form a framework of priorities for the Trust to move toward delivery of our strategic goals and focus on the developments for the next 1-2 years. The refreshed objectives will be reflected in the appraisal process for all members of staff. Our revised Corporate Objectives are included at Appendix 1. 4. Health and Care Academy Work is continuing to develop the Leeds Health and Care Academy; one of the flagship projects of the Leeds Academic Health Partnership. The proposed Academy offers the potential for integration of learning and development for an estimated 57,000 strong workforce across the health and care 2
Agenda Item 9 sector in the city and will be hosted by Leeds Teaching Hospitals. By staff in training and development working together, across organisational and professional boundaries, the Academy will promote systems thinking and leadership, and embed research and innovation across our services. Following an online engagement exercise a refreshed vision and values have been agreed for the Academy and these are included at Appendix 2. 5. Medical Director for Strategy I am pleased to report that Phil Wood has been appointed as Medical Director for Strategy for the Trust. Phil will provide medical leadership on the further development of the Trust strategy in specialist and integrated services, including major strategic projects such as Building the Leeds Way. In addition he will become the Responsible Officer for the Trust, and lead our Public Health work. He will also have a key leadership role across the region developing collaborative models of care with our partners in the West Yorkshire Association of Acute Trusts and West Yorkshire Health and Care partnership. 6. Consultant appointments I am pleased to report that I have, under delegated authority, approved the following appointments: Miss A Ferrara Consultant in Cardiac Surgery Dr Harriet Wallace Consultant in Genito-Urinary Medicine (Sexual Health & HIV) Dr Anna Hartley - Consultant in Genito-Urinary Medicine (Sexual Health & HIV) Dr A Newnham Consultant in Paediatric Nephrology Dr Arockiasamy Sathiapillai Consultant in General Anaesthetics Dr Martyn Robertson Consultant in General Anaesthetics Dr Michael Flatley Consultant in Clinical Oncology (CNS & Thyroid) 7. Listening and learning Last month I visited the team on the David Beevers Day Unit, to personally thank them after I received some great feedback from a member of staff who was treated on the unit. She wrote: Every single nurse, both day and night shift had such a professional attitude and looked after not just myself, but all the patients on the ward with such kindness, respect and compassion. Medications, IVs, observations were all administered on time and no request was too much trouble, even when they were really busy with the daytime routine of theatre. All staff from the senior nurses to the catering staff communicated regularly and clearly with me on an individual basis which made me feel confident and safe in their care. I have such admiration for your expertise and the exceptional kind manner in which you care for your patients. It was great to meet the team and hear about more of the superb feedback they ve received - well done to you all for truly caring for your patients The Leeds Way. I was very pleased to speak at the launch of the new NIHR Leeds In Vitro Diagnostics Cooperative (NIHR Leeds MIC). The co-operative supports diagnostics developers in the design and validation of new diagnostic tests focusing on four clinical themes: Oncology, Musculoskeletal Disease, Renal Medicine and Infection Diagnostics. Each clinical theme has access to expertise in health economics, clinical trials, informatics and multidisciplinary pathology which are essential components for the development of In Vitro Diagnostics. This is an exciting time for research in Leeds and I look forward to reporting more about the progress of the co-operative. I was pleased to meet Lee McDonough, Director General from the Department of Health, visited the Trust to get some insights into some of the work we are doing here to utilise apprenticeship programmes to recruit new staff and to provide professional development for existing staff. Lee 3
Agenda Item 9 was really impressed with our positive can-do approach to Apprenticeships and noted that Leeds were "top of the class" in relation to our work in this area. During her visit Lee also met with our KPO team to understand the journey we had taken with the Leeds Improvement Method and how improvement work was being built into the day job at LTHT. I attended a finance team time out. It was great to see how the team uses these time-outs to develop their understanding of the Trust and the part each area of the team plays in delivering great patient care. They are also introducing a protected time for the team to develop new initiatives; this time it was a Finance Temperature Check which allows the team to understand how improvements are being made and how the team is feeling on a more regular basis than the annual staff survey. On National No Smoking Day I caught up with the Health and Wellbeing team, One You Leeds and Occupational Health on their information stand. The teams were offering help and advice to patients and staff who might be thinking of quitting smoking and also letting people know where they can find additional support. The stand was very busy and it was great to see people engaging with the teams who are helping encourage a healthy hospital! I was delighted to hear about innovation by our teams to improve the out-of-hours response times for organ donation and transplants. Pam Hughes, a Biomedical Scientist in Transplant Immunology, has led teams from across the Trust in developing our IT system permitting scientists to have access to tissue-typing and antibody screening results remotely. This means they no longer have to travel to site when an organ becomes available to facilitate allocations and review donor and recipient compatability. This saves up to one hour every time, which is especially important when it is generally considered that for every hour an organ is removed from its donor it loses a year of transplant life. It was great to have some time set aside last month to speak to both staff and patients on Wards L35 and L37, and hear some first-hand feedback. I went with Krystina Kozlowska, Head of Patient Experience, and Carl Chambers, Non-Executive Director, as part of a regular leadership walkaround programme. This is where members of the executive team get a chance to speak with staff and patients to get a real feel for what s happening on our wards I was pleased to meet our Sleep and Non Invasive Ventilation team. They are a small team who provide a tertiary service for more than 6,000 patients with a wide range of sleep and home ventilation related conditions. The number of patients under their care has trebled in the last 10 years and they explained some of the innovative and patient centred ways they provide care, such as telephone clinics performed by health care assistants to reduce hospital visits, and posting out equipment and parts. Many of their patients have complex conditions such as motor neurone disease and muscular dystrophy, and the team work hard to facilitate discharge, for example through home visits or by visiting other local hospitals. They were the first centre in the world to prescribe Idebenone, a potentially life changing drug for patients with Duchenne Muscular Dystrophy which is fantastic news! It was great to meet the team and I look forward to hearing more about the innovative ways they are caring for patients 8. Celebrating success Congratulations to the ward team on C03 at Chapel Allerton Hospital for going an incredible 3037 days without an MRSA bloodstream infection - a staggering achievement! Earlier this month Yvette Oade, Chief Medical Officer, presented the ward team with a certificate to celebrate this significant milestone and to thank them for their diligence and hard work in caring for our patients. Well done team, you really are patient-centred champions! I received a wonderful letter from a patient praising the efforts of staff in A&E after he needed emergency care. In the letter, the patient says: In the end it was touch and go and required many 4
Agenda Item 9 hours of surgery to put right. It was undoubtedly your teams professionalism in stabilising me and getting me to the right people that saved my life. Without your dedication to the job in hand I would not be writing this now. Can I please offer my sincerest thanks to your whole department. What heartfelt thanks and a true credit to the team s live-saving work! Congratulations to the Nurse-Led Immunotherapy Clinic team from Leeds Cancer Centre who have been shortlisted for a BMJ Award in the Cancer Care Team category. The immunotherapy clinic started in December 2016, and allows patients to be assessed pre-treatment. The team have received great feedback for the service as patients have responded well to treatment and it also reduces hospital visits, therefore saving two consultant clinic lists per week. Well done to our Brain Attack Team who have managed to get a patient safely treated in record time, equalling the 12 minute door-to-needle time set 18 months ago. A big thank you to Brain Attack Team Nurses Antonietta Morciano and Wojciech Chudzinski, as well as Dr Marc Randall, for this fantastic achievement. Well done to Ward L12 who have gone 200 days without a grade 2 Pressure ulcer and on achieving 100% in their ward metrics. Great work team! Congratulations to our Parkinson s Quality Improvement Collaborative who won a UK Parkinson s Excellence Network Award at a prestigious awards ceremony in London. They have seen some great results, with the delay of the first medication on admission going down from over 7 hours to below 1 hour. The average percentage of Parkinson s medication doses omitted over a 24 hour period has also fallen from 15% to 5%. Well done to the team on their award, and for their incredible effort which has made a real difference to our patients. Congratulations to the Dermatology research team at Chapel Allerton who successfully recruited the 10,000th biologic registration to the British Association of Dermatologists Biologic Interventions Register (BADBIR). This is a UK and Eire observational study seeking to assess the long-term safety of biologic treatments for psoriasis. There are currently over 150 hospital sites across the UK and Eire taking part in BADBIR by recruiting participants to join the Register. In 2017 Leeds was also the number one recruiter for conventional patients, the third best recruiter for biologic patients, and the number one recruiter for all patients. Congratulations to the Costing Team who won the Finance Team of the Year at the Healthcare Financial Management Association national awards, which included Dave Tunstall and Tom Burden. Congratulations also to Steve Billingham who won the Finance Professional of the Year award. These awards celebrate excellence in finance departments across the four home nations, showcasing best practice and achievement in financial management and governance. Great work on this fantastic achievement! 9. Publication under the Freedom of Information Act This paper has been made available under the Freedom of Information Act 2000. 10. Recommendation The Board is asked to receive this paper for information and to ratify the delegated authority for the appointment of consultants. Julian Hartley Chief Executive 5
Agenda item 9 Appendix 1 2018/19 Corporate Objectives and Measures Objectives Measures Act on the feedback we receive from our patients to deliver patient centred care and improve our services. Achieve high standards of care for our patients. Empower our staff to drive continuous improvement and become the safest healthcare organisation in the country. Work with our commissioners to deliver timely and effective care to our patients, in accordance with the NHS Constitution. Work collaboratively to improve care and services both locally and regionally. Ensure the Trust provides a leading range of specialist services to the patient communities we serve. Achieve a year on year improvement in Friends and Family Test (FFT) response rate. Demonstrate a year on year improvement in FFT approval in all services, Reduce the number of serious complaints by 5% p.a. Provide examples where changes to care are enacted as a result of patient feedback. Improve our safety thermometer scores, Maintain, and progress towards improving, the CQC rating of Good. Improve our HMSR and SHMI rating, Reduce avoidable deaths, Reduce HCAI and improve antibiotic prescribing, Reduce the incidence of Never Events, Produce year on year improvement in the number of staff trained in the Leeds Improvement Method. Deliver our contracted activity commitments Improve 18 weeks RTT Improve diagnostic 6 week Improve cancer 62 day waits Improve cancer 2 week waits Improve A&E four hour waits Reduce number of cancelled operations Reduce number of inpatients that are awaiting discharge, Adapt hospital services in line with progress made in The Leeds Plan, Build WYAAT clinical networks and standardisation to deliver safe and efficient clinical, and non clinical, services across West Yorkshire and Harrogate. Assess our specialist services against the standards prescribed by NHSI. Agree the required developments (or disinvestments) for this group of services, 6
Agenda Item 9 Seek out complementary business development growth opportunities to benefit the Trust, patients and the Leeds City Region. Be a nationally recognised organisation for research, innovation and education. Ensure that our staff are amongst the most highly engaged and developed in the country. Effectively manage resources across the organisation and support investment in our future. Progress opportunities with national and international partners. Progress the Building the Leeds Way plan as part of the joint plan with LCC for the Innovation District, Evaluate, and where appropriate bid against, service tender opportunities, Be a top five organisation nationally for recruiting patients into research studies, Ensure that we have strong NHSR platforms, Increase the number of patients going through our CRF facility, Improve the results from the staff survey, Seek to minimise use of agency and maximise substantive, stable employment to create a more sustainable, resilient workforce, Increase the numbers and quality of appraisals including personal development plans, Deliver a sustainable financial plan, Maximise the opportunities to reduce waste, Improve LOS v peer, Improve day case rate v peer, Improve theatre and clinical support service efficiency and effectiveness. 7
Agenda item 9 Appendix 2 Leeds Health and Care Academy vision and values 8