Date published: 29 June 2021
Last week I looked ahead to commemorating the huge amount that our armed forces do for us and I included some useful links to resources for veterans. I also recalled our Trust’s many historic links, such as to Whalley where the hospital was used by soldiers in two world wars.
Our site at Hollins Park has a similar history, as the Lord Derby Hospital between 1915 and 1920, when more than 56,000 soldiers were tended to at the site. It was a privilege to be at Winwick with Board colleagues and a veterans’ advocate this week to pay tribute at the memorial plaque in the education centre that reflects the past, present and future connections that we have with all of our armed forces.
We continue to remember and support our veterans. Take a look at these short films we made alongside army colleagues to mark the day:
Telehealth
On Thursday I was pleased to be part of the NHSX Innovation Collaborative online conference. For those not steeped in NHS terminology, NHSX is a collaboration between NHS Improvement and Department of Health and Social Care teams who are working together to drive digital transformation of care.
The context for the discussion was that healthcare has seen a level of change and transformation that 18 months ago we wouldn’t have thought possible. The event featured examples of improvements in the care of patients along with a range of new and exciting therapies which have helped to maintain and improve standards during the pandemic. As we mark the 73rd anniversary of the NHS next week, it’s a reminder of how much has developed and how models of care have changed, as the system now supports thousands of people at home using digitally powered remote monitoring.
As with many COVID-period innovations, people have just got on with it. What’s important is that we retain all of the invaluable learning from the progress that we’ve made. One of the topics of the day was about rethinking how care is provided and not just locking in digitally the “as is” state. And we need to measure and share its impact with hard, quantitative evidence of clinical outcomes.
In Mersey Care, we are already well known as a Trust that delivers real innovation and this includes our position as a Global Digital Exemplar. The local health challenges that we face in Cheshire and Merseyside are well documented and the levels of digital deprivation are huge. COVID ravaged populations that already experienced significant health inequalities. 45 percent of our population live in England’s most deprived 20 percent of neighbourhoods and 26 percent of 0 to 15 year olds live in poverty.
I told conference what we’d achieved during the pandemic and what was already in place. Telehealth has been operating in Liverpool now for more than a decade. We already had a mature remote monitoring and virtual ward service at scale. Over seven years or so, it’s been deployed to some 13,000 people.
We’d understood the opportunity to do something quite different. And to myth bust for a moment – Telehealth is actually NOT about the technology. Ours is a cultural programme enabled by technology. We already had deep engagement with the patients who’d benefit from it and in a world where the whole of the NHS is wrestling daily with staffing levels we have been able to build Telehealth into our care planning to support great care and recovery as close to home as possible. This support is based on safe, effective care planning. When you’ve a patient/staff ratio of 1:400, this is a really significant support that has both care and economic benefits and means that we can deliver high quality, sustainable care for our populations long into the future.
When the pandemic struck, we were already prepared with our well-established monitoring hub. Telehealth is a platform that doesn’t consume many healthcare workers who, in the first wave of COVID, had to be elsewhere. More than 3,500 clinically extremely vulnerable patients with respiratory conditions (those on the ‘shielded list’) were installed onto Telehealth over just two months. It gave us strong sense that we could do more and it became the forerunner of COVID Oximetry@Home and the Virtual Ward.
Since then, more than 8,000 patients have been monitored remotely through Telehealth technology. A small number had to go into hospital but 61 percent remained managed by Telehealth clinicians. When hospitals and care homes were struggling, this ability meant that we avoided the risks of sending people to places of possible infection and also reaching them much earlier to more quickly stabilise their conditions.
Amid this data, the importance of the patient story is critical. Attendees were rightly taken by my example, recorded in our trust magazine this month. “It’s just like having people with us, I never felt on my own” – that’s what we were told. This drives the deep value of this approach.
It’s not just the patients. It’s all our people. Unpacking care from just being in a hospital setting to delivering it online is a challenge. Remote skills are different, with new skills and sets of risks but they are eminently manageable. It’s a cultural challenge not just an implementation challenge. What we have is an opportunity at scale, as a part of the network of care services, allowing us to think of care closer to home. In Mersey Care, we wanted to hand over more power to patients. So we listened to understand what they wanted, what their edges or own limitations were – especially where digital deprivation is very high.
We had also already begun deep engagement with staff on the best ways to work. Those included the Mega Conversations that we’re restarting next month where you can contribute and continue to feed back. I hope that you will all get the chance to engage and tell us more about your services and what we can do together as a Trust to improve and develop the ways we deliver care.
As I told the event, this means much more than being a digitally led programme. We did things, I firmly believe, the right way around. Our business is providing the very best patient care, and listening to people’s needs first is how we do this.
Supporting and rewarding staff
I was also on a very different virtual stage this last week, although we did in fact have an actual podium and I haven’t stood on many of those in recent months! It was a real pleasure and a moment of pride as a chief executive to deliver the Positive Achievement Awards alongside Board colleagues.
Huge congratulations to all the winners and nominees: a list of the winners is online here. The range of achievements, from front line to office, from community to forensic wards, was brilliant and I thank all those who nominated and the organisers for a great event. I know many former North West Boroughs colleagues joined the virtual audience and we’ll continue the celebrations with an enlarged Trust celebration as soon as we can.
Before that the Patient Safety Awards are announced in September. Some of our teams are finalists so good luck to our 24/7 mental health urgent care service, borderline personality disorder hub and MaST - digital offer through COVID-19, our time capsules organisers -19 and also the specialist nursing digital training supported by the Centre for Perfect Care (CfPC).
I also want to congratulate Lesley Newport from the Community Division’s Tissue Viability Skin Team and Danny Roberts from CfPC as runners up in the Tissue Viability Nurse of the Year Category in the BJN Awards 2020. The pair are soon to be featured in the 2021 issue of the British Journal of Nursing for their hard work throughout the pandemic.
Finally – that reminder again. It’s essential and you must play your part. Masks, vaccinations, personal space and personal responsibility. COVID is still with us and the choices we make will affect lives. Stay safe and keep others safe.
Prof Joe Rafferty CBE
Chief Executive