In Mind: Chief Executive Joe Rafferty talks about lockdown; one year on, a new model and service, pressure ulcer progress and more

Joe's Blog

It’s been hard to escape the anniversary of the start of lockdown, which began on 23 March 2020 when the Government announced we must stay at home and shops and certain businesses were told to close. There’s been a lot of distress for many people and plenty of hard work and innovation that’s gone on during those 12 months to allow us to reach where we are now.

Hands, face, space.

I’ve written in previous blogs that we can’t afford to relax now, but I’d like to thank everyone who has helped during these challenging times. If you’ve had your jab, worn your PPE, kept 2 metres apart, home schooled, rearranged a room to fit in a work laptop, carefully checked in on a vulnerable neighbour… then, thank you, because you’ve all contributed to what’s been achieved.

Everyone has played a part during this period, from rearranging shifts, wards, services, doing extra cleaning, offering care through a plastic shield, or running a team meeting with someone stuck on mute or with family noises in the background. It’s been a heck of a year and Mersey Care staff have shown themselves to be amazing. 

At times of anniversaries – good and bad – people find themselves wondering what’s next. I know there are anxieties about the future, which has been put on hold for many of us but please provide your team with the opportunity to make sense of it and talk about it.

 

New model and a new service

I’ve previously written in this blog that one of the major positives from this year is the tremendous amount of teamwork we hadn’t seen before. A great example of partnership working has been a new project we’ve established between Mersey Care and Liverpool University Hospitals Foundation Trust (LUHFT). We’ve been working together closely to create a new reablement model for a gap in patient provision identified capacity modelling. ​

The newly integrated service for people in North Mersey will be based at a refurbished Stoddart House on the Aintree University Hospital site with Mersey Care’s Ward 35 staff moving into the refurbished wards in Stoddart House and the Ward 35 site will return to the management of LUHFT.

Patients from Ward 35 will also transfer to the newly refurbished site and once it is fully opened and recruitment complete there will be 69 beds. These will be released in two phases: initially with 28 beds split with 12 on the ground floor and 16 on the first floor, which is intended to be operational in late April. In phase two, we anticipate the remaining 41 beds going live by the end of May. Both phases will include Activities of Daily Living (ADL) kitchens, activity spaces and a range of single and dual occupancy rooms.

This service will strengthen the resilience in the Out of Hospital sector and jointly increase flow and reduce pressure on local hospitals, hospices, and care homes. It also provides step down capacity from acute trusts for medically stable and optimised patients - those whose care and assessment can be continued at home or in a non-acute setting or who are ready to go home. 

The team have designed the service with admission criteria that supports patients when it’s anticipated the ongoing nursing, therapy and reablement needs will be completed within an average two week length of stay. The service will also be open to patients needing step up care from community settings that require reablement or convalescence where alternative out of hospital home care has been exhausted. 

Patients admitted during the first phase will be similar to those currently being cared for on the Ward 34 and 35, but over time there’ll be opportunities for staff to develop additional skills and competencies and we’re actively recruiting additional staff in order to fully realise the service’s exciting clinical model.

 

Pressure Ulcer progress

I always like to draw people’s attention to new or different work being delivered and, in our community division, our clinical governance lead Nicky Ore has published a piece in the Journal of Wound Care. The title, ‘Clinical impact of a sub-epidermal moisture scanner: what is the real-world use?’ is one I particularly like because it highlights something specialist but with the promise of a clear practical explanation.

We know about the importance of preventing pressure ulcers. The team’s work using the equipment – with 1478 patients – saw a substantial reduction of their incidence in hospital or community settings. Three quarters of all sites saw a 100 percent reduction, which is astonishing but also reflects the excellent result of good practice from a highly informed team.

For context, 20 years ago the Department of Health were asking for 5-10 percent reductions and some of the risk assessment tools used are of a similar age. The article charts how, by fitting this good new practice seamlessly into their work, the teams were able to deliver such clinically important reductions. Effective screening and the use of the latest equipment are clearly making a difference here and I’m proud of the role Mersey Care has played in this joint publication with Trusts from across the country.

 

Online Presentations

The Chairman and I each have interesting online platforms just now. Beatrice Fraenkel will be speaking in her Design Champion role about “Recovery, wellbeing and happiness for everyone” at the design at the health and dementia facilities forum on 31 March. You can join the debate and register as a complimentary delegate here: https://bit.ly/2Ny3k8u 

 

Beatrice Fraenkel, Chairman

For my part, I’d like to point you in the direction of a slightly irreverent but big hearted totally NHS focussed podcast out this week. It’s called ‘The Placemat’ - it features clinicians with poignant thoughts and irreverent commentary from the world we all work in. It’s a good listen anyway, but if I can entice you further, the latest edition offered me the chance to share my views on cooking and fashion and even tried to ask me about politics. More significantly, I discuss the Zero Suicide Alliance and whether we have the NHS we deserve. I hope parts of it will make you smile and all of it will make you think.

 

Prof Joe Rafferty CBE

Chief Executive