Where you come first Where you come first - James Paget University ...

CQC
Reflections by John Hemming
I became Chairman of the Trust in November 2003, succeeding the much respected John Wells, who had been Chairman for
ten years.
For the previous two years I had been a Non Executive
Director on the Board. One of the things that struck me
about the local NHS was that its planning was very short
term and reactive and I felt that we should plan over a
wider time horizon, so we could plan investments and
developments to improve patient experiences and maximise
the benefits from those investments.
I did not realise then quite how frequently the NHS was
reorganised. I have since found out that the NHS has had
three ‘once in a lifetime’ reorganisations in the last fifteen
years.
The Trust decided to produce a Ten Year Plan in 2003/04,
based on the NHS Ten Year Plan of 2001, with the objective
of ‘Delivering the NHS Plan vision of a high quality, effective
and responsive service to its local population.’ We repeated
this exercise the following year, but have now integrated
it into our Strategic Plan (updated annually) and the Three
Year Business Plan, which is produced every May.
Headlines from the 2003 version included:
• Waiting times would halve between 2004 and 2010
• Staff levels would increase
Of the Trust’s estate, 30% required refurbishment within
5 years, 30% in the next 5 years and 40% was fit for the next
10 years.
Investment in training would be essential to helping the
Trust meet patient, public and staff expectations in quality of
care, working lives and patient and public involvement.
Capital funding was difficult in the existing regime, FT
status would improve our ability to obtain and use capital.
Some of the proposals included:
• New Education and Training Centre
• New ICU and later extensions to ICU/HDU
• Pain Clinic Palliative Care Orthopaedics, Opthalmology,
Pre-Operative assessment area, Dental and Audiology
required urgent provision/improvement
• Extended Renal unit (consumed Board Room, Swords into
ploughshares event)
• 9 inpatient wards were in need of major upgrades
• IT would double in five years using the mandated
national programmes
Looking back we have achieved virtually all of these.
The national IT programme did not materialise in the
expected manner and we have developed our own
systems.
We have continued our programme of Ward
improvements. One of the main drivers has been the
desire to improve patient privacy and dignity, by moving
wherever possible to replace six bedded bays with four
bedded bays. Such areas also help improve the reduction of
Health Care Acquired Infection (HCAIs) with greater space
between beds and easier cleaning.
Some of my personal highlights are:
ICU opening with the Princess Royal just before I became
Chair, Education and Training Centre, Pain Clinic, EADU,
Breast unit, extended Renal unit in old Boardroom, award
of Cleanest Hospital in England, revised Children’s ward,
(where seven children all individually cut the ribbon) new
Radiology waiting area improving patient privacy and
dignity, Ward 16, our latest state of the art ward, and
the new Stroke Ward, which moves our stroke care forward
significantly.
University Hospital Status
The Trust was a founder member of the Board of the UEA
School of Medicine and as such played a major part in
establishing the school. There were originally 120 students
per year, now 170, to be trained.It was initially planned that
10% of the teaching should be done at the JPUH. Such was
the enthusiasm and commitment of the Consultant body
here and the quality of training, reflected in the student
feedback, that the Trust now provides about 30% of the UEA
training. A benefit of this is funding for 12 extra Consultants,
effectively back filling the teaching time, a great addition
to our core competencies. It makes us more attractive to
staff as a place to work, keeps us at the forefront of clinical
knowledge and thereby helps us provide better patient care.
The building of the Education and Training Centre, opened
2005, supports the activity.
Foundation Trust Status
The Trust, together with all its stakeholders, decided
that it wished to become a Foundation Trust (FT) in 2003,
and set about the process. As an FT we would have new
accountabilities – operate to national healthcare standards
and targets, and not be performance managed by the
SHA. The Board of Directors would take responsibility for
governance of the Trust and we would be regulated by
Monitor who would initially ensure that we were legally
constituted, financially viable and sustainable and well
managed.
It took us three years to achieve FT status after consulting
widely with stakeholders and the general public, presenting
how we would organise ourselves and how local people
could have more influence on what we do. We recruited
members from the local population (9,500), established
the Governors Council, with elections for the majority of
Governors (Public now 20 and Staff 7) and eight appointed
Governors from some of our key Stakeholders, (Norfolk
and Suffolk County Councils, Great Yarmouth Borough
Council and Waveney District Council, UEA and PCT and
Volunteers) which started to meet in Shadow form
in April 2006. We developed our Governance
structures and the Board undertook an in
depth assessment of our finances and our
strengths and weaknesses.
We were delighted to gain FT
status on 1 August 2006, the first
Trust in Norfolk and Suffolk to do
so. Some of the benefits are that we
have closer involvement with our local
community, which is critical for the
future given increasing demands
and reducing resources for the
acute sector. We retain our
surpluses (c.£12m
since 2006) and
can use them
to reinvest
in facilities
and services
to improve
patient
care.
Page 8 Making Waves Newsletter December 2011 www.jpaget.nhs.uk