Heartbeat December 2019

Toby writes about… why Good is good for you
TobyLewis_SWBH
TOBY’S LAST WORD
If you turned to my article to look
into 2020 and what lies ahead,
best to dig out the back issue
and review that in November’s
Heartbeat (available online too).
Safe to say that, as Richard sets
out in his Chair’s column, there is a
bright future for our organisation,
not just in traditional fields,
but as we work more and more
closely with GPs, and build on the
distinctive success of teams like
our Sandwell health visitors, our
integrated sexual health service,
our alcohol liaison team, and
our specialist community based
paediatric teams.
This article is about our upcoming
Care Quality Commission
inspection. When is it? Properly,
I don’t know. It is likely in 2020.
Probably our three new GP practices
will be the start. Then our Requires
Improvement services – read on below.
And any teams being put forward to
join our Outstanding elite: community
children’s, critical care and end of life
service. Teams demonstrating what we
can achieve with all the pressures and
constraints we tend to talk about.
What I do know is that teams rated
as Good or better are teams who
find recruitment and retention easier.
That might be because the rating
gives cache. Recruits look online and
seeking differences between us and our
neighbours they set store by the CQC.
More probably it is because the things
we want and value at work are the
same things the CQC look for:
• A supportive boss
• Team discussions
• Fun but support when times
are hard
• A commitment to quality
improvement (hold the
front page)
• Multi-professional working
• Training and development
• Getting the basics right
• Having a plan for the future
In 2014, 2017 and 2018 I approached
the CQC inspection with a view that
we should be as we are, and see what
it brought. Good ratings might have
overstated us, poor ones probably
unfairly maligned us. I think on balance
I have changed my mind. Having seen
the huge boost to teams succeeding in
the CQC process, I think now we need
to work as one to get the prize. What
prize? A Good rating, not just in most
teams (we are 70 per cent there) but
across our organisation. Only that prize
will give us the flexibility to develop and
adapt services freed from too much
external bureaucracy, clear that we can
work within a system, but innovate,
invest and develop as you choose we
should.
We have just three Requires
Improvement core services: I know how
hard our children’s services team are
working to get back to Good. Across
emergency care and medicine there
is real determination to see the quality
of our cardiology service, the excellence
of our stroke team, the respiratory hub,
and our GI services, recognised for the
specialist work that they do. Acute
medicine and elderly care dominate
QI awards. A&E stood out at our Star
Awards. I know how hard “winter” is. I
understand that “capacity” dominates
and distracts. I also know that success
brings rewards, mostly more success.
And that is why we need to work
together to show that firstly our
Glimpses of Brilliance are actually
most days. And secondly that we
work together to tackle to genuine
risk issues. Our Good and Outstanding
services are not blessed with ease. They
The way the CQC see us
The domains five CQC are domains described by the CQC as follows
Is it safe?
Is it effective?
Is it caring?
Is it responsive?
Is it well-led?
where everyone matters
too face tough times. They are rated
highly because of how they face
those problems.
This festive season do not put the
turkey down and read our last three
CQC reports. But if you did, you’d
see success, but you would also read
about out of date stock, expired
mandatory training, resus trolley
checklist gaps, and drug errors.
These are not functions of money
or policy, they are symptoms of
attention and detail. The very things
the CQC look for and ones we can
address.
So we can get to Good. The
challenge of 2020 is do we want
to? Is it worth the hassle and worth
setting aside whatever immediate
frustrations exist, in pursuit of a
bigger gain – public credit for what
you do brilliantly, less external
interference in what we want to do
locally, and above all a chance to say
to people not yet joining us – come
here, we know what we are doing?
Going into 2020 let’s think about
resolutions. Please consider where
our ‘rating’ sits in your plans. None
of us come to work for any reason
other than the patients we care
about. They deserve the best. You
deserve that the rating system that
reflects your efforts. Only you can
get us to Good. I think you will.
Sandwell and
West Birmingham
NHS Trust
!Safeguarding and protection from abuse !Managing risk !Safe care and treatment
!Medicines management !Track record !Learning when things go wrong
!Assessing needs and delivering evidence-based treatment !Monitoring outcomes
and comparing with similar services !Staff skills and knowledge !How staff, teams
and services work together !Supporting people to live healthier lives !Consent to
care and treatment
!Kindness, respect and compassion !Involving people in decisions about their care
!Privacy and dignity
!Person-centred care !Taking account of the needs of different people !Timely
access to care and treatment !Concerns or complaints
!Leadership capacity and capability !Vision and strategy !Culture of the
organisation !Governance and management !Management of risk and performance
!Management of information !Engagement and involvement !Learning,
improvement and innovation
swbh.nhs.uk
31