Operational escalation: With United Lincolnshire Hospitals Trust sites under pressure, the trust has introduced new measures for financial and clinical stability.
Following recommendations from the Keogh review in June 2013, in which care provided by NHS trusts was scrutinised, United Lincolnshire Hospitals Trust fear that services could still fail to meet standards.
As previously reported, the trust was put into ‘special measures’ after the national review of mortality rates left targets for improvement over a six month period.
Since the recommendations, ULHT developed 261 milestones, and have now achieved 200 of these.
At a board meeting on December 3 at the Trust Headquarters, ULHT introduced new escalation policies measuring pressure levels within hospitals.
In addition, the trust reflected on clinical and financial instabilities. While maintaining mortality rates below the national average of 100, improvements are needed to ensure staffing levels do not fall due to financial restrictions.
The financial plan for this year was to achieve a deficit of £17 million by the end of March 2014.
With December 3 marking the ‘7 month’ position, the trust announced the deficit currently stands at £16.1 million.
ULHT Chief Executive Jane Lewington said that while the trust is meeting most of the 261 targets based on recommendations, they are struggling to make clinical and financial progress.
“Financially, we have seen a notable deterioration in the last few months,” Jane Lewington explained.
“When you look at the situation in detail, you find a lot of it is related to two things. One is our expenditure on staff. The second is that we are not delivering on our cost improvement programme.
“We’ve had a much higher reliance on bank nursing and agency to operate the new optimum staffing levels.”
Due to staffing issues and demand the trust continues to rely heavily on temporary medical staff. The Chief Executive went on to explain how the percentage of temporary roles is not financially sustainable.
“Some 15% of my consultant posts are actually filled by locum doctors, that’s 44 locums.
“I then have 62 locum doctors below consultant level. It’s a more expensive way of filling those posts. One of the things that the board is very clear on is that we have to protect those optimum staffing levels on the wards.
“We will be putting in place a 5-year financial recovery plan that will look at us needing to save around 6% year on year.
“Across the whole system I believe we will have enough beds to last the season. At the moment we are not looking to open extra beds in hospitals,” added Jane Lewington.
Eiri Jones, Director of Nursing at ULHT, has been leading the Ward Health Check which is a set of performance indicators measuring the impact that the investment is having on the efficiency of care.
Operation Escalation is a new trust wide policy allowing staff to be more aware of levels of alert. Levels of alerts will be displayed across each site and the trust will be working to ensure staff, patients and visitors are aware of the levels of pressure.
“We will be looking at the information from the first quarter based on alert levels. We will look at the areas that have got a red (a high pressure level), and how we are going to manage that in the future.
“As far as recruitment goes, we have already had a big campaign where we had 101 new graduates start in September. We will be conducting further reviews and reporting our staffing levels regularly.”
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Phase two of the works at Speakers’ Corner in Lincoln is well underway and expected to finish on schedule this summer.
Phase two, which began on Monday, January 11, will see existing paving upgraded, as well as new street furniture being installed.
It will follow the first phase which was completed and open to the public on December 22, with a new bench put in place around the existing London Plane tree, instead of the demolished kiosk.
Speakers Corner bench is in place, but closed off until phase two paving works are finished. | Photo: The Lincolnite
Site setup for phase two is complete, with workers on site currently digging out the existing hard paving standings at the Cornhill.
A large portion of the area has been fenced off while work takes place, leaving just two pedestrian strips on either side to access both the High Street and the Cornhill Quarter.
There is limited access in the area while works take place. | Photo: The Lincolnite
Despite the cold and wet weather throughout January, progress of the paving removal has not been affected.
This means that phase two works are still on course to be finished in summer this year.
It is hoped that once the area is completed, the walkways will blend in with those at Exchange Square, as well as utilising the space for events.
A look at how the finished development will look. | Illustration: City of Lincoln Council
Bin collections in Boston and in parts of East Lindsey will be suspended for the rest of the week due to COVID-related staff absences.
The collections will be suspended from Wednesday, January 27 as a number of East Lindsey District Council’s and Boston Borough Council’s waste crews either have coronavirus or are self-isolating.
Boston Borough Council and East Lindsey District Council said it is not a decision that has been taken lightly and it is necessary for the service to be suspended in some southern parts of the district until Monday, February 1.
From Monday, waste collections are expected to continue as normal.
Households impacted by the disruption can present any accumulated side waste in black refuse sacks alongside their black bins on their next scheduled bin collection.
The following areas are affected:
Boston
Friskney
Eastville
New Leake
Stickford
Coningsby (part)
Coningsby Moorside
Dalderby
Haltham
Mareham Le Fen
Moorby
N Bolingbroke
Revesby
Scrivelsby
Tumby
Tumby Moorside
Tumby Woodside
Wilksby
Wood Enderby
Carrington
Dogdyke
Frithville
Gypsey Bridge
New Bolingbroke
New York
Scrub Hill
Thornton Le Fen
Westville
Antons Gowt
Cowbridge
Fishtoft
Frithville
Langrick
Sibsey
East Keal
East Kirkby
Hagnaby
Keal Coates
Midville
Stickney
Toynton All Saints
West Keal
Victoria Burgess, Assistant Director for Operations at the council, said: “Over the past couple of days it has proved a real challenge to keep the service going with a number of rounds having not been completed due to staff absences.
“With more crews off again today we needed to take action now and suspending the service is the only realistic option available to us to keep everyone safe – something we’ve worked hard to avoid.
“Our workforce has done an amazing job over the past year and they’ve received much praise from the community and are grateful for your continued good wishes.”
Meanwhile, Lincolnshire County Council has agreed to extend their open days at the Household Recycling Centre on Bittern Way for the disposal of black-bagged general waste and recycling only.
The two extra days of opening are Wednesday and Thursday of this week and next, between the hours of 8am and 4pm.
Over 6,000 people living in and around the Scunthorpe have signed up to donate convalescent plasma after having coronavirus.
This comes as NHS Blood and Transplant (NHSBT) is appealing for more potential plasma donors ahead of an upcoming third trial.
Convalescent plasma is the antibody-rich plasma of people who’ve had coronavirus. This can be transfused into people who are struggling to develop their own immune response.
NHSBT wants more people in the area hitting the 28-day recovery mark to sign up.
Over 30 donations have so far been taken at the Scunthorpe donor centre at Berkeley House at Berkeley Business Centre on Doncaster Road, which opened in December last year.
People can register to donate online here and can donate 28 days after they’ve recovered from coronavirus.
The Lincolnshire centre is located at Berkeley House at Berkeley Business Centre on Doncaster Road in Scunthorpe. | Photo: NHSBT
NHSBT is collecting the plasma for new trials for older people or those with cancer to treat them early in the course of the infection.
Two earlier trials have now stopped for data analysis. The upcoming third trial’s focus will be on those with low immune systems and all donations are tested for COVID antibodies.
The NHS trials of convalescent plasma are the largest randomised controlled trials for this treatment of COVID-19.
Professor Dave Roberts, Associate Medical Director for Blood Donation at NHSBT, said: “More people than ever are now able to help – the time to donate is now.
“We especially need donations from people in Scunthorpe who’ve had hospital care. Men who had hospital care are around six times more likely to have the high antibody levels which might save lives.
“We have completed two trials and analysis is ongoing. We now need to collect plasma for further planned clinical studies. We’re particularly looking at high risk groups such as the elderly and people with cancer.
“Donations are vital to the ongoing lifesaving research, which gives us a better understanding of how we can best treat patients with COVID-19 and help prevent deaths in the future.”
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