Jan Sobieraj

I am pleased to report that our pilot project to transform orthopaedic surgery across the county has got off to a good start. Our aim is to improve the experience and outcomes for patients by dramatically reducing the number of cancelled operations.

We have been learning from some of the top performing trusts in the country who are able to offer a better service by separating their elective and emergency orthopaedic surgery, resulting in better outcomes for patients.

The model of all of the trust’s sites at Boston, Grantham, Louth and Lincoln, doing everything for all patients is struggling at times to cope with the increasing demand. The pilot will see all of the trust’s sites working together, with each one focussing on elements of care that will help to improve the overall patient experience.

Last year we had high cancellation rates, with 900 patients having their orthopaedic operations cancelled. The unprecedented demand over winter was a significant contributor to this, however it is not acceptable and with this trial we can stop this from happening again and provide a much better service to the people of Lincolnshire.

In the first five weeks of the trial we have only had to cancel one orthopaedic patient’s operation, which is a massive improvement and is really encouraging.

This is a really exciting time for the trust, if we can make the trial a success our vision is to make Grantham and District Hospital an orthopaedic centre of excellence, secure a multi-million pound investment in theatres, with bold visions to make it one of the top performing hospitals in the country for joint replacements.

We have listened and responded to public opinion gathered during recent engagement sessions where the vast majority of people said they would be happy to travel to a centre of excellence for their planned operations, as long as they could still have their other pre and post-op care locally. Which is exactly what this project enables us to do.

It is also good news for emergency patients at all of our hospitals. By managing all of our routine elective surgery at Grantham and almost doubling our day cases at Louth it means that we will be in a better place to manage emergency cases at Lincoln, Grantham and Boston.

It will enable us to get patients into our theatres sooner and free up beds in A&E.

This is an exciting plan with big ambitions to provide our patients with the first class service that we want and know we can deliver and more importantly it is the level of service that they deserve.

In the first week of the pilot the surgical team at Grantham operated on 36 patients who required planned orthopaedic operations and overnight care, which is impressive when you consider that pre-trial Grantham only operated on an average of 11 patients per week who required an overnight stay.

By starting the trial in August, it means it will be established in time to help us with our preparations and plans for winter. At the end of the pilot we will be able to take stock and look at how things have gone with the trial, before deciding on the next steps.

With a new year comes fresh opportunities to look at where we are and where we want to be. After a challenging year, the plan for 2018 is to continue with our work around fire improvements, quality and safety, cancer, urgent care and our financial recovery – all within the context of our 2021 ambitions and our five work programmes.

Our full, detailed 2021 strategy is expected to be published in the spring, and over the next few years, these changes will lead to better healthcare, quicker access to tests and treatments, fewer cancellations and better hospitals for the people of Lincolnshire and ULHT staff.

Within these detailed programmes, here are just a few highlights we will focus on:

Improve the safety culture of the organisation

In 2017, we made lots of small scale improvements but in 2018 we want to see a  big shift in our safety culture. This was never going to be achieved in less than a year but we have developed new systems and processes and now the focus will be on bedding these in and sustaining changes.

We’ll do this by following through on our staff charter. The charter sets out clear expectations. It gives us all a clear picture of what is expected of all of us so that we can continue to deliver safe, high quality services, day in, day out, for all our patients.

Deliver our finance plans

ULHT has a history of overspending, mainly due to the very dispersed nature of our services. Everyone now agrees that this is unacceptable and we need to now deliver 2017-2018 and plan for a lower deficit in 2018-2019.

ULHT will transform our services and redesign our clinical services.  This will focus on:

• Increasing productivity and quality of our services.
• Reconfiguring some of our services.
• Reviewing what services we can carry out safely away from our three main sites.
• Working with partners to ensure services are sustainable and meet all national standards

Strengthen our workforce

We will continue to put our efforts into recruiting even higher numbers to achieve a better balance between our permanent and temporary workforce.

We need to create more reasons why people will want to join and stay with ULHT. Lincolnshire is a great place to live, but we want to make ULHT a career destination for people. There are plans next year to create clearer talent and development pathways, for nurses, doctors and other groups, with a real focus on training and development opportunities.

We know that as well as focusing on the staff groups we already have, we need to make more progress on changing the professional make-up of teams, exploring new ways to deliver care in our hospitals, which will have huge benefits both to our staff and patients.

In the next six months we should see 12 occupational therapists/physio apprenticeships and up to 10 physician associates and physician administrators start at ULHT.

It is about ensuring that we have got the right type of staff in the right place to deliver the right care, but it doesn’t mean we necessarily have to stick to the historic way of doing things.

Work together with community, primary care and social care partners

As part of our 2021 plan and the sustainability and transformation plan, we’ll work with all our partners in the best interests of all our patients. This means we’ll wrap care around the patient, so they get joined up and better care. Our services will be less fragmented and fewer people will come into ULHT for planned care and in an emergency, as they’ll get the right support out of hospital.

We need to play our part to make this happen.

We’ll also keep the focus on urgent care and cancer improvements.

All of these programmes are going to take time, but by having a great team in place and by working with our partners I am certain that by this time next year we will have seen the rewards of all of our hard work.