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Always winter, never Christmas…

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Tony Blog banner Nov 16

Within the last couple of weeks I’ve had some of my most senior emergency, elderly care and surgical consultants come and find me, for a frank and open conversation. There is a pressing matter that is the focus of all our efforts and energy… winter. More specifically, how we will care for our patients and how we will care for each other in the weeks and months ahead of us.

I’ve been doing a lot of listening. This is what is clear to me…

1. All day and all night people keep coming through the front doors of The Countess to see a doctor for diagnosis and treatment. Each year approximately 70,000 people are seen in our busy A&E unit, which was designed 30 years ago with capacity for seeing 40,000 people. In recent weeks our performance for people seen within four hours has been among the worst in the country. When we review the cases that come in, about one third of these patients could have been seen and managed in an alternative healthcare setting.

2. The number of planned routine operations we are cancelling is likely increase, due to the number of beds occupied with emergency admissions. We try our hardest to ‘ring fence’ beds to keep free for surgical procedures, but during our busiest months (winter again) we have to make difficult decisions about those operations that take clinical priority. We work closely with colleagues at Wirral University Teaching Hospital, to enable our surgeons to carry out procedures using its Clatterbridge site when appropriate to help us reduce delays for patients.

3. We don’t come into work every day to fail at what we do, and not meet performance targets. While it is hard, my completely unbiased view is that I am lucky enough to work with some of the most brilliant NHS clinicians in the country. I never lose sight of this. By the very nature of the job, the people working at The Countess have devoted their lives to this place and their patients. As a team we are open minded, fixers, problem solvers and doers. As demoralising as the statistics are, we will never give up. We will always continue to explore new ideas and opportunities that deliver the NHS care that our patients and the local population deserve.

And so, as the nights draw in we know what we need to do. This month sees us trying out new approaches in partnership with GPs for faster streaming and treatment of those patients in need of urgent care. We continue to rollout the Cheshire Care Record to ensure joined up working and ease of information sharing across providers. We have elderly care consultant specialists based with the emergency team to help manage the numbers of frail patients, many living with dementia facing additional confusion and stress when not in a familiar setting. The frequency with which consultants are reviewing patients for discharge in both our Chester and Ellesmere Port hospitals has been increased. Our wards have been re-organised, and we have even opened our first ever therapy-led ward providing additional support for patients who want to get home but need confidence building with the help of physiotherapy or occupational therapy.

This is a whole hospital effort. This is where all our focus must be for now. We try our hardest not to get distracted. Yes, there are plenty of options, discussions and ideas about how we might work in five years from now. We will of course want to represent the views of our clinicians and patients in these plans at the right time. The other week we faced rumours about a new super hospital in Ellesmere Port. This week regional planning discussions continue to be leaked, published and generate much interest. But we will continue to do our job and we won’t let our community down.

Thank you as ever for your continued support, please know it is appreciated.

With best wishes

Tony Chambers, Chief Executive

About the Author

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Chief Executive of Countess of Chester NHS Foundation Trust.

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