The must-read stories and debate in health policy and leadership.
- Today’s painful procedure: Hundreds of women left ‘distressed’ by diagnostic test
- Today’s workforce planning: ‘Two to three years’ before we have enough staff, says trust chief
Contain, delay, research and mitigate
We are currently in both the contain and delay phase. It is hoped the virus can be contained to a few patients but, with covid-19 continuing to spread in Europe and the wider world, it seems likely this will not be sufficient.
If there is more sustained transmission, the government will focus on delaying the inevitable. If the peak of the virus outbreak can be delayed until the late spring or early summer, the NHS should be much better placed to deal with it.
For the NHS, that means postponing or cancelling elective work — or to “slow down or postpone anything that is postponable”, as chief medical officer Chris Whitty put it at a press conference.
The advice should hardly come as a shock. Indeed, it is not uncommon for hospitals to cancel operations to deal with winter pressures. “This is normal medical practice — you adjust what you do clinically to the particular group of problems in front of us,” added Professor Whitty.
Other advice for the NHS includes distributing stockpiled medicines and other “clinical consumables”, as well as working with social care services “to support early discharge from hospital, and to look after people in their own homes”.
Normalising the unacceptable
It’s a trust that has rarely been in the headlines for the right reasons lately. Quality and financial special measures, ambulances snaking out of its emergency departments and a workforce that, by its own admission, “lack[s] a sense of pride or hope”.
Now, with its EDs both rated “inadequate” for the second time in a year, what other assessment could the boss of United Lincolnshire Hospitals Trust give?
In a frank interview with HSJ, Andrew Morgan said his organisation had on occasion “normalised the unacceptable” and admitted: “Nobody can be happy [with] where this trust is in its current position.”
Seconded as interim chief in 2019, recently extended for another two years, Mr Morgan clearly knows there’s little point in polishing the obvious.
Targeting leadership, he criticised accountability of staff, feedback, managerial support and communication.
Although suggesting “the media spotlight” and “double special measures” were “bound to have an impact on staff morale”, these are clearly products of the embattled trust’s many issues.
And it seems he has sight of what to do next, setting out an ambitious plan of bringing the entire trust up to “outstanding” Care Quality Commission status by 2025.
His record is persuasive; he achieved an “outstanding” rating for Lincolnshire Community Health Services as its chief in 2018. It’s easily arguable too that having a leader with sight of the public health challenges in Lincolnshire (rural isolation, obesity, an ageing population, and reliance on hospitals for care to name four) will be an aid to the trust’s in-house challenges.
He now has two years to show things can get better, but will a bold message translate into effective strategy and management?