I had a really informative and uplifting visit to Royal United Hospitals Bath where I met with the trust chair Allison Ryan and chief executive Cara Charles-Barks. Together with their excellent team we discussed how they are tackling the major challenges facing the trust and the system.
We started by discussing the history of Royal United Hospitals (RUH) and how the new team have positioned the trust in a collaborative and participative role in relation both to the acute hospital alliance and the integrated care board (ICB). It was interesting to listen to Alison and Cara describe how the trust has made great strides in its system-wide role and the progress being made by the acute hospital alliance. This alliance is one of the national provider collaborative innovators, working on capital, staffing, demand and capacity modelling, which includes the establishment of a unified waiting list across Bath and North East Somerset, Swindon and Wiltshire (BSW).
The purchase of a treatment centre from the private sector has enabled the creation of an NHS orthopaedic centre across BSW, ensuring the delivery of more rapid elective recovery. Of note was the work that the trust has done with Bath and North East Somerset Local Authority (BaNES) to create United Care BaNES. This joint venture between the trust and the council has allowed the trust to employ staff and the council to run the domiciliary care service. This partnership has made significant progress on improving the trust position in relation to patients with no reason to reside. Although there are still challenges due to the proportion of patients (around 50%) coming from Wiltshire, where the local authority does not have a similar approach.
We also discussed the trust's new strategy – 'RUH where you matter'. The trust has undertaken a significant engagement programme to develop its new strategy and approach. This program places a strong emphasis on improvement and a focus on the 'basics' for staff. This includes ensuring the availability of hot food out of hours and a year one journey for new staff to promote retention, given that the trust currently loses around 20% of new recruits in their first year.
The trust is also looking towards achieving zero Royal College of Nursing (RCN) vacancies by the end of this calendar year. To address financial challenges they are actively pursuing clinical transformation. Notably, they have made substantial progress in its pharmacy work stream, with £1.4 million worth of savings using Scan4Safety, a programme that uses barcodes to track data and devices to reduce device and patient identification errors. The system wide financial challenge stands at £150 million, and the trust must deliver a £24 million savings programme. The team are clear that the way this financial challenge is addressed is through a clinically engaged and participative approach.
I was also able to visit the trust’s Dyson, Centre for Neonatal Care. It's an impressive, environmentally friendly unit, beautifully designed and created sustainably. Having received the UNICEF neonatal accreditation, this centre offers neonatal care for babies and families across the trust's catchment. It has a major focus on zero separation for families, a strong risk management and safety culture as well as a highly engaged team. I was really impressed by the quality of the environment and the enthusiasm and dedication of the staff I met.
Following that, I visited Cheseldon Ward, an elderly care ward where all patients are medically fit for discharge. Despite being housed in an older building that presents some challenges in delivering high-quality care, the trust and its team demonstrated their commitment to ensuring that the ward performs well against the trust’s own accreditation programme based on the five Care Quality Commission domains.
Overall, this was a really enjoyable and stimulating visit. It was great to see how the trust is stepping up to address the major challenges faced by not just the organisation but also the wider system. In addition, the importance of a positive, uplifting vision for the organisation is evident. There is a strong positive culture and sense of community pride permeating throughout the trust.
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