Thursday, 20 October 2016

Toughest ever financial environment

Until last year, NUH had a strong track record of healthy finances, balancing its books every year since the Trust was formed in 2006.

And now, like most other acute trusts, NUH now finds itself in severe financial difficulty.

In line with our plan, we ended the last financial year with a £47.2m deficit, even after making our highest ever cost savings of £44.5m and generating income improvements.  Our plan to reduce that deficit (called the ‘control total’) to £22m this year requires NUH to make at least £43m savings. It is also dependent on NUH receiving £24m national monies from the Sustainability and Transformation Fund (STF) which is itself conditional on hitting financial and operational targets (including 4 hour emergency care performance and cancer targets). £6m is at risk each quarter if we miss these targets. We have missed the agreed trajectories to September for the 62 day cancer standard and the 4 hour emergency access standard, which means a loss of income year to date of £1.1m.

After September (month 6) we are £0.5m behind our planned £15.5m deficit.  We have achieved savings of £16.6m, in line with the target up to the end of September.  The full-year forecast at the end of September shows £43m of savings plans in place (in line with the savings required by year-end), but that still means that we have to deliver £26.4m of savings between October ’16 and March ‘17.

We have saved over £120m in the last three years. We have to make some tough decisions if we are to reach our agreed year-end financial plan for the current year. Our message to staff is that we must individually and collectively do all we can to meet the financial and operational targets required of us. As unpalatable as this will be for many, the reality is if we do not manage to make the required savings ourselves, we will have them imposed on us by our regulators.
Every week we are spending £350,000 more than we can afford. We need to spend £50K less every day. That’s £2k per hour and £34 less every minute.  While this may seem a daunting task, for an organisation of our size, there is always more we can do. 
Pay accounts for 70% of our spend. Our agency, bank and locum bill was £41.1m last year. Thanks to the hard work and discipline of many colleagues across NUH, nursing premium and medical locum pay has reduced significantly in the first five months of the year, but there remains much more to do to reduce ‘high cost’ spend.
Further strengthening vacancy controls and scrutinising all premium pay and discretionary spend is absolutely necessary, though we are equally clear that we have to apply additional measures intelligently and thoughtfully to avoid any unintended consequences (of our decision-making) for safety, our services and our staff.
Through the Nottinghamshire Sustainability and Transformation Plan (the STP), our shared task as a health system is to do all we can to close the financial gap of £500m for the NHS in Nottinghamshire over the next 5 years so that in the longer-term we have a clinically and financially-sustainable system. While we rightly focus on the immediate task in hand – in solving NUH’s financial crisis – we equally understand our part in addressing the wider system’s financial challenge.

Tuesday, 18 October 2016

Associate Nurses: developing home grown talent

I don’t think you will find anyone working in the NHS who thinks that the country’s shortage of nurses can be solved overnight.

It’s a problem that’s placing an enormous strain on the entire health and social care community as we compete to attract the best staff from an incredibly small pool.

The solution will require a number of changes at national level, but one thing that I believe will make a big difference is the introduction of nursing associates, an exciting new role that will soon work alongside registered nurses and healthcare assistants focussing on patient care.

At NUH we attract recruits from many other health settings as well as universities, as ambitious nurses look for the best development opportunities available. The new nursing associate role will provide a welcome and much-needed career path for dedicated healthcare assistants who are eager to learn new skills on our wards and progress their career. It could be the ideal next step for those healthcare assistants who aspire to one day become a registered nurse and this new role paves the way for this ambition to become a reality.

Our Trust is one of just eleven NHS organisations across the country that has been selected to work with Health Education England (HEE) to deliver training for the new role. This is great news for Nottingham, our patients and our staff.

We expect new trainees to start at NUH and SFH before the end of the year. More information to follow on how colleagues can apply if they are interested. Watch this space!

NUH already has an incredibly diverse workforce with many different roles providing frontline care as well as supporting clinicians behind the scenes. But the news that we have been selected to train some of the first wave of associate nurses will be welcomed by our dedicated nurses who look forward to the prospect of developing and nurturing new talent on our wards.  You can read more here.

Tuesday, 11 October 2016

Good luck to smokers quitting for Stoptober

As an ex-smoker, I’m giving my full support to all those who are trying to quit smoking for Stoptober.

Launched in 2012, Stoptober is the 28-day stop smoking challenge from Public Health England that encourages and supports smokers to give up for good. The campaign is based on the insight that if you can stop smoking for 28-days, you are five times more likely not to start again. It breaks down the quitting process, presents it as a more manageable 28 days and rallies people around a specific date to get started.

Stoptober has driven almost 1 million quit attempts to date, with thousands more taking part this month.

The QMC Trust Pharmacy is offering a six-week course of one-to-one support and nicotine therapy worth up to £240 - for the cost of just a single prescription charge (£8.40).

There is now more support available to patients and staff, with full-time stop smoking advisors now working at both City and QMC.

I know that the first weeks of quitting smoking can be very tough, but it’s also around this time that you see some of the most immediately noticeable health benefits.

According to our respiratory health experts, within three weeks you’ll be able to exercise and perform physical activities without feeling as short of breath. Your blood circulation and heart function will improve significantly, while your lungs may also begin to clear, allowing you to breathe more easily.

Reflecting on my own experience, I can say that giving up smoking is one of the best things I’ve ever done – and wasn’t nearly as hard as I thought it would be.  Yes, the first couple of weeks were tough, but with the support of New Leaf I got through, and after that it wasn’t a big issue.

You’re giving up an addictive drug. Getting help wherever it’s available – be that in our hospitals or in the community - will help you stay smoke free even after October.  And trust me, it does get easier – now, I don’t even think about it.

All Nottingham residents can access a range of local stop smoking services in the community as well as in hospital. City residents can contact New Leaf on 0800 561 2121 or text 'NEW' TO 80800. Smoke-free Life Nottinghamshire also provide support to people who live across the county. Call 0115 772 2515 / 0800 246 5343 or text 'QUIT' to 66777. You can do it!

Monday, 10 October 2016

Record week 1 for flu jabs

As we approach our busiest time of the year, I’d like to take time to encourage colleagues to take steps to protect themselves, their patients and their families by having their flu jab. 

Over 2,600 colleagues across NUH had their jabs in the first week of our programme – beating our total for all of October last year! 

Thank you to our nurses and midwives who have signed up as peer vaccinators, volunteering to give the flu jab to colleagues in their own wards and departments. 

This local approach has proved incredibly popular with staff, and one of the most effective ways of increasing uptake.

And this year we’ve gone one step further, by training Allied Health Professionals as peer vaccinators. I’m sure these colleagues will play a pivotal role in helping to boost take-up even further. 

Another weapon in our fight against flu is our new App that provides live data on take-up of the jab by Division – which is generating some healthy competition! At the end of the first week of vaccination clinics our Family Health Division is in the lead with more than 27% of staff already vaccinated.

What an achievement and start to our vaccination programme.  NUH is already well on the way to achieving its 75% target for staff vaccinations. We are on track to reach our target by early December. 

Please help raise to the awareness of the importance of having the flu vaccination to your colleagues and your friends and families.

The flu vaccine is still the best protection we have against an unpredictable virus which can cause serious illness and death. For more information about the national seasonal flu campaign visit:  

Monday, 3 October 2016

Celebrating the best of NUH

Today the 2016 NUHonours Awards shortlist is announced. As we mark 10 years of NUH and 10 years of NUHonours, it’s been another record year, with over 650 nominations. The new categories have been particularly popular, especially the team of the year award, which received over 100 nominations.

Very many congratulations to all staff, teams and volunteers who have made the shortlist – and indeed to everyone who was nominated – and thank you for everything you do for our hospitals. Thank you also to the patients who sat on each of our judging panels with our staff to decide who should be included on the shortlist. I certainly don’t underestimate what a difficult job this was!

And very special thanks must go to our Nottingham Hospitals Charity – who have supported NUHonours for the last decade. Without you, none of this would be possible.

The overarching judging panel  - made up of patients, staffside, local media, Charity and NUH representatives - will meet on the 20 October to decide the overall winners, which will then remain a closely guarded secret (including from me) until the awards evening in November. Peter Homa has personally chosen the winner of the Outstanding Contribution to Patient Care Award, a one-off award for 2016 to mark the 10th anniversary of NUH. And the Nottingham Post are supporting us once again with ongoing media coverage and a special supplement that will be published in the days after the awards. We are delighted that the Post’s editor, Mike Sassi will host this year’s awards.

It’s been an incredibly tough year. We know our staff cannot work any harder. These awards are one of the ways in which we look to recognise the exceptional contributions of our dedicated staff and ensure they get the recognition and praise they deserve.

For now, I look forward to reading the story of each of our shortlists who have been put forward for awards by their colleagues and patients. Starting today, we will showcase our shortlist via social media @nottmhospitals and @nuhstaff and I also wish the overarching judging panel luck and look forward to attending the NUHonours Awards evening on 25 November to celebrate our amazing colleagues who make up TeamNUH.

Attracting the best to Nottingham

Attracting the very best people to work at our hospitals and retaining the excellent team we already employ remains both a priority and a challenge for NUH, particularly when it comes to qualified nurses, given the national shortage.

That’s why I’m delighted that our Nursing Development Team has launched a brand new microsite  to advertise some of the different nursing and midwifery roles available across our many specialties, alongside the opportunities for existing colleagues to grow and develop their career at NUH.

This new careers website has been developed involving frontline colleagues following feedback from Nursing and Midwifery Time Out Days. Our staff identified that they would like to have more accessible information about different career and development opportunities available in nursing and midwifery at the trust, that they could access from work or home. 

As we speak, the new site is advertising 27 different nursing and midwifery roles, with more than 300 jobs available. There are also details about our next recruitment event on 21 October when applicants can be interviewed and receive a job offer on the day if they are successful.

The website signposts prospective and existing NUH staff to information about preceptorship, rotation and training and development opportunities. There is also helpful advice for people considering a career in nursing and midwifery, including school and college leavers.

Nottingham (and the East Midlands) is a great place to live and has much to offer – I only moved to Nottingham 12 years ago, and now wouldn’t choose to live anywhere else! I’m particularly pleased that so many of the ‘reasons to live in Nottingham’ feature on the new website to give people who don’t know our wonderful city an insight into life here.

Whether you’re a student nurse looking for the best way to start your career or a current member of TeamNUH interested in developing new skills and progressing your career in Nottingham, you will find much helpful  information on our new careers microsite. We would welcome any feedback on the site, including how we can make it better. Please send any comments to

Monday, 26 September 2016

Developing the treatments of tomorrow

The Department of Health recently announced that medical researchers in Nottingham were to receive £23.6m to expand the pioneering work already taking place into new treatments and diagnostics for a wide range of health problems. This funding represents a 75% increase in funding from 2012 – a good news story for Nottingham and remarkable achievement for NUH.

We are proud to say that NUH is already home to two Biomedical Research Units (BRUs) carrying out vital and life-changing research into hearing and digestive diseases.

Next year (April) these BRUs will be replaced with Biomedical Research Centres (BRCs) and working with The University of Nottingham we will be leading the UK in five key areas of health research:

  • Deafness and hearing loss
  • Gastrointestinal and liver disease
  • Respiratory medicine
  • Musculoskeletal disease
  • Mental health technology
At the core of the BRC will be Nottingham’s world-leading expertise in magnetic resonance imaging (MRI). It means the latest medical imaging research and technology pioneered here can be translated into real benefits for patients in all five of the BRC’s research areas.

So what does all this mean for our patients? It means new medicines and tests, improved treatments and better ways of providing healthcare here in Nottingham and throughout the country.

Doctors and nurses use research studies to compare current treatments with potentially better ones in order to prevent illnesses and improve quality of life as well as our understanding of medical conditions.

Without health research none of this would be possible.

Our vision is to offer research opportunities to every patient that comes to our hospitals. The BRC will be a catalyst to realise this vision.

Nottingham has a long-established history with health research - the anti-inflammatory drug Ibuprofen and the MRI scanner were both developed in the city. The new BRC will continue this rich history of innovation and development providing the stepping stones for the treatments of tomorrow.