Connec t Issue 4 • May 2015
A young guest paints at the C&W Open Day— full story inside
Date set for integration P
lans for the integration of Chelsea and Westminster Hospital NHS Foundation Trust and West Middlesex University Hospital NHS Trust continue to make good progress, with the date for the launch of the unified organisation now set for 1 September. Chelsea and Westminster Hospital Chief Executive Libby McManus said: “The energy, enthusiasm and commitment of staff at both trusts continues to grow and this extension to the ‘go-live’ date gives us a bit more time to cement our joint approach and ensure we are well-placed to provide the best services possible to a potential population of nearly a million people.”
Staff at both trusts are getting together, both formally and informally, to talk
through opportunities to share best practice and improve services.
and Secretary of State for Health (see Timescales inside).
West Middlesex University Hospital Chief Executive Jacqueline Totterdell said: “The way we provide health services is rapidly evolving, with rising demand, the changing needs of our patients and a growing need to work more innovatively and efficiently.
Libby added: “It is great to see the work underway already and we will continue this in order to achieve our joint ambition to create an organisation of 5,000 staff, with a turnover of more than £500m and the potential to become a world leader in research and patient care.
“In this context, it is imperative that we take the time to get the regulatory process right so that we’re in the best shape we can be on Day 1 of the new organisation.”
“The momentum we are seeing from staff who recognise the potential to improve the way we provide care is driving this process and it is vital that we do everything we can to manage it smoothly.
The integration of the two trusts is also due to be ratified by the C&W Board of Directors and Council of Governors, with final approval from the regulators
“These extra few weeks means we can be sure we have everything in place to ensure a smooth transition to a new way of working in September.”
familiar spaces and to inspire less formal methods of communication with people closely involved in the work of an organisation. I cannot think of a better metaphor for the activities we are all doing as we approach integration!
Welcome
from Chief Executive Jacqueline Totterdell
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ecently I’ve been thinking a lot about the concept of ‘open house’ events. I don’t know if it’s due to the recent success of the Chelsea and Westminster Open Day, or whether it’s because I have spent so much time visiting and meeting staff, but it definitely feels as if both trusts are now throwing open our doors and actively embracing the opportunity to get to know one another better.
As you know, one of the purposes of the ‘open house’ approach is to help people explore areas that are not always visible to them, to find out interesting details about
Although the date for launching the new combined trust may have moved slightly, we really musn’t slow down the pace, particularly in terms of new ways of working and sharing information to help build better services. A key component of making this project a success is for us to grasp the many opportunities the integration presents and to maximise these for the benefit of patients and staff. I think that ‘open house’ also has another, perhaps less obvious function, but one which is equally important—it’s a space where nothing is hidden, where everything is on display, and where people are encouraged to ask questions about the things that they can see right in front of them or about anything that appears to be missing or out of place. This brings to mind the recent series of joint staff briefings that both chief executives gave at both WMUH and C&W. As Libby mentions in her closing comments, we were both very impressed by the broad range of questions we were asked at each session—not just because they were thoughtful and straightforward, but because they required open and honest conversations about the direction in which
we are headed and the topics that people care about the most. We were very grateful for everybody’s input and if you weren’t able to make it along this time, please do try to come along to a future staff session— we really want to hear from you! We were also delighted with how many people wanted to know how to get involved in the overall process. There are lots of ways you can help to champion the integration—if you would like to put your name forward to help spread the word, take part in discussions about how to shape elements of the new organisation or just want to know more then please get in touch with me either by emailing WestMid@chelwest.nhs.uk or by speaking to a member of your local communications team.
Diary dates 20 May
Clinical Summit—further information about the outcomes from the Clinical Summit will be in the next issue of Connect
29 May
TUPE consultation ends for WMUH staff
Look on your intranet for other upcoming dates for events such as branding workshops
Your view Nathan Askew
Divisional Nurse, C&W
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recently joined the trust, with a remit to work across both organisations and with both teams. It is really exciting to join two trusts going into such a massive process of change. One of the most exciting elements is the potential to bring a wide range of benefits for patients and staff. For staff, joining forces would mean more opportunities for career development, better education and training and the chance to develop their skills. For patients, there is the potential for access to a wider range of services, shorter waiting times and more care closer to where they live. Research and development, more access to clinical trials and innovation in techniques and technology all means that local people could receive consistently world-class care. Overall, there are great opportunities to bring out the best of both organisations.
Tracy Armstrong
Modern Matron, WMUH
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oon after the announcement of the merger, I met with Noel Palmer—my counterpart at C&W—to talk about the different ways of working within each of our hospitals. This led to a visit by band 7 colleagues from C&W to our department at WMUH.
We gave the visiting team a tour of our department followed by a social coffee and biscuits session to discuss how best to work together to streamline care for patients who use both services. We also talked about issues which impinge on care delivery and looked at different models of practice that can be shared between our teams. Not only was it good to meet new colleagues, but we agreed there were ample opportunities to maximise resources for both teams. As a result we will be holding regular sessions to help things run smoothly up to and beyond the integration. We are looking forward to getting to know one another better and to working more closely together to deliver a first class paediatric service for patients.
Rob Hodgkiss joins WMUH What is your role? As Director of Operations it is my job to ensure the smooth operational running of West Middlesex and to ensure that performance remains as high as possible. Although I only took on this role very recently, it’s my aim to make sure we are in the best possible shape going into the integration. I will also be looking at what is good across both hospital sites and how we can share this knowledge quickly and
effectively for the benefit of patients and staff. For example by exploring ways of sharing staff across sites to help reduce pressure and waiting times—not only will it mean better services, but will also support us in working together—which is what we will all be doing in the future.
How will your work impact on the first 100 days after integration? By helping everyone to understand how both hospitals operate it should ensure that we hit the ground running from the start. To do this I am working closely with Karl Munslow-Ong, Chief Operating Officer at Chelsea and Westminster, to identify best practice and maximise potential opportunities. Although it’s early days and I have yet to get around to meet everyone on the patch, it’s great to see how many people are making a huge effort to meet with their counterparts across sites and it means there will be familiar faces around the combined trust after we join together. Having worked at Chelsea and Westminster and having newly arrived at West Middlesex, it’s clear that both sites have their own feel and vibe, but our issues and our strengths are very similar.
What excites you about the integration? Many things ! For me it ’s already been very enlightening, and quite a privilege actually, to see the genuine benefits it will bring for patients. On one of my recent walkabouts I was talking to a cardiac patient and having heard his story it was evident that his experience of accessing services will be greatly improved once both trusts have merged. For example, the development of a new cath lab and cardio facility at West Middlesex will help us reduce our reliance on other NHS providers so that we can do everything in-house. Things like this really bring the benefits off the page and into real life.
What does the future hold? We have a chance to really put the new trust firmly on the map. We’re creating something of considerable size and repute, with so much potential to deliver bet ter outcomes, high quality performance and a wider, more flexible, range of services for the local community. All of the ingredients are there for the new organisation to go from strength to strength—I am sure it will and I look forward to being part of it.
Joint C&W and WMUH CEO briefings C
hief executives at C&W and WMUH— Libby McManus and Jacqueline Totterdell—have begun a series of briefings, open to all staff. Around 150 staff have attended the sessions so far to hear more about plans and to ask questions about how the changes will affect them, their colleagues and patients. Those who attended the briefings heard that there will be little change for most staff from Day 1, with the vast majority of people doing the same job from the same location. More information was also given on the timeline for new structures, work to ensure the longterm clinical and financial sustainability, the potential to increase the number of referrals at both hospitals and opportunities to revitalise and develop services. Both chief executives also reassured staff at the briefings that both trusts
would continue to provide all the services associated with modern, acute hospitals including full emergency and maternity services. As Libby explained: “Everyone involved in this process is determined to build on the strengths and proud history of each trust, to become more than the sum of our parts and deliver the best healthcare we can for local people. “While big corporate mergers are often about savings, this integration is firmly focused on developing services for staff and patients.” Jacqueline added: “While the case for change is built on clinical and financial viability, having established these strong foundations we can then focus on benefits for staff and patients alike. “There are a whole host of opportunities and initiatives that the integration could
provide, including increasing the number of clinical trials, providing more security for smaller services, and creating more opportunities for career development to name just a few.” The Q&A section in this edition of Connect comes directly from questions raised at the first four CEO-led briefings. Further Q&As are available on each trust’s intranet.
CEO briefing dates C&W (Hospital restaurant, LGF) • 2 July, 12 noon–1pm • 17 July, 8:30–9:30am • 27 August, 12 noon–1pm WMUH (Conference room) • • • •
29 May, 8:30–9:30am 19 June, 8:30–9:30am 10 July, 8:30–9:30am 14 August, 8:30–9:30am
C&W Open Day celebrations
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ore than 1,500 people attended this year’s open day at Chelsea and Westminster Hospital, to see the wide range of interesting and fun stands and enjoy exclusive behind-the-scenes tours of the hospital. Healthcare professionals were on hand to carry out health MOTs, including giving visitors a quick check-up, advice on how to lead a healthy lifestyle and stop smoking, and tips on eating healthily.
The day of celebration kicked off with a steel band and there was live music throughout the event. Jane Bell, whose three children have all received long-term care at C&W, officially opened the event. Martin Lewis is a Public Governor at C&W and helped run a stand charting the history of the hospital.
He said: “It was a fantastic day and it was great to see so many people come together to celebrate the hospital, its unique history and essential role as a central part of the community. “There was a real interest in the history of both C&W and WMUH, which is really important as each trust has a very strong identity and history. This is crucial as we embark on the next stage of our journey to consider how the two hospitals can join forces to share best practice and to improve services for a catchment population of around a million people. “It was great to see staff from West Middlesex here at Chelsea and Westminster to run a stand with information about their trust, mirroring the C&W exhibition stand at the WMUH open day last year.”
Governors were in the Information Zone, talking about how they represent patients, staff and the local community—they signed up more than 70 new members on the day. Visitors enjoyed exercise classes with Age UK and visited stands covering services such as maternity, pharmacy, learning disabilities and end of life care, and Michelin Star chef Mark Sargeant oversaw a Saturday Kitchen style omelette challenge. C&W hospital charities also had exhibition stands with information on fundraising and the cutting-edge equipment being bought for the hospital as a result. There were also tours of Chelsea Children’s Hospital, with the Teddy Bear Hospital proving especially popular among younger guests and their favourite toys.
Update on TUPE
Our brand and identity
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Every member of staff was sent a consultation document that explained the TUPE transfer process planned for 1 July 2015.
As an NHS provider we belong to a national brand, but in terms of building on our local identity at each site—which affects how people think and feel about us—we need your help!
n 2 March 2015, a staff consultation was launched at WMUH regarding the proposed acquisition of the trust by Chelsea and Westminster NHS Foundation Trust.
s we move towards the integration, one of the key things we need to make clear is who we are and what we stand for.
Further briefing sessions have been organised during May, so if you have any outstanding queries or concerns please attend one the briefing sessions or email Tupe@wmuh.nhs.uk.
We will shortly hold a series of workshops with staff and stakeholders to gather feedback on what the enlarged organisation will stand for. In order to help shape the culture and philosophy of the organisation, and maintain its reputation, these sessions will assess people’s goals and ambitions, as well as how they would like to see their daily work reflected in the image of the overall trust.
The outcome of the three month consultation process will be circulated in June 2015.
The brand messaging, which will be our focus during these sessions, will capture all the things we want to say about what
Although the transfer date has been extended the consultation will end as planned on 29 May 2015.
we currently do and what our aspirations are as one organisation. Please keep an eye out for workshop dates on each trust’s intranet and there will also be an online branding survey where you can give your view. The C&W Board of Directors has already agreed that both the main hospital sites will keep their local branding and history. The Board has also agreed that the Day 1 name of the post-acquisition legal entity will remain Chelsea and Westminster Hospital NHS Foundation Trust, pending further work around branding which will continue post-transaction. This branding work will, in due course, consider the need for a name change to reflect the wider catchment area served by the enlarged trust. We encourage all staff to engage with this branding exercise—to do so, please attend one of the branding sessions or complete the online branding survey.
A new Learning zone world for A policies principle benefit of the integration will be the opportunity to develop new and innovative ways to improve patient care and experience—something that staff involved in the HEADS-UP programme at WMUH are already very familiar with.
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number of staff across both trusts are working to identify the key policies required for Day 1 of the new organisation, so that as many policies as possible are the same across the enlarged organisation from the start.
HR staff from both trusts are working with staffside colleagues to harmonise policies, while clinical policies such as safeguarding are being worked on by the clinicians working in those services. Unified policies will be available on the new, joint intranet which is currently in development. Previous policies will be archived internally in line with NHS requirements. If you would like to get involved, please get in touch with us by sending an email to WestMid@chelwest.nhs.uk.
HEADS-UP was developed to help clinical and non-clinical staff work together to improve the quality and safety of patient care. Each day teams receive a briefing that they use to discuss challenges from the previous day, such as equipment or communication issues. They decide if they can do anything then and there to address persistent problems—if not, they record and escalate the issue upwards. HEADS-UP helps to get a better idea of what staff see every day—the things that frustrate frontline teams and put patients at risk. It’s a proactive way of thinking about safety in wards which helps to identify problems before any patient comes to harm.
So far the programme has generated £30,000 of internal investment in services and vital equipment.
WMUH has also worked with external providers like ISS to improve patient flow at no extra cost—now twice as many inpatients receive their X-rays each day thanks to changes in portering. In their recent inspection report, CQC described HEADS-UP as an innovative and outstanding practice “good at keeping its medical patients safe”.
The programme is also held in high regard by frontline teams, as shown in a recent survey of junior doctors and nurses, where the overwhelming majority reported feeling significantly more confident that their wards provide safe care for patients and that HEADS-UP helps them to work better as a team. As project lead, Dr Sam Pannick said: “We’re excited to see how HEADS-UP might work in other areas of the hospital and having the CQC recognise HEADS-UP as outstanding is a massive boost for this new way of improving care.”
My reflections WMUH Chair Nick Gash reflects on the journey to integration
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aving been involved with WMUH since 2005, it won’t come as any surprise that I have seen a lot of change in that time.
When I first joined the trust I had a firm idea of what my role entailed: to provide an impartial strategic overview and constructively challenge the executive team on the day to day running of the hospital. However over time our approach to interrogating and understanding the realities of what was happening across the site moved to a more creative, collaborative stance. Although we still continued to receive information about operational performance and our financial position via dashboard reports, and used this in comparison with national targets and neighbouring trusts, there was a shift towards not just new strategies and working practices, but fundamentally different ways of thinking. As with any NHS organisation or trust board, patient care and performance were always our top priority, but external pressures required us to consider quality in ways we hadn’t thought of before.
Old West Middlesex Hospital
It’s not easy to maintain focus on daily frontline pressures, while thinking about the resources and qualities we might need today to create the conditions for high performance in the future. However, we knew we needed to find innovative ways to really get a grip on the challenges facing us, including our financial situation. It was through reflective and honest debate that we came to recognise our need to find a partner organisation in order to become a foundation trust and to ensure a sustainable future. The key for me and my colleagues was to retain as much control of our own destiny as we could and to own the process of finding a partner. My absolute priority was and is to maintain the excellent services that WMUH provides for our community and I see partnership primarily as a means to protect and enhance services and patient care. That is why we chose to work with Chelsea and Westminster as not only do they have the same ambitions for delivering the best possible patient care but their core values—safe, kind, excellent and respectful—very much reflect our own ethos.
This is why I view the integration as the next step along in a journey that we began some time ago. It really feels that it is a merger of equals—both organisations have a culture which promotes trust, openness and engagement to enable continuous learning and improvement. So I am looking forward to the opportunities we have ahead of us to teach, learn and grow together.
Specialties share ideas and spot opportunities M
ore than 100 specialties across both trusts have filled out a template which describes the details of their service—highlighting the strengths, challenges, performance and other key information to help establish how best to integrate and improve services.
As a result, specialty level meetings are now being set up, to act as a forum for managers and clinicians (nursing and medical) from the two hospitals to examine integration opportunities. The aim is to run over 50 of these sessions, one for each of the specialties across the two organisations. Divisional Integration Lead, Ben Falk, is leading the process across the two medical divisions. He said: “The meetings have provided a great opportunity for the clinical teams from both sites to come together. Not only has it given people a chance to meet their counterparts, but it has also helped to start conversations around integration opportunities. “The focus of discussions has definitely been on the positives in each of the teams and how best practice can be shared. Ideas and suggestions are then
fed back to the divisional leadership teams.” Assistant Chief Nurse at C&W, Dr Barry Quinn, said: “These sessions are a great example of how the integration is beginning to work in practice and are really showing the benefits of bringing teams together face-to-face.” The first of these sessions have already taken place in cardiology, diabetes/ endocrine, emergency department, respiratory and oncology/palliative care. Following these meetings, some areas where the trusts can learn from one another have already been identified, including: • In A&E, WMUH has a strong ‘frequent attender’ pathway for those who visit the department regularly—the C&W A&E department are keen to adopt a similar model • The diabetic ketoacidosis and sepsis pathway in A&E at C&W is seen as a high-quality service, which is being shared with WMUH to see what elements it could implement
Governance and legal transaction workstream update T
he governance and legal transaction workstream—responsible for ensuring both trusts continue to fulfil their statutory and regulatory duties during integration—is drafting a new constitution for the enlarged organisation.
This will provide an overarching governance framework, within which the unified trust will operate. C&W Board Secretary Thomas Lafferty explains: “The constitution will seek to ensure that the new trust establishes a foundation trust membership base within local WMUH constituency areas—mainly the London Boroughs of Hounslow and Richmond.
“This ‘new’ membership base will elect governors to be part of the reformed CWFT Council of Governors—the role of which is to hold the trust board to account and to represent the views and interests of patients, staff and local people.” Both organisations are also using the merger as an opportunity to enhance and improve other governance systems and processes, including the composition of the trust board, corporate meeting structure and key corporate policies. More information will be shared on this work as it develops.
ESR for everyone S
taff will in future have access to a new self-service Electronic Staff Record (ESR) system.
Once fully implemented the new software will allow: • Staff to review and update their own personal information, view payslips, pension statements and access e-learning • Managers to view information about their teams in the HR system (which they currently receive through HR reports) including workforce compliance issues and HR metrics • Managers will also be able to control the management hierarchy within their units and change employee’s work details (replacing the current forms that managers email to HR) C&W is the pilot site for a new ‘look and feel’ for ESR, to test new features and functionality on mobile devices. Look out for your chance to take part in the pilot.
Timescales of the integration July • C&W Council of Governors consider approval of the acquisition • Joint statutory application to Monitor, including letter of support from Secretary of State for Health • Transaction risk rating from Monitor
August • A p p r o v a l b y t h e N H S Tr u s t Development Authority and Secretary of State for Health
September • New integrated organisation ‘goes live’
Your questions answered T
hese are the key questions that arose at the recent joint chief executive briefing sessions for all staff. A full list of questions and answers is available on each trust’s intranet.
Are there plans to improve technology? There is a large-scale programme to improve IM&T, with plans for: a direct link to join both networks, a shared intranet portal across both sites, collective telephone directory, combined executive and statutory reporting, new external email addresses (although current email addresses will remain active) and remote access for staff who need to work on desktops at the other site. There will also be desktop video conferencing facilities to support ‘virtual’ meetings between sites. After September, there will be a host of other changes geared towards helping the two organisations work together effectively, including the new ESR system (see previous page), combined reporting tools and the integration of some clinical applications.
Are there opportunities to familiarise ourselves with the C&W or WMUH site? Yes, we are encouraging staff to meet with their counterparts and visit each other’s sites. There is an open invitation to do this for all teams. If you don’t have an opposite number, please let us know at westmid@chelwest.nhs.uk and we can set something up for you. We also encourage informal meetings with your counterparts—these provide an opportunity to get to know each other, to discuss what you do well, talk through what could be improved, and so on.
What about specialities with links to other organisations? There will be little change from Day 1 and links to other partnership services would be unlikely to change in the immediate future. Any changes that were deemed necessary would, of course, be clinically led and decided with patients’ best interests at heart. We have already had conversations with organisations where we have shared contracts or partnership working, to explain that it will be ‘business as usual’ at the point of integration and that the merger will not impact on usual referral practices or patient pathways.
Will staff be expected to travel? A shuttle bus will soon be available for staff, travelling between the two sites several times each working day. Further details will be publicised soon at each trust. Managers are expected to visit sites as relevant as part of a regular, scheduled programme to develop a comprehensive system of management that engenders strong teamworking throughout the unified organisation.
What about backfill? Frontline leadership is a critical driver of the integration, but we know that people already have very busy day jobs. Where we need input from an individual, which requires them to the take significant time away from their usual role in order to do this, we will seek to provide backfill for that person. We are delighted that so many people are interested in getting involved in the integration and part of acknowledging that commitment is for us to ensure that colleagues receive the support they need to enable them to play an integral part in the process.
Let us know what you think T
here’s still time to let us know what you think of Connect by completing a short online survey by visiting: www. surveymonkey.com/r/connect-newsletter.
Staff have until the end of May to have their say and share their views, and
everyone who responds will be entered into a prize draw with the chance to win a £25 gift voucher. We will take all of the feedback provided and use this to improve your monthly newsletter.
Closing comments by Libby McManus
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acqueline and I are enjoying meeting many of you at our Chief Executive briefings and you’ve asked for more, so that’s what we are doing. The dates are all here in this issue of Connect so make sure you use these opportunities to ask the questions that matter to you!
It has been a couple of weeks filled with celebration at C&W. We had our annual Star Awards ceremony, with 12 awards given out to individuals and teams, and this year we focused on celebrating those who have delivered values-driven care and experience. I was honoured to present a Chief Executive Award and know that my director colleagues felt the same sense of pride that I did in being able to recognise their peers. I’m pleased that some WMUH colleagues were able to attend, too, and look forward to working together to develop an awards programme to celebrate people from across all our sites in the very near future. We’re also recovering from an action packed Open Day, which this year celebrated our ‘Safe’ value. As I approached the hospital that morning, I was looking forward to seeing the efforts that our different services made on the day to showcase what’s best about C&W—and they didn’t disappoint. I know that WMUH have their Open Day on 12 September and can’t wait to meet more colleagues in person and learn about what they do for the local communities they serve. Innovation is such a huge motivator and I’m delighted that the next joint Clinical Summit has this as its theme. We can work together to be the ‘best in class’ for many of our clinical services. In the meantime, keep on meeting colleagues, visiting each other’s sites, and learning more about each other.