East Sussex Hospitals

Source: Exec Digital UK

Date :28/09/2007 10:26:32

Trust status from 2002 and exciting developments ahead

Director of Operations Jim Davey, tells us about East Sussex Hospitals NHS Trust and how it is working to extend its provisions for the future

Written by Alison Withers & Produced by Paul Radbourne

East Sussex Hospitals NHS Trust (ESHT) was formed in April 2002 in the second wave of trust status. It combined two existing trusts, Eastbourne Hospitals NHS Trust and Hastings & Rother NHS Trust. It Is one of the largest employers in East Sussex, which has a traditionally elderly population.

Jim Davey, 42, is Director of Operations (elective) trained as a nurse and previously managed in Surgery and Anaesthetics for five years. He has been in his current post for 17 months.

New initiatives

The Trust Board has 11 members, including chief executive Kim Hodgson, six non-executive directors and is supported by five other directors each with responsibility for a sector of the activities of a large organization.

In 2006-2007 the Trust treated 94,548 inpatients and day cases (almost 1 in 4 of the population) 97,058 patients in the two A & E departments, 322,941 out-patients and maternity staff delivered 4,018 babies.

“We strive to have very good general hospitals with a good response to patient needs,” Jim says. Bexhill, has the highest elderly population in Western Europe and Eastbourne is a famously popular retirement area. This demographic profile means the Trust has developed considerable expertise in care of the elderly, and is currently planning a dedicated Stroke centre. “Stroke patients have a specific set of physical and emotional circumstances and if you don’t start rehabilitation as soon as possible there’s a significant impact on recovery and quality of life in the future. Managing elderly care is not without its difficulties and we see it as a patient need.”

ESHT has one of the lowest figures for pre operative bed days in comparison with the national figures and a high performance in cancer care, meeting three targets – for referral, diagnosis and treatment. The hospital is one of the top performers in the country.

The Trust has introduced several initiatives which it sees as key to its high service standards. One of these is its excellent communication with the PCT (Primary Care Trust) and local GPs to ensure continuity of care for patients between hospital and home.

Jim Davey highlights two hospital-based initiatives: “We have a matron on site 24 hours a day. Their responsibility is to manage the site and visit every ward in the hospitals. They do spot checks on cleanliness, staffing levels, patient dignity, food and promote understanding of the basic level of requirements for patients. The wards have their own teams so it’s to everyone’s advantage to do the best they can.”

The Trust has also resisted contracting out cleaning services and all its cleaners are directly employed. While Jim accepts there can be financial benefits of contracting out, he argues that there are other aspects of patient care that are more important, for example in preventing MRSA. ESHT’s cleaners are available all day, which is not always the case with contracting out and the hospital has a rapid response cleaning team which can pinpoint any area the matron deems necessary.

The Trust has more than 5,000 full and part time staff, around 1000 volunteers, and support from the Friends of the hospitals and other local charities. It is committed to promoting equality of opportunity for service users and for staff, and to ensuring that difference is valued and individuals treated with dignity and respect.

Job share schemes are available for all posts and the Trust has a facility for on-line advertising of vacancies and for applications through its website. It has a range of strategies aimed at promoting equality of opportunity for staff and of treatment for service users, a commitment to promoting diversity and dignity at work, a carers’ strategy and flexible working procedures. Fine tuning and improving these strategies is an on-going process. There is in-house training using the NVQ system and a link with Brighton University for all nursing training.

One current source of some contention is a proposal to move maternity services to one site, rather than providing them at both hospitals. Health policy nationally is to provide services at larger centres, and changes to medical training and the working time directive have necessitated these changes. The proposal is currently going through public consultation.

The future is NHS Foundation Status

Because of its high performance levels in meeting national targets and managing its budget successfully, (equivalent of the old three star trust status), the Trust has recently been invited to apply for Foundation status and is currently in public consultations.

Jim Davey believes there are important advantages to Foundation status, it would have more local control over its services and could borrow money to fund its longer-term development. So it could tailor services to its local population rather than being subject to some of the national changes the Government might introduce, which might not be relevant locally.

He says: “Local people know what they want. Our aim is to have more than 4,500 public members from April 1 next year.” Currently over 1000 local people have signed up for membership.

The process has involved the Board going out and meeting the community everywhere from shopping centres to schools. One of the key worries, he has found, has been that Foundation status equates to privatisation, and part of his job is to reassure people that this isn’t the case. He admits attendance at public meetings has been “sporadic” but says: “those that want to get involved do. The average local population of individuals just want a good, high standard service when they need it.” As part of the consultation there have been initiatives including coverage in local media, mail shots to ex patients and to staff and large information boards around the hospital sites.

A key target for the near future is to be able to provide all services within the Trust area, for example to set up a service to treat patients with macular degeneration (which can lead to blindness) locally. Another area ripe for development is laparoscopic and minimally invasive surgery, and the Trust already has a reputation for the excellence of its hip replacement service which sees patients admitted, treated and out of bed within 23 hours. It has just spent £500,000 on a minimally invasive operating theatre and has plans for a second one.

Ultimately this would mean that it could promote its services as a centre of excellence throughout the UK and in the longer term throughout Europe. It already generates some revenue from inbound “medical tourism” from Europe, he says, and that potentially could grow much larger.

Links

East Sussex Hospitals