This is my first blog as Chief Executive and many will know my preferred social media outlet is Twitter.  I have been prompted though to say a little more than the usual 140 characters as a result of a Twitter exchange.

What I had intended to convey – appreciation, support and personal engagement with our teams across Derriford (as I try to through Twitter) and how it had been read;  an impression that a hospital under so much Emergency Department pressure that any public messaging was a ‘sign of desperate times’. This exchange with the Editor of the Health Service Journal really got me thinking though about the importance of the whole story and what matters when you look in – and how different this can be when you are in it.

Undoubtedly Derriford is, like many other hospitals, under huge urgent and emergency care pressure. This has a big impact right across our hospital and on all of our teams.

Compared to the same period pre-pandemic, we are now seeing more ambulances handovers, and from 01 June to 06 July this year we have seen 10,976 patients through the front door – a record attendance for this time of year.

The CQC have issued a section 29a notice to improve safety and this sits alongside our absolute commitment to restore all planned operations, diagnostics, support the ongoing COVID demand and being in a part of the world which is the top of the staycation choice list. So yes, UHP is undoubtedly ‘under pressure’.

As Chief Executive though, I don’t see or experience desperation. I see fatigue, tiredness and a sense that days can feel like groundhog days, not enough beds and a frustration and at times real distress that we can’t offer better care within our capacity constrained hospitals.  I try to spend a lot of my time listening to colleagues to try and appreciate what it is like to work here from their perspective and lived experience, not just from my view of the Derriford world.  Experiences are personal and I am always keen to bridge that gap of what is intended and how it feels for colleagues, whatever their role.  This is really challenging when there is so much operational pressure. I recognise many colleagues have depleted emotional energy to always create the right ‘conversational space’ to get things done and support colleagues rather than just get things done. I hear this from colleagues I spend time with, through Freedom to Speak Up Guardians and from our Big Conversations. From my view of the hospital though, most of all, I see very dedicated NHS colleagues all pulling together.

I see teams who are working so hard not just to care for patients today but also to make changes across the hospital, as this video shows below. This is incredible given the pressures we are working under.

Our top three priorities are to address the pressures and impact of urgent and emergency care (ambulance handovers, timeliness of care within the department and the knock-on to planned operations and across the hospital with high levels of occupancy); the work with the wider system to get the model of care right and most of all to continue to develop the deep sense of team and appreciation across the whole organisation to get things done not just for today but for the longer term.

24/7, 365 days of the year , I experience my colleagues taking action to provide responsive and safe services for our patients, applying considerable experience and professionalism to be focused, and support a team of the most dedicated and exceptional colleagues – each and every one of them across the Trust – who want to make a difference.

Our People First approach is about improvement, marginal gains in the absence of a timely magic bullet. It is led by teams to address the issues where they know how to do better. Our monthly ‘People First Report out’ is an inspiring showcase of teams leading change, using improvement methodology to make a difference to patients, colleagues and our environment. Our five staff networks (BAME, Women’s, LGBTQ+, DAWN and Religion) are increasingly our true partners to mobilise change, to raise the uncomfortable lived experiences for those who are most marginalised across our teams and we have made a Board commitment to positive action to be the change we want to see.  Our clinically led Teams are involved daily in making the very best of the constrained capacity we have across our sites – working together to explore options, small tests of change and sharing the dilemmas and choices we inevitably end up making.  We’ve committed to our Big Conversations with colleagues about the things that matter to them: flexible working, health and wellbeing, what does it feel like to work in a great team and what would you value as a thank you for the pandemic efforts. Interestingly feedback was not about events or even badges but art work around the hospital that will be a lasting reminder of everything we went through and for our health and wellbeing support to be there as a constant with a range of services – less opt in and more as a part of a proactive way of supporting colleagues.

My June ‘#ChiefExecutiveShoutOut’ includes a very wet and soggy film footage of an overgrown garden space just at the front of the hospital and next to ‘Little Haven’ a garden of reflection and remembrance for those who have lost babies and children.

The new garden space has a working title the Garden of Life. Across the Trust, staff from nursing, patient council, communications and IMT have all joined together to transform this space, with the support of our tremendous city to be a sanctuary for those who have lost loved ones through the pandemic, staff who have cared throughout this time and anyone who needs to ‘just be’. Once the overgrowth has been cleared there will be a beautiful view of the front of the hospital.  I was so moved by the personal accounts of Becky, Jim, Chris and thank them as well as Sian and Megan who are leading this work, the filming has stayed with me. The Garden of Life, our ICU garden and  Little Haven all embody the team spirit of UHP, the spirit I am honoured to see every day: incredible commitment, working together to support the people we care about, #1BigTeam and to  be a place of positive action today and one of hope and looking to the future.

Thank you #1BigTeam, it is my honour to work with you, to know you and most of all I hope to support you.