Magic Morecambe Bay

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An unusual NHS Health Chat. Roy Lilley chatted cajoled and interviewed a whole set of the movers and shakers in “Magic Morecambe Bay University Hospitals”. Described in the invite as ” a Christmas Feel good story” – just to entice us to visit or watch on Periscope! And if you want to do that CLICK HERE. It’s well worth the look…

The background wasn’t mentioned too much – as in the history and problem areas – and to be absolutely fair, I had forgotten which “scandal” ( as all the tabloids call them) was which. The story was broken in 2010, and some commentators traced the gestation back to 1998. Lots about a new computer system called Lorenzo Data management system, introduction of which created problems. 14000 patients not followed up. The investigations and reports seemed to point the finger at a lack of governance and leadership in the Trust. Maternity and Emergency care were also singled out as major areas for improvement. I wasn’t there – that’s all I can glean from a quick search.

But I bet the 4 people who Roy interviewed knew in far more detail…

With that sort of spotlight, what do you do? Do you run away, ignore it, curl up and die or what? As has been said very often, it’s not how many times you get knocked down, it’s how many times you get up that counts. And boy, did they get up and fight.

My overview? I think they decided, as a team (and that is absolutely key) to not just fix things, but to be the best.  Especially in the areas that had been problems.

Turning around the pendulum when it still appears to be accelerating towards self destruct is no mean feat.  And to then become the good news Christmas Celebration focus for NHS Health Chat 2018 – well, who needs the CQC?  (I know Roy – it’s them again…). This might be the best surrogate measure of successful turnaround humanly possible?

It’s hard to imagine a team that were saddled with more luggage than this group had inherited.  But they really seemed to take the rebuilding prospect as an exciting challenge, not a bear trap. One big thing that stood out for me was that everyone complimented the team ( from patients to Roy Lilley!) on the Birthing Centre.  Not maternity unit, you notice.  The Birthing Centre.  Words are so important, aren’t they? Suddenly we are focused on Mum, Baby, Dad and family.  The maternity staff are there to help make the experience as wonderful as possible.  Described by many as being more like a Spa at a nice hotel, than being a hospital maternity unit.  And remember, this after it being singled out as a major area of under-performance, and patient safety problem unit.

What did they do? ” The community helped us to design it. Especially people who had lost kids.”  I am loathe to write “it’s not rocket science”. But it isn’t.  You know what though? Having the guts to hit it face on and do it and not assume you are the experts and having the humility and teamship and positivity to just do it that way – that’s beyond rocket science.  That takes vision and guts.

Have a review of the examples on periscope of the data management and records system.  The detail will mean a lot more to you who work day to day in the environment.  Here’s what I saw though.

Firstly, the vision.  “Sharing data is the right thing to do”.  And everyone knew that was “conceptual until it becomes real and live”. Yes, fine – fine to have the vision.  But talking action is not taking action.  This team knows that.  The next thing was that data sharing was part of The Integrated Care Community. GP records, ward level pharmacy, Care Homes, Social Services, Mental Health and even local government.

What helped this to actively happen? We are looking at the holy grail here – one version of truth.  A visible record shareable with trusted people.

  1. Long culture of engagement with the GPs – and guess what, you get buy in then.  Who knew?!

2. An overall strategy and a plan, to get to less paper and the single electronic patient record.

3. They had good people to bring on, ex Shipyard workers whose skills were very appropriately transferable.

4. A top team and hands on management who had a focus, every hour of every single day to bring all the parts together.

5. Embraced modernism – happy to go with the likes of MyGP – which helps in hands off triage of patients and many are sorted and reassured very early in the process. All this helps to keep the back end of secondary care free of patients who really don’t want or need to be there.

6. There was trust building in the Trust.

7. The data is there, real time so any problems are visible and fixable, not hidden and forgotten.

 

Fab.  A blended approach with no sacred cows and a bedrock of team belief that anything was possible and eminently fixable.

There were many wow moments with the data use.  And they do get lots of visitors to The Bay.  Not just because it is a splendid northern town.  People want to steal the best bits with positive pride and thanks.

There was also a day to day example of using technology to create efficiency, better patient care and happier staff.  Fixing 3 problems it’s one fix? Interested? Tablet PC ordering of meals! Solves 3 things

  1. Patient gets the right food, not what was ordered for the previous occupant of that bed.
  2. Saves nursing time at a stroke
  3. Saved £50 000 in wasted food – so Kitchen and Accountants love it too!

Remember, this all started with lurid headlines and accusations of low level performance.

Do we always need such a calamity to make us sit up and fix stuff? We shouldn’t do. But it certainly helps give a huge push.  It usually means we move from problem to middling.  Now Morecambe Bay University Hospitals and all the healthcare services in the area are beacons for others.

Now, could thisis powerful team help mould their solutions nationwide? Possibly. But each Regional need is different, probably.  Maybe that’s the best size to fit our solutions to?  Interesting thought from Roy Lilley.  Where did Regional health Authorities go? Can we send out a search party?

Team work success was perfectly personified in this celebration. Thanks to all.

 

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