Dear colleagues,

CUH Reflects
Here at work, I’m very grateful for the thoughts of those of you who have taken part in CUH Reflects. Over 3700 colleagues have completed the Covid-focussed staff survey and we had hundreds of responses to the questions we issued through the staff portal. It is important that we identify the really key lessons to take with us into the future. Emerging themes focus on: working across different services and divisions; remote working and flexibility; empowered clinical leadership; communications and clarity of purpose; staff health and wellbeing and small things that make a big difference. I look forward to starting a conversation with you all about how we emerge from this pandemic a stronger, better team.

Status of the hospital
We are currently treating 29 patients diagnosed with Covid-19 and five of these are in intensive care. The number being admitted has fallen to one per day generally, with some days seeing no new admissions. We have re-opened urgent elective surgery with seven theatres open at Addenbrooke’s and three in the independent sector.

Demand in our emergency department is back up to 75% of the pre-Covid-19 levels from a low of just half of expected activity, however the patients we are seeing are more acutely unwell than our previous caseload. Emergency surgery demand is back to near normal levels and these increases mean we need to continue to innovate and find new solutions to saving patients’ lives and keeping our staff safe; the two fundamentals of our strategy.

There are five areas I would like to highlight:

The new hospital bed plan
Last week we shared the new bed plan with all CUH staff. This plan has been designed so that we can provide safe high quality care during any future surges of Covid-19 while restarting and sustaining as much elective activity as we can and returning to pre-Covid levels of emergency activity. Demand and the pattern of Covid-19 transmission remains very uncertain and changeable with fluctuations and future peaks likely.

Since we haven’t run a hospital during a pandemic before we are learning all the time and some teams are working in different parts of the hospital or caring for patients with different needs than they are used to. In this context I’m so grateful for the energy and flexibility everyone is showing as we embrace new ways of working. We will be supporting clinical teams through a phased implementation phase between now and 1 July.

We won’t always get things right and we are prepared to listen and respond to staff working at the frontline. The key to success is that we all stay flexible and adopt a mindset that things in the future may change again and again. This is the new reality and it brings opportunities as well as challenges. In managing this change we need to stay very close to our values of being together, safe, kind and excellent as we have done so far.

Staying apart – social distancing at work
Our colleagues and friends in procurement, occupational health, workforce, IT and many other departments have worked tirelessly for the last twelve weeks. Their purpose has been to keep us all safe by supplying PPE, providing testing, enabling remote working and assessing risks. This effort is undermined when we don’t follow best practice ourselves in staying apart at work.

I know this is difficult and in some situations social distancing might not be possible in the workplace as it may in our home lives. But when you are not wearing PPE and are with colleagues in staff rooms, during handovers, in the concourse and outside the hospital, it is important that you need to stay two metres apart at all times. This may mean for example, taking breaks at different times, or in different areas. We’re receiving an increasing volume of complaints from our own staff and patients about groups of staff congregating closely when this is not necessary. We will continue to provide further information, signage, guidance and help to support all of you in achieving the professional distancing we all need to see for our safety. Thank you in advance for your help with this.

There has been a cluster of cases of Covid-19 identified among staff where it is possible that transmission may have taken place during social contact. Thanks to our excellent testing facilities here, we are able to rapidly screen asymptomatic staff who are working alongside colleagues in this cluster and I have been hugely impressed by the way we are now responding to new cases. This may not be linked to the distancing of staff on our site, but it is a reminder that this virus has not gone away and the risks are still high for all of us.

Developing taskforces
To assemble the resources we need to manage the coming year at CUH, we are redefining our taskforces. These bring together relevant experts to concentrate on a single mission. We now have a taskforce to create a Covid-secure environment for us all to work in and are developing another to look at how to achieve safe staffing across every service by working as a whole hospital. Other taskforces such as the oxygen and ventilation group are being stood down now they have achieved their goals.

PHE risks and outcomes report
The DHSC-commissioned inquiry by Public Health England into disparities in the risks and outcomes of Covid-19 was published this week. This has identified major inequalities, showing that the risk of dying or being seriously unwell as a result of Covid-19 is higher among black, Asian and minority ethnic people.

This data is very worrying. We have a multi-national staff family in which everybody is equal and we treat patients from all backgrounds without discrimination. There are now some important questions to answer to explain why the difference in mortality rates is so significant and I was pleased to see that NHS England and the NHS Confederation have formed the NHS Race and Health Observatory that will tackle inequalities in health outcomes across the whole spectrum of health.

Black Lives Matter
The death of George Floyd in the US was a horrible incident that impacts all of us. The aftermath across the US and around the world show us that there is growing anger at the injustice of racism.

We are a multi-racial workforce with backgrounds that embrace more than 100 nationalities and many black people work for CUH, sharing in our mission to work together and save lives.

The CUH family stands against racism and structural discrimination in all its forms. Black Lives Matter is as much about the systems that support and propagate structural discrimination as it is about specific acts of racism. To speak directly to our black staff and our whole BAME network and colleagues; please know that you matter, you are valued and you are part of the CUH family. We have much more to do to tackle the underlying causes of structural inequality and the lack of diversity at the most senior levels of this organisation.

Finally…
I would like to welcome Claire Stoneham to our executive team. Claire joins us from the programme director role at the Cambridgeshire and Peterborough STP and will lead our strategy and major projects directorate. She is highly experienced in national as well as regional roles and I know you will all join me in supporting her in this role.

We are now moving steadily, but with focus, towards the next phase of managing the Covid-19 pandemic. It has changed our lives dramatically but we are still here, achieving seemingly impossible goals. We share a determination that our much-loved NHS hospitals in Cambridge will emerge from this crisis much stronger. We have everything we need to make this the reality.

With best wishes
Roland