Dear colleagues,

As children return to school and Covid transmission falls in our communities, the significant restrictions of living with this pandemic are slowly starting to ease.

In our hospitals we’ve seen the number of daily admissions fall more sharply than we expected after peaking during January. I’m noticing that while for many staff this is the cue to bounce straight back to normal, for some of our teams this is a period of time when fatigue and the mental and emotional processing of the last few weeks is a very significant factor in daily life at work and at home. Please do all look out for each other.

Status of our hospitals

Today we have just four patients in the hospital with Covid-19 and three of those are in an intensive care bed.

Since my last bulletin, we have been busily returning wards from red to green and sending staff who were re-deployed in this surge back to their home teams. Our huge thanks goes to those of you who changed roles and teams with little warning, and also to the staff who welcomed new people into their team and trained and supported them so effectively.

Re-building after the surge

I’m incredibly impressed by the huge amount of work that is being so rapidly delivered to carefully re-build services in a planned way and start dealing with the backlog of patients waiting for treatment at Addenbrooke’s and the Rosie.

We have to balance the need to manage emergency care pathways quickly and effectively with the need to ensure that patients receive their elective care within a safe timeframe. To do this we need some new capacity and at the end of May we plan to open 20 beds for patients who are ready and fit enough to leave hospital as part of our surge centre scheme. Another 40 beds will also be available in units opposite the Rosie Hospital at the end of May and we are currently resolving how we can use these for the maximum benefit of patients. Beyond these developments, another 60 beds are due to be open by the end of the calendar year for acute medical patients in a facility that is linked to the main hospital. These projects are working to very challenging build timelines and could be subject to small delays.

Another focus for re-building at CUH is our intensive work involving hundreds of colleagues in risk-assessing the care of many hundreds of individual patients who are now waiting longer than we would normally expect. I’m very grateful for the clinical expertise that we have here and the willingness of our colleagues in taking the time to help us with the delicate balance of prioritising patients. This is critical for safety and we will need to find the most effective way to build this into our systems and processes over the course of this year.

We’re also focussing relentlessly on patient flow, which really refers to efficiency across every aspect of delivering care to our patients. It means that we move from decision to action, without any pause between the two, wherever possible. Thanks to huge efforts across multiple teams we’ve just enjoyed two weeks of good patient flow and it has made a huge difference. Everyone feels it, whether you’re a patient relieved that the next step in your recovery is underway, or you’re a nurse on a ward or in an emergency department that feels calm and under control. We all have a good day when patient flow is not inhibited by creaky processes and delays. The importance of this is that a calm hospital will help staff to rest after this latest surge by working in an environment that supports them to do their job enjoyably.

Staff health, resilience and wellbeing

We know that many of you are full of energy and focussed on getting things moving again. However, for some staff the last few weeks have emptied the reserves of resilience and all of us may be feeling that to an extent, whether consciously or unconsciously. Please do make sure you read about everything there is on offer here to support you. You are our most valuable asset and the time you take to look after yourself, ultimately also cares for our patients. The resources are on the portal, but perhaps the best thing you can do is speak to just one other person. No-one will be surprised if you need to do this and they’ll take it as a compliment that you chose them to ask for help.

The most recent survey that you have all been helping us with is part of a series of initiatives that mark the second phase of our CUH Reflects programme. This is how we tune in to the stories of staff across the organisation and think more deeply about staff experience here and how we can improve it and support each other. The stories we’ve heard, whether from data generated by a survey or in-depth interviews where we can really see the world through someone else’s eyes, are all feeding in to the priorities we’re setting for the future.

National staff survey 2020

Thank you for the terrific response we had to the last annual staff survey undertaken in the early autumn of last year. The feedback shows us that fundamentally, staff engagement remains good at CUH with a noticeable improvement in our scores for staff health and wellbeing and flexible working. However, there are two areas we need to tackle. Firstly, we’ve seen that the experience of staff in minority groups including disabled staff and those from ethnic minorities is poorer than amongst the majority groups. Secondly, we’ve seen some less positive feedback to questions that relate to team working, team relationships, line management and the ability to influence change, which all indicate how it has felt to be in an organisation going through so much change. Among the positive scores, staff here still overwhelmingly recommend us as an employer and as a place to receive treatment and we should all be immensely proud of that. Clearly we need to think about how we support staff going forward and we need to be purposeful about designing the right package of support over the coming year.

New hospitals for the future

Some really inspiring progress has been made in our plans to build two new hospitals that will enable us to provide exceptional standards of care for our patients. Cambridge Children’s Hospital and Cambridge Cancer Research Hospital projects are reaching stages where staff and patients are being engaged in aspects of design and how the hospitals will work. Both projects are demonstrating how research and clinical services can be integrated alongside a stronger focus on holistic care that stretches across medical disciplines and beyond the hospital walls. By linking the life sciences industry, academia, hospital and community services together we can collectively deliver what patients really want – to avoid getting sick, and when they are sick, to receive care that is seamless and backed up by the best research. Cambridge is where we can demonstrate that this new way of doing things is the future of healthcare.

Finally…a day of reflection

In the last few weeks at CUH, we created a new hospital within Addenbrooke’s to deal with the third surge of Covid patients. We doubled the size of our intensive care units in a matter of days and converted 200 acute beds across multiple wards to Covid beds. We accepted patient transfers from hospitals across the region to help with their pressures and we’ve saved many lives as a result of these efforts.

With our partners across industry, academia and the health and social care system of Cambridgeshire and Peterborough, we’ve also been contributing to breakthroughs in our understanding of Covid-19 and its treatment. The strength we have in respiratory medicine, genomics and immunology, built up over decades, have enabled us to contribute fundamental understanding that will benefit all countries in tackling this pandemic.

Next Tuesday, 23 March, the country will be marking one year since the first national lockdown. This is an opportunity for CUH to come together and think about what the last 12 months have meant to us. There has been trauma, bereavement, loss and fear, as well as friendship, support, pride and monumental professionalism. On this day everyone can join in by helping us to build a heart made of your personalised pebbles, attending one of our special meetings or witnessing the lighting up of the Addenbrooke’s chimney.

I hope you will participate in whatever way feels right to you and details of opportunities to do this are available on the portal here.

Once again, my sincere appreciation for all that you have done, not just since my last bulletin, but over the course of the last year. It is impossible to put into words what this means, not just to me, but to the people and communities who have relied so heavily on us in such difficult times.

You have delivered more than anyone could have expected of you.

With best wishes,

Roland