Dear colleagues,

As we head into the winter I would like to set out the challenges we currently face. Particularly, how we can respond together as one hospital, and why we will thrive if we act as a united team. We’re dealing with mounting pressure on all fronts. After a recent doubling in Covid cases, the current situation is fragile and in leadership briefings this week I’ve shared quite honestly that I’m the most concerned I’ve ever been since I joined CUH in 2015.

The challenge

Rates of Covid transmission in the community are high enough to be causing an admission rate of at least four cases per day and significantly higher over the course of last week. Cambridgeshire and Peterborough has this week been designated as an Enhanced Response Area by the government due to high Covid infection rates. Our bed base is reduced, by both the 62 beds we have lost through the need to establish greater physical distancing and now the additional loss of beds due to closures that prevent the spread of infection among our patients and staff. At the same time, ED attendances are above pre-pandemic levels, outpatient referrals are high and the elective backlog is well described and in some areas growing. Dealing with this is tough at a time when we also need to protect patients and staff by limiting human contact and achieving social distancing.

The difference between our situation now and the impact of the early waves of this pandemic is that we are managing the needs of Covid patients while continuing to provide surgical, outpatients, diagnostic and emergency care at the same rate or even higher than before Covid-19 arrived.

We continue to provide vital life-saving specialist services to the region and to deliver transplantation, complex surgery and high-risk therapies such as bone marrow transplants. Our staff keep on giving their very best, working with inspirational levels of professionalism, but CUH people are also subject to seasonal illness, Covid infection and isolation measures and these are reducing our numbers in ways that can be hard to predict.

A ‘one hospital’ response

As we head into four months of colder weather, how do we manage our hospitals safely, bearing in mind not just the patients currently in our hospital, but those who are still waiting to be seen and treated? The only way we can tackle this successfully is to respond together as one hospital, united as a team. Each of us shares responsibility not just for the patient in front of us, but the patients in queues, both seen and unseen, who need access to the services we provide.

What I must ask you all to do is think as flexibly and broadly as you can about the whole capacity of the hospital and the people who need us. Our 1,000 beds, 37 theatres, outpatient clinics and 11,000 staff are a finite resource. To keep our community safe this winter, each of us has a responsibility to consider the needs not just of our own service, but the service next door, or the one on the other side of the hospital that might be unseen.

Providing care in the most efficient way, pulling forward the hour of discharge, being judicious in deciding who to admit and how to provide treatment efficiently has always been an important part of the job. But this winter, the line between success and failure is much narrower than before. We need everyone to be engaged in ensuring that we balance our risks as one team, united in a collective focus on the overall safety of the thousands of patients who need us for a multitude of different reasons. You will know what can be done in your own areas to help with this. But centrally we would ask for your help in discharging patients as early as possible in the morning rather than in the afternoon, in ensuring full compliance with PPE guidelines and in supporting staff to be vaccinated for flu and receiving their Covid booster jab.

How can we thrive?

It may seem incongruous or even naïve to talk about thriving at this time. However I truly believe that if we can unite behind our strategy of providing excellent care for Covid and non-Covid patients as we have done since March 2020, then we will have a strong chance of seeing the fruits of our labour in a grateful community, a calm and efficient hospital, a continued track record of superb clinical outcomes and a workforce whose wellbeing is nurtured and prioritised. In short, we will be able to go into 2022 ready to deliver our strategy of improving patient care, supporting our staff and building for the future.

Improving patient care

We have continued to provide outstanding care to patients with Covid. Our clinical outcomes for patients admitted to CUH are among the best nationally and we have made a major contribution to the development of new current treatments for this infection with our partners in industry and at the University of Cambridge.

Our services for non-Covid patients have been through an enormously turbulent time as we responded to the waves of the pandemic. However, almost across the board, our specialties have demonstrated their resilience by offering very significant volumes of care considering the reduced bed base, theatre availability and staffing numbers that Covid has caused. Huge innovation and determination has been at the heart of this response, for which I am immensely grateful.

Supporting our staff

We have recruited significant numbers of additional staff across many professions, especially in nursing. We have a strong pipeline for recruitment and are pushing to return to our very healthy pre-Covid vacancy rate of 4% compared with our current rate of 8%. For all of our staff we’re focused on welfare and experience and are investing in rest and relaxation areas, the availability of quality food options and rewarding and recognising efforts, for example by awarding the Covid star to our workforce along with a recognition payment of £100. There is more to do but we are working towards a really positive picture of staffing levels as we forecast the numbers for next year.

Building for the future

Our hospital needs investment and development to continue to thrive and our reputation for quality and excellence is what enables us to call for support and new resources.

We are being supported by NHS England and Improvement to open an additional 120 beds on the Addenbrooke’s site to help with the recovery from the Covid pandemic. While we opened 20 beds some months ago, we are now focused on progressing the 40-bed facility on the land opposite the Rosie Hospital where we plan to open an elective surgery unit. We are also pushing forward with an additional 56 beds in a two-storey block opposite the clinical research centre in which we can care for medical patients to decompress the hospital and enable refurbishments of the main site to take place. These developments will make a big difference when they open and will enable us to improve patient care and the staff experience.

Our plans to build two completely new hospitals – for children and for cancer patients – are landmark projects that herald the transformation of our environment that we describe as Addenbrooke’s 3. Working with our partners across the NHS, local government, industry and the University, we have built a strong and influential community of support for both of these buildings that will improve patient care immeasurably and demonstrate what state-of-the-art research hospitals allied to world-class research can deliver. These are genuinely exciting prospects that put Cambridge on the map, not just in this country but globally.

Finally…

It is tough at the moment and we’re asking a lot of you this winter, I know. Our values of together, safe, kind and excellent are our north star and we know we have the talent, the professionalism and the tenacity to do extraordinary things. All of us must continue to look after ourselves and our colleagues as we approach this challenge, and as ever please be aware of the resources available to support your wellbeing and access these the moment they are needed.

My thanks for everything you have done and continue to do for your patients. Awarding you the Covid Star might be just a small token, but it speaks to a simply vast appreciation felt not only by me and our Board, but also the people of Cambridge and the whole region.

With best wishes,
Roland