Warrington and Halton Hospitals

Chief exec's blog - Mel Pickup

My blog aims to offer an insight into the running of our hospital, and the issues that the board and management team face.

The blog is a way to keep you regularly informed and to give my personal perspective on activity and some of the news stories and happenings at the trust. It is a way of communicating personally about the life and times of our hospital—when things go well and, just as importantly, when they don't.

My aim is to publish a new blog every month – I hope you’ll follow and check back for this perspective on what we do in our hospitals and how we do it. I welcome your comments on the blog and questions – please note that these are moderated before we publish them. You can also follow me on Twitter at @mel_pickup

Providing the best in acute hospital dementia care


I’m really honoured to be presenting at the dementia quality of care conference this coming week in Manchester as it helps to show the impact that working with staff can provide for patients with dementia in the typical acute hospital. It’s something that we are incredibly proud of at Warrington and Halton Hospitals because we’ve managed to make a real difference for patients at our trust over the last two years.

In many ways we’re a typical busy district general hospital. We face the same challenges that all hospitals do around dementia. A growing number of patients coming to us for acute hospital care also have dementia and that means that they have distinct care needs. These are needs that are not always easy to provide on a busy surgical or medical ward.

Around two years ago we started to take action around this. Or more to the point, my staff did, and we gave them the tools to do it. I became aware on my visits around the wards that some of our staff were doing some very special things to help patients on their wards who had dementia. From memory boards through to interactive displays with locks, bolts and other hardware for patients to use to occupy them, we saw some really innovative ideas. We also saw the take up of our now famous knitted 'twiddlemuffs' across the hospitals. If you’ve not seen them, these are knitted comforters with tactile ‘bits and pieces’ attached. They’re designed to provide a simple stimulation activity for active hands and we got our local community furiously knitting to make them so our patients can each have their own twiddlemuff.

What we did next was group those ideas together and develop a strategy for dementia. It also led us to look at our environment at the hospitals and what we could do better. We put in a bid to create a new £1 million ward at Warrington Hospital to lead the way in providing the best quality care for hospital patients who have dementia.

The bid was successful and our Forget Me Not ward opened last May and features a number of innovative design features including its own mock bus stop, lounge area with traditional looking fireplace, quiet room with a 1960s style TV and a special dementia garden area. Everything is designed to provide relaxation and stimulation for patients who need hospital care but who also have dementia. It’s been designed to look unlike a typical ward and provides a calm and relaxing environment for care using state of the art design principles, use of colour and light.

The Forget Me Not ward is unlike any other ward in the hospital. We wanted to set the benchmark for this kind of care in the NHS and worked closely with the King’s Fund, dementia groups and patient champions to design the ward. The secretary of state visited last October and said it was the best environment he had seen of its kind.

It’s only one part of the story for us though. Alongside this fantastic facility is a focus on training and developing our excellent teams so they deliver the very best in care for our patients. Length of stay has dropped and feedback from patients, relatives and carers has been fantastic.

We’re also working hard to encourage our community to understand more about dementia and to get involved as volunteers and dementia friends with us. The opening of the ward is just one part of a commitment to providing the best in dementia care and it’s something that we are incredibly proud to showcase here and a credit to the ideas of our staff.

As a chief executive I’ve been delighted to give the staff the space and time to make this happen and look forward to sharing ideas to other trusts next week.

Thank you at a busy time

December 19th 2014

Over the last week in the hospitals we have seen winter pressures start to arrive in earnest. In some ways, winter never stopped this year for the NHS. Across the country A&E departments have been busier than ever this year and the patients that we have seen have been sicker and need our care more than ever.

When the wards and departments are busy leadership is vital. We have some fantastic leaders across our trust who are managing and developing our wards and departments day to day with some pioneering work.

The executive leadership role also becomes more important and I’ve tried to ensure that time has been freed up over the week so I am visible on the wards – even if it is just to say thank you to our staff for what they are doing.

I think it’s fair to say that however much a chief executive tries to get out and about, it will never be seen as enough but I’m working hard to meet the balance. One of the things I’ve done over the last year is to spend a protected morning or afternoon once a month in a department, getting to know the staff and what happens there from their perspective. Thank you to the areas that have taken me under their wing this year – which include A&E (twice), neonates, A8, C23, A3, the clinical coding team, chaplaincy and switchboard amongst others (you can see some of my selfies from these areas above).

As well as all the day to day things that keep us all busy, we’re currently preparing for our comprehensive CQC inspection in January. We know from other trusts that the inspectors will ask staff to describe the executive team. Now, in some instances inspectors have been known to not only ask whether a staff member knows, for example, who the chief executive is, but also asks for a description of them. So just to let you know, unflattering physical descriptions are absolutely fine as long as they know us and know that we are available for them at any time if they need us!

Trusts engage with their staff in different ways and our most recent staff survey suggests we are getting better and that our trust is one of the top 100 places to work in the NHS which is fantastic, but one new thing that I’ve introduced, following on from the Perfect Week exercise that we did back in May, is an executive buddying system. Each one of the exec team now has a number of areas that they will buddy with. As well as informal visits, it also gives the wards and departments an exec contact that they can use to unblock any issues that come up and talk to in general terms about any concerns and the things they want to showcase.

I’ve also written out to all staff at this festive time to say thanks for everything this year. It’s been a tough and challenging one for our health service but we are looking forward to 2015 and beyond with confidence. There’s so much going on and I’ll touch on that in future blogs.

As a small token of thanks execs have been out delivering chocolates to all the wards and departments this week. Knowing that the lifespan of a box of chocolates in most areas is a matter of milliseconds you probably had to be quick to get one. I know it’s not much but please believe it’s sent with heartfelt thanks for everything that our staff do day in and day out across our hospitals.

Merry Christmas and a happy New Year to everyone.


1,825 days later

November 1st 2014

Five years is a long time. In fact a quick calculation tells me that it is exactly 1,825 days. Can you look five years into the future and predict what you’ll be doing, where’ll you be and the changes that you will have seen in those 1,825 days?

That’s exactly what we’ve been doing this last week with the launch of our five year strategy across the hospitals.

We’ve called it creating tomorrow’s healthcare today because that is exactly what we are trying to do here at Warrington and Halton Hospitals. In the next five years we’ve got one big overall aim – to redesign the district general hospital so that it is fit for the future and providing the services that you need.

If you follow the health service and the news about it you’ll know that times are tough at the moment for hospitals. Demand on services is increasing, our patients are older and sicker, finances are tighter than ever before and there’s a drive to move to more services in community settings. It’s been described as a perfect storm for hospitals. Our strategy gives us the way through that storm.

We’ve set out the things that need to be done to ensure that we have a sustainable hospital at the end of that period. Some of the changes will be obvious ones and are happening already or are in advanced planning. We’ve set out our plans to change our estates – demolishing some of our older buildings and creating new healthcare environments to complete the modernisation work across the hospitals. Others are much more subtle and you might not see them day to day but they’ll make a difference to your care. New IT systems are a prime example of that. We can free up our staff time to care by making some of the administrative systems easier to use. Being more efficient and more productive will mean we can do more with the resources that we have.

Other changes will happen further down the line. We’ve set out the need to collaborate and develop new services in partnership with other local providers (collaborate rather than merge you’ll note) and with our GP and community colleagues. There’s no doubt that by 2019, many services will be delivered in different ways than they are now. There’s a lot that should rightly be done in the community rather than hospital if it’s more convenient for you – but we want to make sure that it’s our expert staff doing it to the highest quality standards.

I won’t give too much more information on creating tomorrow’s healthcare today – it’s all available for you to look at elsewhere on our website and in our plan on a page version (which should pop open if you click here). We’re genuinely excited to put our plans and strategy down on paper in this way.

For too long some staff and stakeholders have felt that we don’t have a clear long term plan and that’s led to a feeling of uncertainty about our future. Following our launch event, our senior leaders across the trust – nurses, doctors and corporate managers – seem to have been genuinely energised.

I’ll be sharing more with you about our plans over the coming months so I do encourage you to have a read. Our message at Warrington and Halton Hospitals is very clear – despite the challenges that many hospitals like ours face, we’re here for the long term and have a bright future that we are in control of.

This is our plan and we need you to understand and support it. We’ve only got 1,824 days left to do it now so let’s get moving.

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