Over recent months, the Board of Directors has identified a number of significant issues of operational and financial performance that it believes must be addressed as a matter of urgency. These include:
- Persistent serious issues with the installation of the electronic patient record system (“EPR”), including clinician and staff acceptance and usability
- An inability to live within the financial resources allocated to the Trust over a period of time
- A need to focus on appropriate staffing levels to maintain high quality patient care
- A need to establish and maintain a collaborative leadership style of an executive management that listens, evaluates and properly implements actions based on concerns, particularly those raised by staff
As a result of resourcing issues, it is probable that the Trust will shortly be found in breach of its Authorisation by its Regulator, Monitor. That will result in a greater scrutiny of the affairs of the Trust by the Regulator but the Board is optimistic, as a result of the significant actions outlined in this communication, that no further intervention will be required and that the Trust can rapidly resolve the issues identified and continue to provide the high quality of patient care that patients in Rotherham and beyond have the right to expect.
The Board would also like to take this opportunity to express its appreciation for the outstanding dedication displayed by its clinicians, nursing staff, and all Trust employees during this difficult period and for maintaining an extremely high quality of patient care. As a result of this dedication, despite the above challenges, we continue to deliver high quality care to our patients and consistently achieve nationally determined standards and targets. It is every member of the Trust’s workforce, particularly those on the front line, who have accomplished this.
The Board wants every employee to understand that it has listened to the concerns raised in recent months and put in place an initial plan, which will commence today, to work through the challenges faced.
The key elements of the plan, subject to due process, are:
- An immediate reduction in the number of Executive Directors. This will provide for a focused, more streamlined executive team and structure and will enhance communication and move forward the effort to provide a participative and collaborative leadership style.
- The imminent engagement of clinicians in the work of the Board. This action will provide for more clinical director / consultant engagement through attendance and participation at Board meetings. This is the beginning of a much more participative collaborative leadership style, involving clinical leadership and managerial support.
- There will be an immediate pause to the ward closure programme announced last year. This is until the well organised and methodical plan of patient demand management currently being implemented, with our staff and healthcare partners, safely and sustainably delivers results.
- The immediate review of the EPR programme. The Board will institute a strategy to correct or take other actions concerning the electronic patient record system in such a way that it does not hinder or slow the work of clinicians, nurses, AHPs and others during their time caring for patients. With this in mind, we have engaged an independent external EPR expert, with experience in multiple types of implementations. Larry Blevins will join the Trust mid-February for an interim period of up to 3 months. His job will be to review and resolve the issues causing the EPR situation from an independent standpoint. The details of his terms of appointment will be the subject of a separate communication shortly.
- A focus on connecting and integrating community and acute services. The Board will initiate a deliberate and concerted effort to properly utilise our Community Health services. Full utilisation and integration of the Hospital into Community and Community into the Hospital has not been robust enough. As a result Community Health services will begin to participate in the weekly senior management meeting. Our Community Health services are an important part of this Trust and its development and we must make every effort to understand how all services can work together more efficiently and productively.
In order to lead the plan, and with the support of the Regulator, the Board has engaged the specialist healthcare management firm, Bolt Partners LLP based in London to lead the recovery and restructure of the Trust. This firm’s recovery leadership philosophy is one of participation and inclusion.
Bolt Partners will provide three recovery and restructuring professionals on an interim basis, Michael Morgan, Tim Bolot, and Joshua Ejdelbaum. Michael will be engaged with immediate effect as the Trust’s Interim Chief Executive to lead the recovery and restructuring. Michael has a successful track record of hospital restructures and turnarounds spanning 30 years. According to Michael, “experience illustrates that if an inclusive, collaborative leader unites a team with a clear common goal and enables the team to do their work while supporting their self-esteem and their decisions about scope/time/resources, the workforce and the organisation thrives. The key is recognising the importance of employees who interact directly with the patients we serve. The role of a leader is to serve and support employees so they have resources and processes they need to optimise patient experiences”.
Tim Bolot’s continuing work with the Trust will focus upon the financial recovery and supporting plans, and Joshua Ejdelbaum, a financial and productivity analyst, will support both. Within the next week we will publish the terms of this engagement along with their biographies.
In advance of any further formal announcements and acknowledgments which will follow after concluding established HR processes, the Board, as part of this communication, wishes to thank each individual who undertook stepping up into interim positions as Executive Directors during the last few months’ transition.
It is expected the Trust will move forward at a pace with its recovery. We need to dispel rumours but most importantly ensure we don’t encourage or spread them, keep relentlessly focussed on our cost reduction plans whilst safeguarding the quality of care. In order to mitigate distraction, we must continue to work to maintain the strong relationship we have established with our commissioners, GPs, Governors and with our local union staff side representatives, to ensure that all initiative implementation is managed sensitively and expediently, delivering the intended outcomes and returning the Trust to financial stability. All this should serve to reinforce the long held public confidence in the Trust as a high quality healthcare provider, whose current financial challenges, when tackled as one team, working with a single unified approach, are without doubt, surmountable and within our own control.
The Board would also like to be very clear that the cash position of the Trust is sufficient to meet all payroll and creditor obligations. There is no imminent risk to payroll or other creditors. A number of communications clarifying further detail and timescales will follow over the next few days and Michael will run a series of open sessions with every staff group as quickly as possible, the scheduling of which will commence immediately.