Each of us will probably always remember where we were on Saturday 10th August 2019 when Wales became the number one ranked rugby team in the world. Sadly, on Sunday 11th, the technicalities of a loss (in a meaningless friendly that nobody at all cared about) meant that we lost this iconic status. We were heroes, but just for one day.
NHS Scotland does not use league tables as universally recognised as the IRB rugby rankings. Probably the closest thing we have is the analysis on the NHS Performs website NHS Performs | Home . Here you can see how NHS D&G performs against some of the major national targets and how this performance compares to the Scottish average. The tables make very good reading from our perspective and we should all take great pride in our performance. Behind all these statistics are real people and families who are receiving safer and faster treatment in D&G than in many other parts of the UK.
Given all of this, I should be sleeping better than I am and dreaming contented dreams of Welsh sporting triumphs. But the truth is, I’ve been pretty worried about our ability to keep on performing so successfully given the pressures we’re facing regarding workforce, rising demand and limited money. I could add Brexit to the list of course but that probably needs a blog of its own which, If Ken insisted on redacting all the swearing, would be a pretty quick read.
You’ll have heard it all before of course. Interviews for new Chief Executives largely consist of exercises proving that you have a sufficiently pessimistic outlook to take up post. We are renowned for prophesies of imminent doom and at our monthly meetings in Edinburgh can create such a singularity of gloom that no light escapes.
But, and I appreciate you need to trust me a bit here, this is different. Across the health and care system we’ve identified over 70 key posts to which we’re struggling to recruit. We started this year with a gap between our funding and our projected costs of over £21M and, even after a thorough and very difficult cost reduction exercise, still have a projected gap of around £8M after the first quarter of the year. Meanwhile our primary care workload, our A&E attendances and our hospital admissions continue to rise as our population ages. Add to that our requirement to make sweeping reductions in CO2 emissions (and to become carbon neutral in a couple of decades) which will necessitate radical change to our health and care model. These are not run of the mill problems and they are not going away. I think we now run a real risk of struggling to maintain the levels and quality of service that our population deserves.
This just isn’t an option for us. So the gloom has to stop and we have to change the future.
I’ve been CEO here for over seven years now and have been absolutely astonished at what we’ve been able to achieve in terms of patient safety improvements and successful delivery of huge infrastructure projects. I simply refuse to accept that we can’t transform our current situation with equal success. If I’m wrong, well, we’ll still have much more fun trying to improve things than gloomily managing their decline.
So we’re creating a project structure to have a real go at putting things on an even keel again (it’s modelled on the project that delivered the new DGRI in 2017). NHS CEOs are required by law to use acronyms wherever possible so we’ve called it ‘SAM’, standing for Sustainability And Modernisation. You’re going to be hearing a lot about SAM.
(the graphics will improve, honestly. My suggestion for a Welsh fireman fell foul of copyright)
Whilst we’ve stolen some features from the financial recovery programmes already running in various parts of the UK, SAM has to be ours; it has to address what you see as the real problems and fix them in a way that’s right for NHS D&G. I don’t want us to shy away from the money problem (if SAM doesn’t reduce our costs it has failed), but I also want to raise the bar so that we make changes that improve our patient experience, make our working lives more enjoyable and make the delivery of health and care greener, with a lower carbon footprint. These aren’t optional extras of redesign, they are essentials if we’re to make change that will last, and that will give us reason for continued pride in our services.
We’re launching SAM next week and are going to try to talk face to face with as many of you as possible. We need you to tell us how to shape the programmes and work with us on the redesigns because nobody knows the services better than you. In the great lesson from Brexit, this time we’re going to listen to the experts.
We need to make sure the changes work across health and social care so the tour will be a double act between me and the IJB Chief Officer, Julie White.
I appreciate not everyone will be able to come to one of the sessions below so we’ll re-run the tour in the autumn. We’ll also film one of the events and post it on Beacon so that if first time round you miss SAM you can … play it again.
I look forward to seeing and talking to as many of you as possible over the next couple of weeks.
SAM Director Tour
19 – 27th August 2019
Jeff Ace is the Chief Executive Officer for NHS Dumfries and Galloway