Q: What were your first impressions when you arrived at the trust, and how have things changed since then?
Matthew Kershaw (MK): My overriding first impressions were of the commitment and passion of the people who work here – for their hospital, their service or area of work, their colleagues and their patients – and the real desire to keep making improvements to the treatment and care we provide.
That impression has not changed. The people I meet don’t generally talk about how good their services are, they talk about what they want to do to make them better.
What I think sets Brighton and Sussex University Hospitals apart from other trusts I have worked in is the opportunity we have to take what is, on the whole, a good hospital and make it consistently good – and ultimately a great – hospital.
Q: What has been the highlight so far?
MK: The people. I spend as much time as possible out on the wards and in different departments of the hospitals talking to staff and patients at all hours of the day and night.
I never fail to be impressed and inspired by what I see and hear, and learn new things that help me in my role.
If I had to pick one moment it would be last Friday night when I had the pleasure of attending the Surrey and Sussex Proud to Care Awards.
The awards celebrate the work of nurses, midwives and other care-givers across the region, with individual and team awards given for each of the “six Cs” of nursing – care, courage, competence, compassion, communication and commitment – as well as a public choice award.
I am exceptionally proud to say that in those 14 categories we had a total of 14 winners and runners-up and I believe this is most definitely a reflection of the quality of care provided to the vast majority of our patients across the Trust every day.
Q: What has been the most difficult challenge you have faced?
MK: Combining working on what is happening right here and now, whilst simultaneously thinking about and planning for the next one, two, three, five and ten years.
It can be easy to get caught up in the day-to-day but I also have to look at the wider picture and make sure the trust is heading in the right direction and planning for the future.
And all of this means we need to pay equal attention to the safety and experience of our patients, maintaining and improving the quality of what we do, the culture of the organisation and our responsibility to our staff, our performance in relation to the national standards against which we are monitored and our finances.
Q: There has been a lot of anger over the last year around reduction in pay (including bank staff). Are there likely to be any more changes or any job losses?
MK: The NHS is currently experiencing the toughest period in its history and unfortunately that means every healthcare organisation has to make difficult decisions.
I totally understand why people would feel angry over some of these changes, but I hope they also see the bigger picture. For example, we have just made some changes to the rates we pay the healthcare assistants and nurses who work on the bank (a pool of staff who do shifts on an ad-hoc basis mainly to cover sickness and other absences).
There are a number of reasons we have done this. Our bank rates were higher than most other hospitals which meant there were instances where a bank healthcare assistant was being paid more than a more qualified and experienced trained nurse working on the same ward or where a Band 3 bank nurse was being paid more than a Band 3 permanent nurse for exactly the same shift on the same ward.
We also have a large number of healthcare assistants and nurses who only work on the bank and what we want is to increase the number of nurses and healthcare assistants we employ, so we have already begun to offer them permanent jobs in the trust with the added benefits of paid holidays and pensions.
The bigger picture is that, now more than ever, along with every NHS provider in the country, we have to examine and re-examine how we spend our money.
None of this is easy but it is the reality. We have promised that we will do everything we can to protect permanent jobs but that does mean that to make the necessary savings we need to look elsewhere.
Q: What has the trust learned from the Care Quality Commission report this week?
MK: Firstly I’d like to say that whilst the body of the story on this in Thursday’s Argus was pretty balanced, and a true reflection of the CQC report, I think it is a shame that the prominent bullet points on the front page didn’t include at least one or two of the things the CQC highlighted as positive and beneficial to patient care.
We actively encouraged our staff and patients to talk openly and honestly with the CQC about the things they are proud of, their concerns and the things they think we need to pay more attention to.
The CQC report does highlight some important issues and areas of concern but they are all things that we are aware of and dealing with.
It does also say that the patients they spoke to were positive about the care and treatment they received. Like all the feedback we get, we will of course use this report.
Q: What will the planned £420m redevelopment of the Royal Sussex mean for Brighton and Hove and Sussex?
MK: You only have to spend five minutes walking around the older parts of the hospital to realise that there is a desperate need for the 3Ts project to modernise and redevelop them.
Some buildings pre-date Florence Nightingale and are totally unsuitable for the delivery of 21st century healthcare. That said, the staff who deliver care from these facilities work hard to ensure they do the best they can for patients despite the limitations of their environment.
The redevelopment will not only improve the environment for our patients and staff, it will also allow us to run our services more efficiently and effectively, and help us to provide the best possible district general hospital services for our local populations and specialist services to patients from across the region.
Q: Extra funding was provided to help the trust cope with the winter months. Did it help?
MK: Extra funding is always welcome and it did help by creating extra capacity within the hospital. It also allowed those who provide primary and community care and our ambulance service to make some improvements to the services they provide and the way they work too.
We have invested in enhancing services within the emergency departments, bolstering the teams and services within the hospital who are responsible for patients admitted through A&E and, crucially, we have worked with others to continue to strengthen services in the community and in GP surgeries.
This is in an effort to try and reduce the number of people who end up in the Emergency Department and to ensure patients who are ready to leave hospital can be discharged quickly.
There is still work to do, and we have had another challenging winter, but I believe we are now in a better place than we were previously.
Q: The hospital experienced problems with A&E last year which led to a negative report from the CQC. How are things now and will it happen again?
MK: Many emergency departments across the country experienced similar problems last year.
The patients who come through our doors are getting sicker as the population ages and more and more people are living with severe and enduring long term conditions.
It is also difficult to plan for and manage spikes in activity, which are often sudden and unpredictable.
People have worked really hard to improve how the whole system works and we are responding better to these spikes in terms of safety, quality and patient experience.
Our performance against the four-hour A&E waiting time standard has sometimes been better but not consistently where it needs to be and, as ever, we still have more to do.
I can’t and won’t say the problems we experienced last year could never happen again but it is my job, working with everyone else with a responsibility to provide efficient and effective healthcare both within and outside of the hospital, to do our utmost to keep making the necessary changes and improvement to keep things working well.
Q: What will the trust look like in five years’ time?
MK: I do not have a crystal ball so I can only say what I hope it will look like.
What I hope is that we are a trust that provides patients with consistently high quality, well-organised, kind and compassionate treatment and care. I hope we are a trust that learns from its mistakes, is committed to education and innovation, continues to set itself high standards and that the culture of the organisation is on the whole positive and that all our staff consider Brighton and Sussex