Session recording
VACANCIES / RECRUITMENT / HR
Q: Can the vacancy scrutiny panels be held more than once a month. I submitted before the deadline then the meeting was cancelled twice so it took 6 or 7 weeks to get it through – meanwhile the non-clinical team are over stretched and people are leaving which starts the process again!!A: This isn’t acceptable, will enquire as to why these were cancelled as their infrequency means they shouldn’t be. Thanks, James Sumner
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Q: I would like to ask why yet again there has been an admin freeze on employment and for overtime? Why does this Trust think it is acceptable to not employ when there is a vacancy and expect the other members of the Team to pick up the work without any extra payment? The Trust would certainly not expect a Nurse or a Consultant to work extra without any extra payment. Why does this Trust think it is acceptable to expect Admin to do extra work in the evening and at the weekend for time in lieu, isn't that defeating the object. They do not have enough hours in the day and you are offering time in lieu to be taken at any time. Why is every other staff level allowed overtime except Admin?A: Overtime usage is being reviewed and has reduced considerably over the last 12 months. All areas will be asked to review and reduce the use of overtime across all staff groups not just admin and clerical.
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Q: How much money is the trust spending on agency bank staff?A: Thanks for your message – If you would like to email me at James.dawson@liverpoolft.nhs.uk and James.woods@liverpoolft.nhs.uk we can respond to this. Thanks, James Dawson
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Q: How will LCL be supported for staffing given staff freezes? This is a very short, staffed area and the laboratories never get prominence in this (also in this Exec update).A: Please see above earlier response relating to recruitment. You will see all vacancies and recruitment is risk assessed to ensure the safe delivery of services. Please do raise with your site leadership team on any specific concerns. Thanks, James Dawson
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Q: A&C Vacancy freezes are absolutely killing all admin areas, we can only re-prioritise so many times, and this is affecting morale massively- I think is reflective in sickness targets, staff at all bands acting down to keep areas afloat. Serious issues with career progression with staff due to minimal vacancies being approved, this will do huge harm in the long term.
A: We acknowledge this is a significantly challenging time, our aim is to limit the impact on front line patent services and protect roles within the organisation. All recruitment is being risk assessed at Exec MD and Executive level on a weekly and monthly basis. We would encourage you to discuss this with your SMT to ensure that you are supported. Thanks, James Dawson
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Q: What is the expected timeframe for submitting a MARS request and final sign off. Can staff who have submitted a request apply for jobs outside the NHS while they are waiting for an outcome without invalidating their claim?
A: The current MARS scheme is open until the end of June and guidance documents are available on the trust DMS. MARS does need to be considered at both Site and Executive level before a decision is made. Staff are not prohibited from applying for jobs, however if successful, this will be factored into the consideration of a MARS application.
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Q: Given the update on the challenges around costs and the impacts on corporate teams, how is the impact on already tired, overstretched staff being considered and what are the plans to manage morale so we don't continue shedding staff as people leave for other sectors, better paid and less stressful roles?
A: One of the things that we will be talking about next week, when we’re talking about LAASP and the Five Organisations, is we’ve held a lot of posts over the last year because we’ve been mandated to and there are posts being held in the other organisations. One of the things we need to do as part of the next few years, as we’ve been clear about with LAASP and the UHL Group, is we need to work through corporate services and create new corporate service models that support the Five Organisations effectively. By holding the vacancies for now, it means that we won’t, hopefully, have to go through anywhere near the sort of organisational change that we might do if we did a complete restructure of some corporate services and found that we had too many people for a service.
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Q: There is a concern that changes to divisional structures and alteration of roles is reducing the representation of AHP's in the trust, specifically at higher management levels. What can you do to reassure staff that this isn't happening?
A: Thank you for this point. We are looking at how the strategic element of AHP leadership can be appropriately managed and led. We recognise that this important group of colleagues do need a clearer focus for all AHP professions.
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Q: Waiting for ward clerk vacancy to be approved has left my ward under pressure and no case notes filed or patient follow-up letters being sent. This was a straight vacancy, replacing our Ward clerk that left with a new ward clerk. The panels are taking too long to approve jobs
A: Ward clerk posts have been agreed as critical for replacement – if this is Ward 5A I picked this up and approved today. If not, let me know which ward this is and we will sort for you. Natalie Hudson
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Q: With the admin freeze, is there any advice on how teams can successfully deliver and focus on CIP targets when workloads are increasing due to sickness, leavers, vacancy in departments.
A: All we can do at the moment is continuing to do the best we can. The constraints we’ve got on are not something we can do anything about, but what we have to do is just try and create as much certainty as we possibly can and just keep going. James S
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Q: Is there any process in place for band 3 admin to progress to band 4 without having to apply for a different role? I sometimes see vacancies for my own role at a higher band but don't actually want to move to a different trust or dept.
A: We'd encourage you to speak to your line manager if you believe there are inconsistencies or to discuss development opportunities. Thanks, James Dawson
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Q: Theatres are still having waiting list ops being performed and staff getting enhanced pay, why is this fair?
A: We need to look at this – I’m not aware of theatres having an enhanced pay. I know we were aware of a couple of areas and those, I think, Nat had said before are all being gone back to and discussed so can we take this comment away and have a look at it. James S
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Q: Why is the freeze focussed on the lowest paid staff? Do we never learn? There are not huge savings to be made from B4 and B5 roles in admin when we have layers of management from 8A up. Without the admin staff (patient facing and non-patient facing) the Trust would cease to function and yet we are consistently kicked while we're already down.
A: I think I’ve already answered this but there’s freezes on all admin and clerical roles, which basically go from Band 2 right up to Band 9. So it’s not just all on 4’s and 5’s, unless you are referring to the bank but the freeze is basically on all of them. James S
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Q: A government health minister was on a national radio station this week saying, "without the clerical and admin staff the NHS would simply not function and not be able to provide the care that it does." They didn't mention management at all. Yet the 'lower paid' staff members are usually those who are kicked while they are down. They do a brilliant job. So, can't this trust be a trailblazer, flip it on its head and look at the quantity of managers it employs instead?
A: We’re looking at this as mentioned earlier. James S
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Q: There seems to be huge disparity, some teams are still recruiting to full capacity, and even bringing on new roles. Some teams can purchase what they want, and have offices renovated, go on away days. And others are stripped of staff and resource, working in terrible conditions. The national financial position is clear but not reflected equitably.
A: This is interesting, given the freezes are across the board. So if there’s any more information on this that would be helpful to have and if you’ve got examples of where it’s happening in one place and not another. You can either email me separately or the Comms Team. James S
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Q: In the future when you can recruit to A&C staff, will staff get the opportunity to apply for roles internally first before going out externally? Particularly those who are wanting to progress in their careers
A: Thank you – We are keen to retain and develop our staff and this is something we can factor in moving forwards.
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Q: In theatres, waiting list incentives have been taken away from nursing staff, overtime pay has been taken, now bank pay is being reduced. Due to shortage of staff it’s hard to get AL approved and many of us lose it at end of the year without being compensated for this. Is there any possibility to overcome this by providing pay for our annual leave hours or carry forward?
A: Good suggestion, thank you. We’ll pick this up and have a look at this. James S
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Q: Is there any updates on the cost of living rises?
A: Thank you, we await National steer on this and will update once a position is confirmed. James D
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Q: When will the annual pay rise be given?
A: Pay rises will be backdated to 1 April 2025 and will appear in your pay slips from August. To check the specific details of what the pay award means for you, please visit the relevant link for your staff group below:
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Q: Are corporate jobs going to be at risk in the future
A: Thank you – Our intention is to protect roles and retain knowledge and expertise within the organisation. James D
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Q: Cutting pay rates has been mentioned previously, and what it meant was staff refused to work the bank shifts and agency rates went up. Let’s see if this happens again.
A: We are going to remain focused on any consequences of the decisions taken.
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BANK PAY CHANGES
There is a dedicate page about the bank pay changes with FAQs here.
Q: It is always the lowest staff nurses that are penalised. I appreciate that nursing is a big group and so it will look good to saving money. But you are targeting people who are already under pressure and stress with low morale. Why not look at the highest paid people in the trust? Do we need so many manager and managers?A: Managers and senior posts are being reviewed as well; we will be transparent about this following review by the turnaround director.
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Q: Are these bank rate changes for all staff or just nursing? I am not sure if this has been disseminated to other staff.A: It is for all staff who work on the Bank – not just nurses.
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Q: If nurses choose not to work on the bank due to pay cuts surely this will increase the demand for agency staff?Q: Surely this bank payment will result in an increase in agency when our own staff refuse to pick up additional shifts?A: We are using less bank and agency now than we have in a long time, but we will be monitoring any unintended consequences of this decision. David Melia
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Q: Why are you only looking at patient facing staff and restrictions to bank pay. Why are senior managers not under review? How many ADNs and operational staff do we have for example. The new system will impact patient safety and penalises senior staff.A: Thanks for your message – for clarity, all staff groups and grade are subject to workforce controls that have been shared previously and during this Staff Brief. Regarding your specific question relating to ADN's and operational staff, please discuss this with your site Leadership team. Thanks, James D
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Q: Was consideration given to pay substantive staff bank pay at their normal pay spine for bank work? Staff at the top of their band feel that it is unfair to pay staff at the bottom of the band an enhanced pay (midpoint) and that they will work for less than what they receive on a day to day shift.A: Thank you for this – we considered all approaches to reduce the spend on Bank staff. We wanted to be consistent with the rest of Cheshire and Merseyside and all Trusts are taking the same position, and their pay rates will equally change. Again, I do recognise this is a difficult decision to take and staff will feel that it is unfair. David Melia
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Q: As an RN it is really disheartening to hear that the trust is willing to cut my pay while it keeps booking agency staff. are the rates of pay for agency staff getting reduced too? and does the trust have a plan for what they will do if all us nurses decide to join agencies where we will get a rate we deserve. A: Thank you and again, we recognise that the decision on Bank pay is not popular. We have don't use 'off framework' agency staff in nursing and nor do we pay above 'cap' (both measures to make sure that we keep agency fees manageable) we have reduced our nurse agency spend in the last year by nearly £6m. we will continue to review the situation. I do need to repeat that all Trusts in Cheshire and Merseyside are taking the same position, and their pay rates will equally change. David Melia
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Q: Have staff side supported the pay cut for the b5s and above?A: Trade Unions have shared their position on behalf of their members. The trust continue to work with TU partners during this challenging time. Thanks, James Dawson
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Q: If staff are not working on the bank, but have agreed to work to enable additional capacity such as breast ACC's will the rate of pay now be fair and consistent with nurses and radiologists' ?A: We will be reviewing all different pay agreements for additional or locum work to make it consistent and fair.
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Q: Have the bank only members of staff been made aware of the reduction in pay and if so, how?A: I believe that this has been communicated but will check to make sure.
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Q: I understand your saying bank rates drop is a reaction to covid, however at this point the RNs who worked in covid have been here 5 years +, why should they expect their pay to now drop, I don’t think this is a valid reason A: This will impact all colleagues at band 5 and above working via our bank in an Agenda for Change role. Core substantive salaries remain unchanged. If you are a substantive colleague undertaking bank shifts - your bank work rates will be recalibrated to the mid-point level.
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Q: Appreciate the current financial constraints but surely reducing the financial incentive for nursing staff is going to cause additional pressures on the wards as they are already short staffed due to the lengthy process of recruitment and the current sickness rates
A: Other organisations locally have or are looking to take the same position and haven’t seen that, so it will be interesting to see what happens next. Again, I highly anticipate that we’ll be pushed towards standardised rate cards for bank across the patch. James S
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Q: Can I still work overtime rather than picking shift up via bank?
A: We’d need more information to answer this as I’m not exactly sure where you work and therefore unable to provide an answer. James S
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Q: Other areas such as radiology have agreed other rates for Waiting lists or additional capacity clinics. Will this now be made fair with the new bank rates and they be at the same rates as other staff, or will they still have special rates? Thank you
A: We are in the process of reviewing all rates across the organisation. We will be speaking directly to those teams who may impacted or have a historical arrangement in place.
ORGANISATIONAL DEVELOPMENT / STAFF WELLBEING
Q: Thanks for noting the mental health support available. Can you confirm if there are any plans to expand and improve these offerings given many staff are feeling increasingly overwhelmed and stressed in their role? A focus on more frequent, more accessible, and better quality mental health support from the Trust would be appreciated.
A: There is a wealth of information and support available through our Life at LUHFT Staff Support offer, and we are continuing to review and improve this to ensure that it meets the needs of colleagues. You can access this through our Staff Hub and Life at LUHFT Staff app. It covers a range of information to signpost you to help you stay well at work around your physical, mental and financial wellbeing, as well as your working life.
For colleagues feeling overwhelmed and stressed, we offer enhanced focussed support through our Staff Support Services. This includes self-care strategies and online sessions through a range of topics including sleep, mindfulness, 'switching off' and CBT. Managers can also play a vital role in helping colleagues to stay well and they can access training and support to help promote positive mental health and manage stress in their teams. Targeted support can also be accessed through our in-house Staff Psychology service, which includes partnerships with local organisations and in-house counselling to help colleagues stay well.
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Q: Are there plans to take any Body Shop Gifts to offsite based staff?
A: Thanks for your message - The OD are leading this donation distribution; we have products ready for Community and Offsite teams - Please email organisational.
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Q: Re the Body Shop gifts, I didn't know about this. Please can we have some comms for these type of things?
A: Thanks for your comment, the Body Shop donation was promoted through Liverpool News, Staff Facebook and via the staff app. We still have a small amount of products if you would like to email organisational.
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Q: What will be the impact of the Supreme Court clarification on the definition of a woman being based on biological sex on the trust. What are the trusts plans for providing single sex spaces for female staff (and men - men need single sex spaces too) and how they will accommodate trans and non-binary staff.
A: Thanks for your comment - We are in regular contact with national and regional teams to ensure any actions we take are in line with are consistent with the ruling and how we can best support all colleagues. We will share further information and updates once they are available to us.
IT / EPR / DIGITAL SERVICES
Q: What is the timeline for someone who works across both LUHFT and LWH being able to access everything from one account? Having to sign in on different devices on different accounts is not an efficient use of time or resource.
A. Work is currently underway focussing on combining Royal and Aintree user accounts together, which is part of a wider piece of work to have a single sign on for the UHL Group organisations. A small pilot is about to take place for some RLB/AUH users; however this is a large project and the anticipated endpoint is to have the new single login live prior to EPR go-live.
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Q: Can we please review the process at AUH (unsure if the same is in place across the group) for having stocks of printing ink/other key equipment for printers. There is one individual tasked with replacing inks, photoconductors etc who usually finishes about 2pm – anything after this we have to wait until the following day causing delays. Surely it would make more sense to allow areas to have at least one spare of each item to avoid disruption and move away from this single point of failure? Very easy win to be had here!
A. The maintenance of printers and delivery of toner cartridges and consumables at AUH is provided by a sub-contractor staff member from Lexmark (who provide the printing service). Digital Services will discuss with Lexmark on changes that can be made to the way this staff member and the consumables service work in order to provide a more efficient service.
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Q: The Trust is looking at electronic letters for patients, but what happens when the individuals don't have a smart phone and will not be able to receive these – do we have a backup option?
A: Yes, there are rules in place for all letters for patients that are being sent electronically. If the patient does not open the electronic letter within 72 hours, the letter will be printed and posted directly to them. There are also checks on the date of the appointment/TCI. If the appointment or TCI is within 7 days, the letter will automatically be printed and posted as well as sent electronically, to ensure the patient receives the information in time. As we are expanding the use of digital letters, we are also developing integration with the NHS App so the patient will be able to see their letter, appointment and TCI details here alongside other healthcare information.
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Q: Are there any plans to update the ICE testing printer systems here? MWL/Whiston have been using thermal label/Zebra printers for years and having worked there I have found that they are much faster & efficient for clinical staff. Less paper used and much less stressful.
A: The review of end user devices to support ordering and reporting (pathology & radiology) will be considered within the EPR programme.
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Q: Can we have an update as to the issues on Monday and any resolutions as a major acute trust we cannot have IT systems going offline. Some clinics had to send patients home; this then adds to the waiting lists.
A: The EPR Team are reviewing the resilience of our systems including IT. The review will identify where we may need to increase resilience in both IT and electrical systems.
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Q: RE: the recent network instability and cyber-attacks/political instability, wouldn't it make sense for us as a trust to have periods throughout the year whereby we have planned drills & go back to paper/analogue systems so it's not as chaotic when the systems do go actually offline? We've become very reliant on digital systems we've largely forgotten what to do when it's not there!
A: I am not sure that anyone from EPRR is on the Q&A, but all areas should have a business continuity plan in place. As a department/team you can practice this at any time to test its validity. You may have 'action cards' in place too that are agreed as part of the major incident plans. So in the event of a major incident, the action card is instigated. Hope this helps, thanks Alison
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Q: IT issues seem to be terrible at the moment, everything is so slow. What is the reason?
A: I assume this is in reference to the beginning of the week and then recovery from that. If you are experiencing other IT issues across the board, that were before Monday, please let us know and we’ll pick it up. James S
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Q: What is the position on driving investment in digital innovation and technology for service and quality improvement.
A: We’re still pressing ahead with EPR, which is funded separately. We’re getting on with that at the moment and that’s the next big investment that we’re going to have here. But nationally, we’ve still got this position of there is no money - the NHS has no money and the NHS needs to spend less than it is today, and that’s not going away certainly for this year. James S
ESTATES / CAR PARKING
Q: How much longer will the temporary car park at Aintree be in use? If it's for some time, can we please have some lines painted for parking spaces as people are just abandoning their cars and it's not efficient
A: We do not expect use of the temporary car park to extend beyond June. We would encourage drivers to park considerately. Thanks Alison
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Q: Broadgreen car park was closed last Saturday, are there any more dates of closure planned? I didn't see any prior notice that it would be closed.
A: Part of the car park was closed for electrical work for a short period. At this stage, there are no future works planned that will impact on the car park. Thanks Alison
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Q: As the car parking issues at AUH are on-going particularly with the 4th floor of the multi-storey being out of action until July I understand- it is really difficult to find a parking space. This makes it more challenging when attending meetings - despite this I note the security team are very quick to issue fines – could we ask penalties are suspended particularly when staff are paying premium parking and can't get a space.
A: Car parking management will always be a challenge, this is made worse by drivers parking on grass verges, pavements etc and blocking access for pedestrians and wheelchairs. We need to discourage this and keep our staff and visitors safe. The breach of contracts are a deterrent and do work to educate drivers. Temporary car parking is in place and the work on the top floor scheduled to be completed by the end of June.
Half of the top deck will be reopened in the next two weeks and this will mean we are back to the norm; we also have other works underway to open further spaces near car park 1. When the site is under pressure the need for traffic enforcement increases to maintain safety and traffic flow.
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Q: What will go in the site of the old Royal? What are the plans?
Q: I do think it's very important that the trust pushes for multi-storey car parking with large capacity and utilises the old royal site appropriately to address this. If it becomes an open air area or park, sadly I think it will only attract anti-social behaviour long term.
A: The future master plan for the RLH site is currently being consulted on with LCC planners. The plan will see two additional routes on and off the podium, the first of which starts on site this month. There will be several plots developed as part of the Knowledge Quarter with system partners including Uni of Liv.
LAASP / UHL Group
Q: What’s going to happen with the money the trusts in UHLG owe each other?
A: In the next year or so, we’re going to be looked at as a single entity and what we’ll be looking at is a single financial position across the organisations. We will, however, need to work out a fair apportionment of costs for services, because a lot of the time, we find that we end up doing more for external organisation than we get in return, and we don’t always get paid for doing this. So, we’ll be able to work that out across the Five and make sure budgets reflect that over time – but what we won’t need to do is keep invoicing each other for things in the long-term. James S
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Q: What is the timescale for the Walton Centre to come into the new group model?
A: We’ll pick this up next week on Wednesday when we go through the LAASP stuff and when each of the organisations will come into the Group.
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Q: As part of the CIP or UHLG programmes, is LUHFT considering outsourcing any services?
A: UHLG remain committed to our role as an anchor institute and employing all of our staff where possible is a key part of this delivering Agenda for Change T&C to all, each case is subject to value for money checks and to date we have passed this test and delivered the equivalent service for less than the cost of outsourcing. We continue to look for further opportunities to consider this as other Trusts join the Group.
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Q: Is there a rough timeline for the Turnaround Director to have an idea of what corporate non clinical staff will be needed going forward? (weeks/months/year etc)?
A: I’ll specifically brief on corporate services next Wednesday and what we’re trying to do there across the Five Organisations. James S
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Q: Are LHCH staff invited to this staff brief? doesn't seem they recognise to be part of the group?
A: Hi - LHCH are not part of the Group yet so this is just for LWH and LUHFT staff at present. James is currently CEO but they remain a separate organisation.
GENERAL
Q: Not a question as such but disappointing there was no E&F staff members on the photo related to ED when they played a significant role in the improvements.
A: All staff groups were asked to be part of the photo but some members of staff chose not to have their photo taken. I agree our E&F staff have played a critical role in supporting our fantastic improvements.
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Q: Performance is showing good trend to the positives. For OPDs more work needs from what I see on DNAs.
A: Yes, absolutely. That is in our improvement plan for this year, so perhaps we will do a bit more on that next month – you are right DNA and outpatients is a significant issue. Penny Dash, Chair of NHS England, will tell you every time that this productivity issue we see in the NHS, that we’re being pressed on and reason why there’s so many big financial cuts, could be improved massively by even the smallest improvement in outpatients in terms of reduced DNAs. James S
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Q: Our ward has lots of delays in discharges. They are all blocked by social issues. Too many layers and people needing to review the patients is slowing things down. Waiting for a social worker to allocated to patients causes significant delays, weeks and weeks
A: You’re absolutely right, this next phase of work that Natalie, Pete, the Cheshire & Mersey Turnaround Director, MerseyCare and the Council are involved in is out to rapidly speed up this social worker support for patients who often don’t have too many complex issues to get home and we expect to see improvements imminently.
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Q: FDS is not achievable while services are so short, we are being pushed to breaking point to hit the target while being given no additional resources to deliver, then being told we are "on the naughty step"
A: I understand. The whole organisation, the whole of Cheshire & Merseyside and the North West are all having the same constraints put on them and then being asked to deliver, and it’s not great, but unfortunately, is where we are.
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Q: With CCC taking the running of pharmacy – are there plans for them to be able to dispense GP prescriptions? I had a prescription that would have been really helpful if I could have picked up my meds from work.
A: Unfortunately the outpatient pharmacy do not have an NHS contract to be able to dispense "GP" prescriptions so are unable to dispense them.
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Q: Hi, Could some up to date org charts be circulated at some point? There have been several changes and it would be helpful to know who is who on each site. Thank you.
A: Hello – we are currently working on a new org chart as we are conscious there have been a lot of changes within the structure.