Weeknotes 2023-04-10

New boss

This week I met my new boss Phil (well, one of my bosses - I have either 2 or 3 depending on how you count). It was a really good conversation and gave me a lot of hope for what we can do next. During the meeting I also made a point of asking more of my "stupid questions" - it's impossible to hide the fact that my background is in manufacturing, not hospital operations, but with more time and a stabilising team available I intend to close more of my knowledge gaps by asking what I worry are basic questions. They're not really - they're often useful to others too, but there has been so little spare time for them over the last 2+ years.

Information priorties

I've written in previous weeks about the bed occupancy work we've been doing. This was the week when a few more next priorities started to fall into place. Namely activity metrics, and referral to treatment leadtimes. Both of these will help us plan in more detail - both the start of winter planning and annual planning, and also planning to meet the elective activity waiting list targets being set by NHS England.

New maternity reporting pipeline

The new maternity pipeline went live, and although there were more loose ends to tie up than ideal, the team dealt with it well. Particular shout out to Fran, who was hugely determined to see it through. We now have the safety of version-controlled R and SQL code running our reporting, and changes from here on are incremental. We won't need to re-invent that wheel again for a long time. Success! Everyone has gone home for a weekend away and next week we'll be fresh to go again.

Load and capacity conversations

The most interesting part of the week was a 30min conversation with maternity service deputy and the community midwifery matron about approaches to help understand community midwifery load and capacity planning. 3000 patient contacts per week in that team, lasting between 30mins and 90mins each. I had no idea of the scale of their work! I was able to help with a few ideas from back in my car manufacturing days, when capacity planning was a core part of my job with suppliers. We're going to meet again in a week or so, and I'm looking forward to seeing how things are looking.

So as usual a busy week, but the junior doctor strikes meant relative calm, as there were meeting cancellations to support clinical capacity. This was enough to give back some thinking time, and turned what would have been a very tricky week into one with more breathing space.

Creating that breathing space deliberately is something we need to do more of. This job is among the most challenging I have done. Having the time to plan deliberate incremental improvement is so important if we are to get where we're going.