“We’re fighting a culture that’s been part of life in the NHS for more than 75 years,” Suzie Hayman, the lead governor of the University Hospitals of Morecambe Bay NHS Foundation Trust, told Cumbria Crack as efforts to balance the organisation’s books continue.
“In the past an NHS trust would have been supported despite the deficit – that’s now no longer the case,” she added.
Elected as governor three years ago and lead governor last year, the voluntary role is aimed at holding the foundation trust’s board to account on behalf of patients and staff.
Her decision to take on the role in the first place may surprise many.
“My husband died just after the pandemic at the Royal Lancaster Infirmary and when it came to his care, the trust admitted they’d got it wrong – they dropped the ball,” Suzie said.
Vic, her husband, was being cared for at the RLI and as his condition deteriorated she was not allowed to see him as often as she wanted, something the trust later apologised for.
“I didn’t want to take the matter any further but I did want to help and was welcomed to join the trust as a governor with open arms,” Suzie recalled.
The professional agony aunt and author has spent a lifetime counselling and felt becoming involved would support a trust which four years ago was battling to reduce an £80m deficit and still coming to terms with the measures highlighted by the Kirkup report, an investigation into the deaths of mothers and babies in their care.
Three years on, she has had a ringside seat to observe efforts to turn around the organisation.
“It is remarkable to have come as far as it has to live within its means but it’s also important to know UHMBT is not an outlier in being in deficit – what is unusual is the geography of the area served,” Suzie said.
“The area is 1,000sq m and we employ 8,000 staff serving a population of under 350,000 – in Manchester that would be one hospital – but have the Bay in the middle of it.”
Last year, for the first time, the trust received money from the NHS centrally which recognises the challenges faced in providing acute care across a wide area.
Called Local Price Modification, UHMBT received an extra £22m to support services around Morecambe Bay. The money was awarded because of progress made to manage finances.
“It’s just a shame we have not had this in the past when we were operating services where the income we received did not match the cost of providing them,” Suzie said.
So why is the trust still struggling to balance its books?
According to Suzie, new ways of working – which she claims are paying off – are being introduced, but pressure on existing services continues to grow.
“In Barrow the Integrated Wellness Model helps reduce the reliance on the NHS by people who use it most frequently by working with GPs, social workers and others to help better manage the underlying issue – frequent falls for example – to help them manage,” Suzie said.
“In a surprisingly short time this has changed from a 75% readmission rate to just 11%. As the NHS 10 year plan says, prevention rather than treatment is the aim and this is proof it can work.”
The system also saves money because the number of beds needed is reduced.
“While we have to break even, having systems like this in place as well as community hubs, so people don’t have to go to hospital, and ‘virtual wards’ where staff will visit people in their own homes, means the quality of care doesn’t suffer and hospitals are kept for acute care,” Suzie said.
Communicating why and how there is a change to the way that care is offered will, she admitted, be a challenge.
“We do have to get a grip to make sure that nobody gets left out of it,” she conceded and says the system that has prompted a decision to close beds is still in transition.
The morale of staff has been hit by the changes and publicity surrounding them but Suzie said in recent weeks it had lifted, praising acting chief executive Scott Maclean – a former cardiology nurse – for taking to the wards to talk to staff.
With flu and norovirus adding to the financial headaches faced by the trust how does she see the next few weeks as the countdown to the end of the financial year continues?
“Grit and determination as staff knuckle down to do our best,” Suzie said. “The trust’s care didn’t work out as it should for my family so I of all people shouldn’t trust them – but I do.”
