Back to the frontline

Allison Williams reflects on her return to the NHS frontline.

I must admit that when I was driving up the A470 in the howling wind and rain to work as a healthcare assistant at the Emergency department in Prince Charles Hospital I was absolutely terrified. My doubts had nothing to do with the weather – it was more that I hadn’t worked as a nurse on the wards for nearly 25 years! I was worried what the staff would think of me, how they would react to me working beside them, and how I would cope.

But working beside colleagues, rather than simply visiting or shadowing them, was exactly my intention earlier this year when I made a pledge as part of NHS Change Day that my entire Executive team would go back to the frontline to do a full shift in a variety of roles to learn more about the challenges our staff face every day. The aim was to generate meaningful feedback, build relationships and make tangible improvements to our patients’ care and experience.

As soon as I walked into the Emergency department with Sister Pam Parsons I was transported back to my late teenage years and strong memories of what motivated me to become a nurse. As a chief executive the responsibility I feel for our patients is huge but it’s easy to forget how truly privileged you are to be able to directly support and care for people when they are at their most vulnerable.

In the midst of an increasingly hi-tech environment it’s the simple things that still have the most impact – holding someone’s hand; a kind word, or making someone a cup of tea are all priceless. I witnessed it many times that day and had the good fortune once again to play my own part in it.

In Cwm Taf we run two district general hospitals – Prince Charles Hospital in Merthyr Tydfil and the Royal Glamorgan Hospital in Llantrisant– as well as four community hospitals and a University Health Park – the only one of its kind in Wales which has integrated health and social care services under one roof.

We are one of the smallest health boards but care for some of the most deprived communities in Wales with some of the highest rates of ill health.

With a workforce of almost 8,000 in Cwm Taf alone NHS Wales is a vast organisation where staff engagement is challenging, but also a vitally important part of the role of Boards and senior managers. Our staff are our local community too, and it’s crucial they feel involved, respected and valued.

Porters for instance are rarely in the limelight but without them we couldn’t run our hospitals. Our Corporate director Robert Williams, who started his own NHS career as a porter 30 years ago, did his frontline shift with the team at Royal Glamorgan Hospital. He was reminded how they are often the first to comfort patients and their families after a bereavement, or provide the reassurance that is so important before an operation.

Our philosophy as a health board is Cwm Taf Cares, which is embedded in how we support staff to look after themselves, to enable them to care for our patients.

The challenges facing the NHS in Wales are well-rehearsed and they are here to stay. The solution lies in facing those challenges by doing things differently, and that is what we are doing in Cwm Taf.

Challenging what we do every day is vital to achieving high standards and we believe that the good relationships we have built both inside and outside of our organisation are the key to motivating our people to strive for excellence. Connecting with our staff, building trust and working in partnership with our local communities is how we will achieve that.

Our Back to the Frontline initiative involved shifts across our hospitals and community settings including in catering, physiotherapy, mental health and a GP practice.  Many of the suggested changes have been simple and fairly inexpensive such as new calling screens for the A&E departments, less duplication of data, replacement of broken equipment or simply more visits from senior managers to see the frontline.

Our porters’ request was a humbling one. They wanted a newly concreted path to the mortuary to ensure patients and families are afforded as much dignity as possible on their final journey. We are ensuring that this is done as soon as possible.

It promises to be another challenging year for NHS Wales – but challenges also pose opportunities – and if we have our staff on our side we can embrace them together.

Allison Williams is Chief Executive of Cwm Taf Health Board.

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