CARAGH Merrick is under no illusions of the size of the task facing Worcestershire Acute Hospitals NHS Trust, but by the same token she is already putting together a strategy to put it back on the road to recovery.
In post since September 12, if the new chair of WAHT is fazed by the trust’s £59 million debt, it’s Care Quality Commission special measures status or its history of consistently missing a sleight of Government set targets, she doesn’t show it.
Instead the Belfast-born former accountant- she describes herself as a child of The Troubles – gives off a positive can-do air overlaying a steely determination and she is quick to praise the people who work at the Trust.
“What struck me most on coming here is that we have wonderful staff who do their very best, despite sometimes difficult operational conditions, and I believe the issues we have here are eminently fixable,” said Ms Merrick, who lives in Worcester.
Against a backdrop of an ageing population, those issues boil down largely to two – patients fit to leave the acute service with nowhere to go to continue their rehabilitation. This creates a problem at the front door of Accident and Emergency where as a result there are no beds available to admit patients, so they end up waiting on trolleys in the corridor: “I know what it’s like – I was in those corridors with my elderly mother,” says Ms Merrick.
The solution is multi-faceted but includes a new fast referral centre for GPs so their patients are seen early and pass quickly through A&E, coupled with a new patient discharge lounge, modeled on the successful one at the Alexandra Hospital in Redditch.
Here patients can wait in comfort before going home or moving to their next destination. This is backed up by a new ‘Evergreen’ ward run by GPs to further patient rehabilitation – and free more acute beds.
A further innovation is putting an emphasis on paediatric expertise so children can be quickly seen and treated without necessarily being admitted overnight.
The benefit of freeing up beds should be felt throughout the Trust: “We have challenging (Government) targets and we want to bring our waiting lists down – when you need a hip replacement 18 weeks, which is the target, can seem a very long time – it’s all about focusing on what the patient needs,” said Ms Merrick.
The second issue facing the Trust is its £59 million debt: “Fifty per cent of it is something we can tackle operationally through patient flow, getting waiting lists down, reducing agency staff and so on and I’m confident where we can find those operational improvements.
“The other 50 per cent requires us doing something a bit more strategic and there are things we can do with commissioners and I don’t believe it would be impossible, although getting to break even is a big ask,” she said.
This would involve “making sure the assets we have are used to their capacity.”
She won’t be drawn, but an example could be by cashing in on ‘9 to 5′ facilities by renting them out of hours to private providers or doctors’ practices, earning money for the Trust and maximising use of a building.
Given the dispersed nature of Worcestershire’s population of close to 600,000 she emphasises the Trust is offering a county-wide service, served by staff on county-wide contracts, which inevitably may mean some patients criss-crossing that county for operations.
However she is hopeful that a new ‘hopper’ bus service – possibly paid for by a philanthropist, but offering a heavily subsidised fare – would ease travel problems and talks of setting up a 90 day trial in the near future to gauge public response.
Elsewhere she expects to have a new chief executive in place by the end of November with a ‘really effective board’ ready in January.
“This is my local trust and both my parents were cared for here,” said Ms Merrick, who moved to Worcester in 1985, “I took this job because of the patient and the needs of the patient and I will not exclude anything if the patient needs are served and the patient benefits.”