Meet the new boss at Preston and Chorley hospitals as he prepares for winter
The man who has just taken charge of the Royal Preston and Chorley and South Ribble Hospital says that the pandemic has resulted in closer relationships being forged between the NHS and the local authorities that deliver social care – to the benefit of the patient.
Kevin McGee, the new chief executive of Lancashire Teaching Hospitals NHS Foundation Trust (LTH), told the Post that he believed a “breaking down of the barriers” between the two services was one of the few positives to come out of the Covid crisis.
Closer integration of health and social care has been a long-held goal at a local and national level, with the most significant strides being taken in the years before the pandemic struck.
In Lancashire, that involved initiatives such as “Home First” – which saw health and social care teams co-operate to ensure that patients were discharged from hospital as soon as they were medically fit to leave. They were then assessed in their own homes for any support they would need from the county council rather than having to remain in hospital until that assessment was carried out.
Far from being derailed by the pressures of the pandemic, Mr. McGee says that such co-operation has been enhanced by it – putting patients at the heart of what are sometimes complex processes.
“If you’re a patient, you don’t care whether it’s health or social care [doing the work], you just want your needs looked after – you want to be safe and you want to be at home if you can.
It’s about how we try and reduce the bureaucracy [at the point at which] patients are discharged between health and social care.
“You only want patients in hospital who actually need to be there – hospitals are not the best places to be, you can pick up infections and, particularly if elderly people are in hospital for too long, they can start to lose mobility.
“The Central Lancashire system – the trust, primary care, community services and local government colleagues – do work well together.
“I think that will be tested – both the relationships and our resources – as we go through this winter. But we’re probably in a stronger place now than we’ve ever been because of those relationships and what we’ve built up through the pandemic.”
Mr. McGee – who was previously chief executive of East Lancashire Hospitals Trust from 2014 and then also jointly took on Blackpool Teaching Hospitals two years ago – says that the challenge of another Covid winter, along with the demand to reduce waiting lists for pre-planned procedures, is his most pressing priority.
Preparations for those twin pressures are already under way – including a recruitment drive for nurses from both home and abroad and an expansion of critical care and other capacity.
"I think it's going to be a really busy winter for the NHS, because we've got an endemic level of Covid activity and it's never really gone away, particularly in Lancashire and Central Lancashire," he said.
As the Post reported earlier this year, Mr. McGee told a meeting of the Lancashire and South Cumbria integrated care system board that the NHS in Lancashire could eventually adopt shared waiting lists – something which he now says he believes will happen and “is right”.
“Why should somebody in Preston wait, say, six months for an operation and somebody elsewhere wait three months or vice versa? We need to give people the opportunity with the capacity that we’ve got…[for] a fair choice and a fair chance.”
Mr. McGee also says that financial and operational considerations could result in some specialist procedures being carried out in only “one or two locations” in Lancashire.
“There is no doubt that the more you do a procedure and the more you centralise the capacity and capability of the workforce, the better your clinical outcomes.
“But with [some] other services, we actually want to take them closer to the community. If you think about some of the long-term conditions, you want to have that care as close to the patient and as close to the communities as possible – for instance, with COPD or diabetes, you want to keep them [as] very local services.
“If you needed a hip replacement or cataract [removing], you would want to go to the place that gives you the best clinical outcomes and where you can get the quickest care.”
Mr. McGee says that the pandemic has already laid the groundwork for such collaboration between different parts of the NHS, which have historically been in competition with each other.
“There were times last winter in LTH when we didn’t have enough critical care capacity, so some of our patients went elsewhere and [at times] vice versa.
“Now we’re looking at how we restore activity, patients are moving around the system, where they can, to get the shortest wait and the trusts are supportive of one another. Staff are moving between organisations more – that would never have happened pre-pandemic.”
Meanwhile, he also pays tribute to a “tired workforce” at LTH and throughout the NHS for their efforts over the last 18 months.
“A massive thank you – we can’t say it enough, The staff are magnificent and have worked incredibly hard – and there has been no respite.
“Coronavirus hasn’t gone away, it will be with us going into winter and it will probably be with us endemic in our communities – so I’d encourage everyone to get their vaccinations to really support [hospital] staff.”
Like his predecessor, Karen Partington, Mr. McGee denies having any preference for either a new like-for-like Royal Preston or the creation of a so-called “super hospital” to replace Preston and Lancaster hospitals – both of which are options under consideration as part of the New Hospitals Programme, which is currently developing a pitch for government funding.
“It’ll be based on what we can afford, what we think will [deliver] the best clinical outcomes and also the feedback that we get through our local communities.
“It’s too early at this stage to say which will be the best option – but it’s a chance to really right-size health facilities for the next generation, so it’s an opportunity we really need to grasp.”