I felt a huge burden of expectation on my shoulders before I’d even set foot in my office at Basildon university hospital for the first time.
17 September 2012 was the date. I don’t think I was the only person who had made a note of it in their diary.
Hospital staff, patients, our regulators, and our MPs were all watching closely to see whether this would be the beginning of a new, positive chapter. They were desperate in the hope that a new chief executive, and a new board, would be able to make a difference to an organisation which had been in the spotlight for so long, and for all the wrong reasons.
But with this weight of expectation, I sensed an enormous opportunity. What I found was that people were willing to invest their support in me – they wanted the hospital to succeed.
What we needed to do very quickly was to give people something to be optimistic about, some concrete evidence that things were about to change.
We did this for patients, and particularly complainants, by talking to them – and listening. We needed to do the same for local politicians.
One of my first meetings was in Westminster, organised so that I could listen to what our local MPs had to say. Sitting alongside Ian Luder, my new chairman, I heard about an organisation in denial, unwilling to accept that it had been failing its patients. Not unreasonably, our MPs wanted significant change and real accountability. And they wanted to see true leadership.
On the whole, the MPs supported our vision. We went on the front foot, opening our doors to them, and inviting them to see first hand some of the improvements we were making, whilst being realistic that dramatic change was not going to happen overnight. We asked them to come to open new facilities, launch new services and appear on hospital radio. I gave them my mobile phone number so that they would have direct access should any issues arise.
We made sure they received all of our press releases and were alerted to bad news in advance so that they didn’t hear about things in the media first.
When reports were published about the performance of Basildon hospital, I called our local MPs personally in advance to talk through the headlines. I did the same on the day we were put into special measures as part of the Keogh review into failing hospitals.
Openness, honesty and transparency needed to be at the heart of everything we did. Not just in our dealings with politicians, but in our relationships with regulators and our local partners in the health service. One of our main objectives was to better manage the politics of the local health economy too.
We were still accountable to our regulators and needed to win back their confidence.
To do that, we had to live up to our promises – if we said we were going to do something by a particular time or date, we needed to do it, whether that involved us sharing good or bad news.
We put a lot of focus on achieving the deadlines we were set – for reports, performance updates or ministerial queries – and responding to requests from the system, which were various and multiple.
Our poor historical performance meant we were in no position to be obstructive or tardy – we needed to deliver on requests from our regulators if we were to show them we were serious about turning things around.
In a short space of time we built strong working relationships with the Care Quality Commission (CQC), Monitor, and our local clinical commissioning groups (CCGs). We used their expertise to help us improve care for patients.
Regular communication and delivering on, or ahead of, deadline built confidence and trust. This was reflected in the shift we experienced – from being challenged to being supported.
Soon Basildon and Brentwood CCG was conducting informal, unannounced inspections to help us test our performance. This was – and still is – an immensely useful part of our improvement process. Our hospital is certainly heading in the right direction: in June this year we were the first to be taken out of special measures after being rated “good” by the CQC. For the first time in a very long time, we are operating without any regulatory intervention.
If we can maintain strong relationships with our critical friends, I am confident we can keep it that way.
Clare Panniker is chief executive of Basildon and Thurrock university hospitals NHS foundation trust. The trust was under scrutiny in 2012 from healthcare regulators and politicians due to high mortality rates and poor A&E performance. She will be speaking at the Foundation Trust Network annual conference on 18-19 November
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