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James Thomas

James Thomas
Chief Operating Officer


Suzanne has allowed me to use her message this week to relaunch our Making Every Day Count programme.

Many of you will be aware that our urgent care service has been under sustained pressure. This winter has seen record numbers of patients attending our Emergency Department and patients requiring admission.

Winter pressure is usually abated by May. We are now in July and we are still experiencing the same level of pressure. This has been constant since the New Year. And we are not alone. Nationally the last three consecutive Mondays were the busiest days the NHS has ever experienced in terms of A&E attendances in June.

Many of you will have felt this pressure directly. We have used escalation areas (clinical areas not usually used for in-patients), outliers across the hospital (such as medical patients using surgical beds) and added temporary extra beds to wards. However, we know that this pressure results in some patients experiencing care that is not in line with our Patients First approach. Patients waiting overnight in the Emergency Department, and those cared for outside the specialist ward most appropriate for their care, are being affected the most. Colleagues are feeling the pressure too as providing care of the highest level is challenging.


We have to recognise that demand for emergency care is not reducing. I have been working with operational and clinical teams to increase capacity and work in new ways. We have opened additional beds and have a plan for two further wards to open at St Peter’s around Christmas time. More detail on these changes will follow in the next few weeks. However, opening more beds is challenging both in terms of cost and, even more significantly, the difficultly in recruiting clinicians during a time of national shortage. To support teams to provide the best patient care, we are renewing our commitment to the Making Every Day Count programme to ensure each day a patient spends with us adds real value to their care and recovery, and that all of our patients receive the care they require without delay as stated in our vision. This will also encompass our urgent care recovery programme.

We know we can’t carry on doing what we have always done. And we need additional expertise to help us manage the changes we have to make. In response we have engaged a company specialising in supporting NHS organisations dealing with the challenges we face. This team of specialists will work alongside us and form the core of our new Making Every Day Count Programme Office. Bringing expertise from working with other NHS hospitals, the team will support colleagues and provide additional capacity to focus on pathways of care.


The team starts with us on Monday 15 July for six months specifically looking at:

  • Non-elective admission - focusing on patient flow within and from ED to speciality teams, assessment areas and how patient flow to appropriate beds can be optimised
  • Optimising the flow of patients through the Trust - making each inpatient day count, and optimising how services communicate and respond effectively to support inpatients without delay
  • Patient discharge - improving the way we provide effective discharge from patients going home without support to the most complex, who need ongoing significant input from many other agencies.


We are optimistic about the impact of this work and having support from a team of experts in taking forward Making Every Day Count, and our urgent care recovery programme. This is essential to improving our current challenges and ensures we are in a robust position for the coming winter. This will be an opportunity for many of staff involved in identifying the changes we need to make and ensuring they are sustainably implemented and the best care delivered to patients.

With very best wishes,

James Thomas
Chief Operating Officer


Chief Executive's Message

On a regular basis, our Chief Executive sends a message to staff about events at the hospitals, special achievements, and plans for the future.

We shall be adding them to this section as well as including them on our Twitter and Facebook pages.

From time to time, we shall ask other members of the Trust Board and clinical team to give their perspective on the week in our hospitals.