As many of you will be aware, our system moved to a new ambulance offload process in November 2023 in response to significant handover delays and risk to patients waiting in the community for emergency care if an ambulance was unable to reach them in a timely way.

The change has made considerable improvements to delays and has reduced risk in the local community. This has been testament to the commitment of staff across our providers to make this happen.

This new process, coupled with challenges around discharge and increased demand has meant that our hospitals are experiencing considerable pressure on beds. This has meant that some people are being cared for in escalation areas and corridors and I recognise how difficult it is for patients and staff too.

Staff are working hard to support patients, relatives and colleagues and ensuring only the most appropriate patients receive care in these areas in the safest way possible. They are only being used if there is absolutely no other alternative, with efforts being made to ensure privacy and dignity.

To help relieve the huge pressure on beds we really must focus on timely, safe and appropriate discharge, to improve patient outcomes and deliver the best care for our communities. Everyone has a part to play in thinking how individuals can be safely discharged once their care is optimised.

We’ve also been seeing the usual seasonal pressures associated with Norovirus and Influenza outbreaks and Trust Infection Prevention and Control (IPAC) teams have been providing oversight and support to clinical teams to keep disruption to a minimum.

Teams have worked hard to ensure IPAC issues have a minimal impact on the management of beds and the Integrated Care Board (ICB) has been supporting to ensure consistency of process, communication and to share best practice and learning.

The ICB’s IPAC team joined teams across the county to showcase two innovative system initiatives at NHS England’s East Region Nursing and Midwifery Sustainability Conference (pictured above) held in Newmarket earlier this month.

Firstly, the Care Home Hydration Pilot which aimed to reduce the incidence of dehydration and related infection, and secondly the Glove Reduction Programme which looks at the safe and sustainable reduction of single-use gloves.

I’m also proud to announce that I’ve recently committed to become the Executive Lead for Down Syndrome, championing opportunities for around 800 people living with the condition in our system.

I’ve been working very closely with the Down Syndrome Organisation as we prepare for the launch of the National Down Syndrome Policy to support the Down Syndrome Act 2022.

We’ve been busy scoping training options, clinical pathways and models, and how to promote this work widely across the system. Our aim is to find ways we can all support people with Down Syndrome in our work.

I’d like to thank Bertone Santos Socorro, our Learning Disability and Autism Senior Programme Manager who has been supporting with this important work.

This month we had a fantastic time raising awareness during Neurodiversity Celebration Week (18 – 24 March) which included a bake sale raising £210 and many people signing up to free webinars to learn more.

I’d like to wish everyone who celebrates a very fantastic Easter. I hope you have some time in the coming weeks to reset and spend time doing things that you enjoy. I’ve been trying to get outside to enjoy the rare sunshine (despite the temperature not always been too warm!), bring on summer.

Kind regards,

Tricia D’Orsi

Executive Director of Nursing

NHS Norfolk and Waveney Integrated Care System