Executive Medical Director Blog: January 2025 – Dr Frankie Swords

31st January 2025

As the weather remains cold but the evenings begin to lighten, I want to take a moment to reflect – the past few weeks, especially over the festive period, have been incredibly challenging, yet we are seeing improvements in performance thanks to your hard work and dedication. Thank you to everyone for your efforts during this difficult time.

Looking ahead at 2025

2025 is here and there are several positive developments for local health and care services. Early this year, we’ll see the opening of:

  • The Willows Therapy Unit at NCHC which will support patients who don’t need hospital care but need help before going home.
  • The Rivers Centre Wards at Hellesdon Hospital which has increased inpatient mental health beds in Norfolk and Waveney – it started welcoming its first patients on 20 January.
  • The Community Diagnostic Centre or CDC, at the Norfolk and Norwich University Hospital. This follows the recent opening of the CDCs at the Queen Elizabeth Hospital, James Paget Hospital and the Northgate sites and will further expand our capacity to perform scans and other tests to speed up diagnoses and treatment of cancer and other conditions.

While these investments in facilities are exciting, we are also focusing on improving services and anticipating significant innovations throughout 2025.

However, financial challenges remain very difficult, not just locally but nationwide. So, alongside investments and innovations, we will likely face tough decisions.

Looking ahead at 2025/26 and beyond, we know finances will be tight for us and our partners across the public and voluntary sectors. The scale of the challenge is immense, with the ICB needing to save over £160m in 2025/26.

Several factors are straining our finances:

  • Inflation has resulted in higher costs for equipment and supplies.
  • We’re still experiencing legacy effects of the pandemic treating the backlog of patients who missed care during COVID-19.
  • With a larger proportion of older residents in Norfolk and Waveney, the demand for care in our aging population is greater and growing faster than in most other systems.

Despite efforts to improve productivity, the gap between funding and costs continues to grow, necessitating a reset for sustainability.

We will always seek efficiencies that don’t impact services, but given the scale of savings needed, I’m afraid that some service changes are unavoidable. Some of the changes will be hard, but necessity also breeds innovation and improvements too.

We expect our financial allocation and planning guidance in the coming weeks and will be working with stakeholders and providers as we assess the implications.

I encourage you all, as clinicians who know your services inside out, to help identify areas where we could improve or maintain care while also saving money or improving productivity. If you have ideas on how we can save money while protecting services, please reach out and share your suggestions. Your input is invaluable as we navigate these challenges together.

On the Frontline of the UK’s Corridor Care Crisis

We have done a massive amount of work over the last year, to speed up the handover of patients from ambulances to our emergency departments, and this means that overall, ambulances are able to respond much more quickly to emergencies in our community.

However, when the number of people being discharged does not keep up with the number of people arriving and needing to be admitted to our hospitals, we do still use temporary escalation spaces including corridor care. This is an emergency response which we have called on in times of crisis but should absolutely not become normalised. 

I encourage everyone to take the time to read the Royal College of Nursing’s (RCN) newly published report, On the Frontline of the UK’s Corridor Care Crisis. Released this month, the report shines a light on the issue of corridor care across the UK, as revealed by thousands of nursing staff who responded to a survey at the end of December. Their raw, unedited, and often heart-breaking accounts capture the daily struggles and emotional toll of delivering care in overcrowded and under-resourced conditions.

This report is a powerful reminder of the urgent need minimise or better still prevent the use of these spaces completely.  Thank you for your ongoing work to support people to stay well at home, to avoid hospital admission in the first place, and to help people who do need an emergency admission to be discharged as soon as it is appropriate for them.

Closer Collaboration Across Acute Hospitals

From April, our three acute hospital trusts will begin working more closely under a group model. This collaboration aims to streamline processes, reduce variation in care pathways, and strengthen our workforce. By moving towards a “one team” approach across three organisations, we can address challenges in areas where small teams have struggled to provide sustainable services. This unified model has the potential to create a more robust and resilient system for patients and staff alike.

Leadership Changes and Stewardship Roles

With most specialty advisor roles concluding in March/April, new stewardship roles will soon be advertised. We have surveyed the previous post holders and used this feedback, as well as best practice from other systems to change our approach. The new stewardship roles will be different in several ways: 

  1. Fewer roles overall but with most having an increased number of sessions for greater efficiency and impact.
  2. Each steward will oversee a broader area of clinical care, for increased flexibility.
  3. Stewards will be expected to coordinate multiple stakeholders and bring in relevant expertise as needed, rather than being the subject matter expert themselves in every area.
  4. The stewards will be permanent rather than fixed term positions to allow for long-term investment and integration into the ICB team.

These changes aim to provide stability, foster leadership development, and create a more cohesive system of support The advertisements are expected to go live in the first week of February with interviews planned within then next few weeks.

Help us build a ‘Collective Culture’ for health and care colleagues across Norfolk and Waveney

Norfolk and Waveney Integrated Care System (ICS) is taking an important step towards building a stronger, more supportive culture across Norfolk and Waveney.

As a system, we want to create a restorative and just culture where every member of staff feels valued and supported, and where we can learn and grow together.

To begin this work, we are holding three workshops in February which aim to:

  • Promote compassionate, emotionally intelligent leadership across the ICS.
  • Build trust and psychological safety within teams.
  • Support the retention and wellbeing of our valued workforce.

Following the workshops, we are launching a Community of Practice – a space where colleagues from across our ICS can work together, share ideas and learn from one another. This will be a key part of embedding these changes into our daily work and strengthening relationships across the system.

I hope you will join us at a workshop. I know winter is a busy and challenging time and while we are mindful of these pressures, this work is essential to building a supportive culture for everyone.

For more information and to book your place at a workshop, please use the links below:

Thank you for your ongoing commitment and contributions. Again, if you have thoughts or ideas to help shape our work, please don’t hesitate to reach out.

Best wishes,

Frankie