BHRUT boss on addressing A&E waits, alleged bullying and trust's finances
- Credit: Ellie Hoskins
"If there were quick fixes and easy fixes here, one of the previous 14 chief execs would have found them and made them work."
That was the message from Matthew Trainer, who is the latest chief executive of Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT), which cares for east London patients at Queen's and King George Hospitals.
The trust is facing a winter set to bring Covid and flu pressures, a multi-million pound financial deficit and below target emergency waiting times.
Queen's Hospital has also seen its maternity unit downgraded by the Care Quality Commission (CQC), which found an alleged culture of "bullying" in the department.
Mr Trainer addressed these issues in a wide-ranging interview with this paper.
From his office at Queen's, he admitted it would be a tough winter for the trust but believed it had plans in place to cope.
These include the construction of a £7.5m critical care unit at the Romford hospital.
One of his biggest priorities is dealing with A&E waiting times.
The target is for 95 per cent of patients to be admitted or discharged within four hours - the trust's latest figures for July showed it was at 64.5 per cent.
Mr Trainer said: "I know that if you're a local resident and you come to A&E, I know people are waiting longer than they should.
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"What we're trying to do is make sure those who are sickest are getting care as quickly as we possibly can."
Plans centre around taking patients out of the ED, with investment in 30 short-stay acute medicine beds, same-day emergency care for the likes of heart and pregnancy conditions and the permanent introduction of a frailty unit for elderly patients.
Mr Trainer joined BHRUT after three years as boss of Oxleas NHS trust, which serves south east London and parts of Kent.
He also helped to run London's Nightingale Hospital at the ExCeL and has worked for NHS England and the CQC.
"It's going to take a while - this stuff is not easy," he admitted.
"In my last trust, I was the third chief exec in 20 years - I'm the 15th chief exec in 20 years here.
"If you have that sort of leadership turnover, it makes it hard for people to make plans that are going to take two years to see through.
"We're going to do this properly, stage by stage, and build in the changes we need to make."
Another issue on the trust boss' agenda is addressing criticism from CQC inspectors of an alleged bullying culture in the maternity unit at Queen's.
The regulatory body made the damning conclusions in a report in which it downgraded the department to "requires improvement".
Mr Trainer said the trust is working to change the culture of the maternity team and make it an environment where staff can speak up about care concerns.
He also believed increasing staff levels would help to address the issue.
"Sometimes some of the bullying culture comes about because if you've got two very busy teams who don't have enough space and resources, they're asking each other for help.
"If you're doing that in the context where you're too busy, you're stressed all the time, you're anxious and worried about your patients, quite often those relationships can become fraught very quickly."
On top of this, the trust is facing a yearly budget deficit of more than £70million.
It has identified £20m it can save through cutting its spend on agency staff.
Mr Trainer felt the choice of different hospitals in east London and Essex had driven up costs.
"I don't mind paying staff well, I don't mind paying surgeons very well because the stuff they do is really incredible.
"I'll pay very skilled doctors and nurses very well. But I'd rather pay permanent members of staff.
"Sometimes we have an unfair situation where we've got a permanent member of staff and an agency member of staff and the agency member of staff is getting 30pc more."
Extra government cash has helped BHRUT invest in facilities, which Mr Trainer felt was needed because it was "underfunded" before the pandemic.
"A combination of the extra investment and the efficiencies we can make, I think we can improve the quality of care here while also pulling our resources into position."
His first experience of Queen's was inspecting it for CQC in 2012.
Now in charge, he is loving the responsibility, he said.
"If you've got great colleagues and you're given the resources to do your job properly, people can thrive."