Chief Executive Fortnightly Blog to NHS Orkney Staff - 3 July 2023

Message for All NHS Orkney Staff

Celebrating 75 years of our wonderful NHS

Good morning Team Orkney

This Wednesday (5 July) marks the 75th anniversary of our NHS. Milestones and occasions such as this prompt us to look back and reflect on how far we have come and also look to the future.

In recent years alone, we have opened our state-of-the-art hospital The Balfour, responded superbly to the pandemic, begun the early stages of digitising our health and care system and seen the integration of health and care in Orkney so that we can ensure more seamless pathways of care and services for our patients.

The NHS has always faced challenges – it did in 1948 when it was founded and it faces new changes today.

My experience of working in the NHS for the last two decades is that somehow, often against all odds, the NHS always seems to find a way – and that’s because of the people – you.

The NHS is great in responsive mode and reacting to issues and challenges (that’s what we do best) – and now we need to shift to proactive mode and do both proactive and reactive mode equally as well so we strike the balance between dealing with today’s problems whilst looking to the years to come to make sure our health and care services are fit for the future for the local population we serve in Orkney.

So just like in 1948, just like in any year in the last 75, the NHS faces challenges now and NHS Orkney is no different.

For Orkney – the challenges include:

• A growing and ageing population – and more patients presenting with multiple long-term conditions and complex health and social care needs. We are forecasting a 30% increase in people over the age of 65 in Orkney (2023-2035) and double the number of people over 85

• Widening the health inequality gap as a result of COVID, and addressing the pockets of deprivation we know exist

• Workforce fragility and shortages in key areas – including an ageing workforce (Nursing and Midwifery) and unstable locum medical workforce (inability to recruit to several posts requires an innovative approach to collaboration)

• Higher than average staff sickness absence and an outlier for long-term sickness rates, with a worsening position post pandemic

• Problems with the wider social care system impacting flow through and out of The Balfour (delayed discharges impacts on 20% of our total bed base)

• The need to invest in and focus on improving staff engagement/morale and in turn your experience of working here

• Fragile services – including Pain Services, Ophthalmology, Dentistry

• Bureaucracy, overcomplicated processes and information flow

• Lack of leadership stability and creating a culture where we lead with compassion and kindness

• Transport (lack of national investment)

• Housing availability, which impacts adversely on recruitment and retention

Part of responding well to challenges is knowing our issues. At NHS Orkney we know our challenges and we are now well on the way to developing plans to address these in the short, medium and longer-term.

When creating the NHS, 75 years ago on 5 July, Nye Bevan said: “Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune, the cost of which should be shared by the community”. And ever since, an NHS – free at the point of use – has been the cornerstone of our society.

So a big thank you for your continued hard work and for making a real difference for patients and our local community. Our job will never be done because our job collectively is to ensure we create a culture where we continuously improve (which is an ongoing cycle where we listen to and act on patient and staff feedback and learn from our mistakes), but what is most rewarding about what we do is knowing that by working together as Team Orkney, we can make a positive difference to so many.

As we enter a new chapter at NHS Orkney – we will refocus again with a refreshed energy and with optimism and address our challenges together as Team Orkney.

In conclusion - history of the NHS is one of challenge. It was there on day one. It’s here today, almost 75 years on. It will be here tomorrow, next year, and on the 85th anniversary too.

But what successes, too, including for NHS Orkney – of which we should be proud.

I consider it the biggest privilege to be your CEO and serve this wonderful local community – and I can honestly say that I am as motivated (if not more motivated) today as I was 20 years ago when I joined the NHS in my first role at University Hospitals of Leicester NHS Trust.

There is no better place to work, even on the most frustrating of days, knowing that we have an important role to play in making a positive difference and changing the lives of others for the better.

Happy 75th anniversary NHS and thanks for everything Team Orkney.

Laura Skaife-Knight

Chief Executive