A new vision for health and care – Blog by Caroline Donovan, CEO @CombinedNHS

Hi all… it’s been another week of challenges and developments… as they ALL seem to be at the moment!

Caroline Donovan CEO Web


Last Thursday, I was one of a number of health and care leaders who came together with the Care Quality Commission (CQC) to discuss the challenges we face and how we are rising to that challenge. The CQC was giving us its findings following a review of health and social care in Stoke-on-Trent. This report is one of 20 targeted local system reviews looking specifically at how older people move through the health and social care system, with a focus on how services work together.

The CQC found that older people living in Stoke-on-Trent sometimes have poor experiences of care and do not always have access to the right care, in the right place at the right time. It also found there was a need to develop an agreed, shared vision of how we can improve things. The challenges the CQC highlighted are not new to us and include:

  • People finding it difficult to access a GP appointment in a timely way and, as a consequence many people going straight to A&E or were referred to A&E by their GP.
  • Older people sometimes having poor quality experiences when they were admitted to hospital, including long waits in A&E before being admitted to a ward that met their needs.
  • Older people being delayed in hospital after they were ready to return home or move to a new care setting.
  • People’s needs and care packages in the community not being reviewed as regularly as they could be.

The CQC also said  it is encouraging there are some leaders working in the local system who have a clear understanding of the challenges that the system faces and are committed to transforming services for people by working in more of a joined up way.

As you will know we have been proud to be supporting the development of the North Staffordshire GP Federation and the North Staffordshire and Stoke-on-Trent Alliance Board. At the meeting and in our official collective statement in response to the CQC Report, I made clear our commitment to helping urgently implement through the Alliance Board a new vision that recognises the crucial role of GPs, primary care and the voluntary sector working alongside health and social care moving to integrated services across North Staffordshire and Stoke-on-Trent.

It was particularly heartening the CQC specifically singled out the Meir Partnership Care Hub as an award-winning example of the types of partnerships and joined-up services they wish to see. This is an Alliance initiative in which we have played a full part and of which we are very proud.  It was great to see it get the recognition it deserves – well done!


One of the initiatives our Director of Nursing and Quality, Maria Nelligan, has been championing is the use of video patient stories at our Trust Board meetings. These can often have much greater impact than a written report or summary. Our first video patient story featured at last week’s Board meeting and I found it really powerful.

The story featured a young service user who has been helped over a number of years by a range of our services, starting with the Community CAMHS Team and moving through the Darwin Centre, Ward 3 at Harplands and now Summers View. The young person explained how she had found moving from a children’s setting to adult particularly challenging and gave her thanks to a whole host of frontline staff who had helped her on her journey of recovery. It was truly humbling to hear how much she had been through and how much our fantastic staff had understood and supported her every step of the way.

The Board congratulated Carol Sylvester and Dr Pernia Arshad on their retirement. Both have given years of service to Combined and are truly fabulous examples of NHS professionals. Maria even surprised Carol by giving her one of our new Nursing Badges! We were also delighted to recognise with Individual REACH Awards the fantastic contributions made to the Trust by our Chief Information Officer, Dave Hewitt and Emma Mellor from our HR team. Both Dave and Emma had had a fantastic impact on the Trust’s continuing journey of improvement. Well done to both of you!

Having introduced the REACH Awards to the Trust a few years ago, it’s been really rewarding to see them grow year on year – both at the Board and the annual awards ceremony – and it’s a great way to show our staff how much we appreciate all they do. ​You can download my CEO Board Report here.


This week is NHS Fab Change Week (13-17 November), which gives frontline staff from all over the NHS the opportunity simply to make a pledge to do something better and to showcase great ideas and initiatives.

Growing out of the original NHS Change Day, we’re big supporters of Fab Change Week and we’ll be putting on a big show for it. On Wednesday (15 November), I’m looking forward to welcoming back to the Trust an old friend of ours, Roy Lilley. Roy is well known as an NHS commentator and champion of innovation and it will be great to see him again.

We’ve been counting down the days to Fab Change Week via our Twitter account @CombinedNHS. We will be holding a special event from 10am-3pm on Wednesday at Harplands and are hoping that more staff and teams than ever will get involved by:

  • Showcasing their change with a visually dazzling stand on the day.
  • Sending a write up about any positive changes teams have made – along with a selfie of the team or people it’s impacted on.
  • Making pledges in areas of work throughout Fab Change Week and adding them to the national website at https://fabnhsstuff.net/fabchangeweek/ to showcase to other organisations the wonderful changes Combined is making.
  • Popping along throughout the event to hear about other team’s changes and to make a personal pledge of change.
  • One of the biggest areas of change this year has been in the launch of ROSE, our new Electronic Patient Record and the event will feature a number of ROSE-related activities showcasing the excellent work that has taken place.