Something different everyday (#DoingOurBit)

by Steve Brown

16 April 2020


Whatever we can do to help, it’s the Leeds way. That’s the attitude of Ben Roberts, assistant director of finance at The Leeds Teaching Hospitals NHS Trust, who has supplemented his financial role during the Covid-19 pandemic with daily work supporting the trust’s procurement and supplies team.

Mr Roberts (pictured) is effectively one of a few members of a 60-strong financial management team still onsite daily having moved more or less the whole team and other staff to home-working. This was a huge exercise that involved building a Microsoft Teams infrastructure with Manhei Chan (clinical service unit accountant) over a weekend and registering some 200 staff.Doing our bit_portrait

Most of financial services (accounts payable and accounts receivable) are also at home, and although the working from home solutions aren’t perfect, Mr Roberts says the teams are putting in a fantastic effort to make them work.

The only area within finance where the trust has been unable to provide a complete home working service is payroll. A third of this team is working from home, the remaining members of the team are still office-based but are using vacant finance offices to ensure a safe working environment.

Throughout the Covid-19 period, Mr Roberts says the payroll team has demonstrated high levels of resilience and an ability to adapt to change in a short period of time, and has continued to deliver a high quality payroll service under exceptional high pressure. Mr Roberts initially stayed on site as the IT lead for finance and to support the move to homeworking.

But along with many other colleagues, he has also taken on a role supporting procurement after some short training in materials management. While normal ordering of everyday supplies is still being done out on the wards, the trust has built a central store for personal protective equipment (PPE) – with separate operations at the St James and Leeds General Infirmary sites. ‘These are run by the procurement and supply team, but we collect orders and run them to the ward,’ says Mr Roberts.

The aim is to ensure the trust as a whole makes the most effective use of scarce resources and to avoid one part of the trust being short of key equipment while another area has surplus stock.

‘Under the system we are operating currently, a ward will ping in an email with a PPE request and 15 minutes later one of the team shows up with the bits they need,’ he says. ‘It saves them ordering more than they need right now. This gives us the opportunity to split a lot of the PPE down. Visors, for example, come in boxes of 200, but we hand them out in bags of 25. We might take two bags to a ward rather than them ordering a box, which could lead to a lot of waste in the system on a resource that is so precious at the moment.’

The trust is working closely with other local providers across the surrounding area including Bradford Teaching Hospitals NHS Foundation Trust and Calderdale and Huddersfield NHS Foundation Trust. The national supply of PPE is now using a push model with core supplies pushed out to trusts on a daily basis. The approach doesn’t always match supply with the demand of a specific hospital and the local trusts are working together to smooth out local surpluses and deficits in key PPE kit.

‘There is no typical day, I’m doing something different every day. One day I’m running kit to wards, then I might be making a trip to Bradford to pick up some particular masks that we are short of, and then working through stock adjustments on a video call in Teams in the van,’ says Mr Roberts.

‘Sometimes it is about helping the people who need headspace to think to have that time – so I can lug some boxes, while someone from the procurement team can spend some time looking at a  sample of equipment we may be able to purchase,’ he adds. ‘It is just about creating the capacity for people to keep doing these essential jobs. Having our guys in has made a massive difference in this area.’

It is a real team effort. For example, Mr Roberts says a number of colleagues spent Easter Sunday ringing suppliers to find gowns and other items of PPE that the trust was growing concerned about.

However financial duties continue. The team has met its normal timetable for month and year-end – achieving its working day one target for issuing budget statements. The financial management team is still providing support to its clinical service units. ‘Even in this environment, where it feels like it is just ‘needs must’ –  do what you need to do and order what you need – we still need to know that we are following good governance and still making sure the money we are spending is adding value,’ he says.

There are still demands placed on the team. Services will call wanting to purchase something. Or they might want to ensure new nurses and doctors, brought in after an early end to their final year of study, get paid and that there is a process in place for signing-off their hours. What has changed is the time taken to action these requests – with everybody working to a massively compressed timescale. It’s a mixture of working longer hours, working faster and eliminating steps in the process that can be avoided.

‘Teams just need to be on the case,’ says Mr Roberts, ‘ensuring there is good solid financial governance in place. At some point there will be a retrospective look at the decisions we’ve made and they need to stand up to scrutiny. We need to be taking good value-for-money decisions and not just making knee jerk reactions.’

Some processes have changed to reflect the emergency response. In other areas, business is carrying on as usual. Trauma theatres and cancer treatment are examples of services that need to keep running during the pandemic response and these clinical teams continue to need support. Decisions still need to be taken on a day-to-day basis, supported by financial information. Mr Roberts says that the NHS will return to normal at some point and the trust needs to be ready for that.

Until then, Mr Roberts will keep on his dual role. ‘I’ll keep showing up as long as I’m useful,’ he says.

 

If you have a story about how your finance team is delivering core services during the NHS response to Covid-19 – or how it is supporting frontline efforts in different ways – contact steve.brown@hfma.org.uk