The first year as Medical Director – one like no other!

When taking up his new position as Medical Director at Doncaster and Bassetlaw Teaching Hospitals (DBTH) in March 2020, Dr Tim Noble expected a period of finding his feet within the role, little did he know he was about to experience a real baptism of fire.

As COVID-19 developed into a global pandemic, the impact on the Trust and its local communities became more evident and the pace and scale at which the Trust responded escalated rapidly. New in post, Dr Noble had to grapple with the demands of his position, as well as help to lead the organisation during a once in a century health crisis.

The respiratory doctor shares his reflections of his first year in post: “I’m really proud of how swiftly the NHS as a whole responded to the pandemic. We transformed some of the ways we deliver care in a way we have never done before. As an organisation in the first wave I think we were ahead of the curve in making some of those changes, working well with our partners in health and social care, which served us, and our populations well – which is what we are here to do.

“Obviously the nature of making changes and decisions at such speed means you have to keep reviewing those changes. I can wholeheartedly say that every member of Team DBTH did their very best in extremely difficult circumstances, putting the safety of patients at the heart of every choice.

“I know that my background as a Respiratory Physician, stepping into the Medical Director role during the COVID-19 pandemic, I was able to help, shape and influence some of our response. My understanding of this field meant that I, alongside colleagues, anticipated that the second wave would be more difficult than the first wave. With this insight, this meant as an organisation we were as prepared and organised as possible to deal with the additional challenge of more COVID-19 patients who were unwell for longer during the second wave.

“I take heart and find reassurance in this year having shown us that as a hospital trust we now know we can respond to serious challenges. We routinely complete ‘emergency planning and major incident training’ in order to learn about how we would respond to significant event, and as part of the training the big concern is always that the organisation might fail to fulfil its function.

“In many ways COVID-19 has been ‘the emergency’ we have trained for and it has brought some of the most challenging conditions. It hasn’t been easy for anybody, but our hospitals have continued to deliver care to the most unwell people in the community at their time of need.

“Our role as executives and senior leaders is to ensure that the structure and governance is in place, creating the right environment for all the members of Team DBTH team to deliver care in the best way that we can.

“This last year impacted upon all of us in some way. The commitment of everyone in the organisation to deliver high quality care has been phenomenal and it has been amazing to see how people have managed to carry on despite the challenges. That said it is so important that we look after ourselves and each other, as we can’t look after our communities if we don’t look after ourselves.

“Personally I’ve aimed to keep mentally and physically healthy throughout in order to maintain some level of resilience. This includes ensuring I get home once in a while and going out for a run (I’ve managed to run every day bar six in 2021).

Asked about what is next for the Medical Directorate, and his vision for the future of the Trust he continued: “My vision for the Medical Directorate, and the Trust, is that we don’t just recover from COVID-19, but we emerge stronger. Always moving on from the past and learning from it is the cultural shift we are ready to take as an organisation.

“Whilst medicine is rooted in science, the delivery of it relies on people, and all humans can make mistakes. Unfortunately sometimes things do go wrong and of course you can’t change the past. However, you can change the future and so I am certain we must continue to learn from every episode.

“This supports our vision to be the safest trust in England – outstanding in all we do. Whilst we already have some excellent practice in place, we are finding more ways of spreading and embedding learning, and we remain vigilant as to how we can continuously maintain and improve safety.

“That can only be achieved by our care givers making the decisions that change patient care. My role in that is to create an environment to support and empower teams to make real changes.

“And on that note, and in closing, I would like to say a big thank you to all my DBTH colleagues, and our patients, for being so supportive during this incredibly challenging year – one that none of us are likely to forget.”