THE new chief executive of Cornwall’s main hospital says she doesn’t want it to be outstanding – she wants it to be brilliant.

Former nurse Kate Shields was appointed as chief executive of Royal Cornwall Hospitals Trust (RCHT) earlier this month having acted in the role after previous chief exec Kathy Byrne left last summer.

But the 52-year-old has been working at the Trust since 2017, when she was brought in after the Care Quality Commission (CQC) gave it an “inadequate” rating and placed it in special measures.

And the married mum of five says that she believes she has “probably the best job in the world”.

It’s not without its challenges though, with the hospitals trust – which is responsible for Royal Cornwall Hospital, West Cornwall Hospital in Penzance and St Michael’s Hospital at Hayle – now rated as “requires improvement” by the CQC after an inspection at the end of 2018.

But while the watchdog has called for improvements it has also consistently praised RCHT for the care and quality of its staff.

And that support for the staff at the hospital is also backed up by the general public who are always quick to jump to its defence whenever negative reports are issued.

Kate said: “The people in Cornwall are really supportive of RCHT and we need to deserve that support.

“The CQC report says that we have a community who are lovely to us but we let them down sometimes as the services could be better than they are.

“The CQC never give ratings of inadequate lightly and we know there are things that we can improve on. We have had nine near misses in the last year, we have infection control issues to sort out.

“It wasn’t the first, second or third time that we have been told this and it was a timely reminder to us that our population deserves the best so we should do the best.”

Kate highlights that the CQC report in December gave many good ratings for some of the Trust’s services and that West Cornwall Hospital and St Michael’s Hospital were rated ‘good’.

She said: “If we can turn the dial on safety we start becoming a good hospital. That is where I want us to be.”

Asked whether that is something that can be achieved quickly she says: “I am the most optimistic person. A look at our staff and services and our performance and I can’t see why we can’t be good. Some of our services already are.”

She added: “I would like to say we can be good very quickly, but I don’t want to be naive. Within four years I would like us to be outstanding.

“But outstanding isn’t a word that I use so we will aim to be brilliant.”

Kate said the RCHT’s performance so far during the winter pressure time – with the worst month of February still to come – had improved on last year and this was due to staff doing some things differently and learning from previous years.

“Our staff last year were run off their feet and no matter how fast they ran, it wasn’t getting any better. This year it wasn’t about ‘can we work people any more?’, we looked at what small things we could change to make it better.”

One way in which services are set to change is down to more integration between health services and social care. RCHT is working closer than ever before with Cornwall Council and other health and care providers to ensure that health and social care work in tandem.

Kate says this partnership is the only way to make services better for people in Cornwall.

She said: “RCHT doesn’t have to do everything. Services for people who are older and frail, we are not the best services to do that.

“We have staff who are brilliant in providing that kind of care, but they would be better spending their time on other things.”

Kate said that hospital is not always the best place for people to be and they would have better quality of life if they were receiving services closer to or in their homes.

“I feel very strongly that where we are not the right place we should be helping those others (providers) to develop the services that people need,” she explained.

And she added: “The health trusts and local authority are working as one team. We are putting people into the most appropriate care.”

One issue which regularly comes up whenever plans for new housing developments are revealed is a concern that health services – and the hospital in particular – will not be able to cope with the additional population.

So does Cornwall need another hospital? Kate doesn’t answer the question directly but did say there was a major piece of work being carried out for a “strategic refresh” of services in the Trust.

She said she would like to see centres of excellence being created across Cornwall using existing sites such as West Cornwall Hospital and St Michael’s Hospital in Hayle as well as possibly using the likes of Bodmin Hospital.

Royal Cornwall Hospital in Truro would become the place that people go when they would need intensive care.

Kate said: “It might mean going somewhere other than Treliske but it means that operations would not be cancelled and treatment would be in a place where it is a speciality.”

She said that by having these centres of excellence and better use of the facilities available to the Trust would help it to become “brilliant”. And the work that the Trust is doing also aligns with the recently published NHS long-term plan.

And the hospital boss says the Trust also needs to shout a bit more about all the good work it is doing.

“I believe passionately that we can do and do do really good stuff here in Cornwall but we are very quiet about it, we hide under a bushel.”

One other challenge for Kate concerns the Trust’s finances and she said that next year the Trust will be asked to get rid of its deficit.

To do this she says that “we will have to do a lot of looking at how we can do things ar RCH to deal with finances”.

She added that “more money won’t make our lives any easier, we need better workforce models”.

Kate said: “When I am 85 and on a ward do I need a qualified nurse to look after me or do I need someone who makes me less frightened on the ward and wash me and talk to me and help to get me back home?

“That is not necessarily a job for a qualified health or care professional. Looking at how we do those jobs could really help and could help get our nurses doing the things they are best at.”

RCHT has had a number of management changes in recent years but Kate points out that the average tenure of a hospital chief executive nationally is 18 months.

Having already been working in Cornwall for 15 months, she is clear that she has only just started and has no intention to leave.

“I am really looking forward to it. I think it will take four to five years to be a sustainably and consistently good hospital. I am not thinking of leaving until we are.”