9am – The NHS Transformation Unit (TU) value the skills a nurse brings to the team and have offered me a permanent position. So, as I’ve got a patient facing role, I start my day by attending an appointment at our HR Department to undergo the necessary ID checks and enhanced DBS clearance. I’m now ready for a productive 2019.

10am – I park up at Trafford General Hospital, part of Manchester University NHS Foundation Trust and, as the first NHS hospital opened by Aneurin Bevan in 1948, the birthplace of the NHS.

At the TU we’re being approached more and more by clients wanting support to meet the challenge of running sustainable smaller hospitals, and I want to learn more about the real life and experiences of the staff and patients who’ve been through similar challenges and changes. I’m keen to apply this learning in our work and the clinical teams have kindly let me visit so I can experience their front line services first hand.

10.15am – I meet the doctors and nurses in the High Care Unit which supports elective services at the hospital. They talk about their shift patterns and how rotation works across the different Trust sites. We discuss retrieval arrangements for the patients needing transfer to Critical Care and the highlights and challenges of both providing care and working in a high care area.

11.15am – I meet the unit manager and emergency nurse practitioner in the Urgent Care Centre (UCC).

The UCC is nurse-led and I’m fascinated to hear the stories of the patients that walk through the doors. Understanding the behaviours of the local population and the experiences of the patients after a  major service change has taken place is vital learning and will be incredibly useful when looking at other systems. I learn that passion for local services can often override logic and that this must be anticipated and planned for.

The baubles on the Christmas tree are the biggest I’ve ever seen in a hospital department; the staff laugh at my comment. They’re a gift, but they struggle to store them; they ask that I remember these finer details in doing clinical design!

12.30 – My final visit is to the short stay medical ward. I spend time with the ward manager who is sat talking to an elderly lady with dementia. They are trying to get the lunches out and she is handed 3 sets of keys for the drug round, reminding me how hard working on these wards can be and that we have a huge responsibility to ensure services like these are more sustainable. I’m humbled by her patience and the time she spends with me to tell her story, explaining how the ward is supported and the type of patients it temporarily homes.

1.30pm – I drive from Trafford over to Lancashire for the next part of my day. While driving I get a call from our Chief Operating Officer about some potential future work to test the most effective ways to identify and address a person’s holistic needs after a cancer diagnosis. This sounds really interesting and I promise to look at the requirements in more detail the next day. Then I get a call from our Chief Transformation Officer who’s been reviewing my first draft for a model of care. Writing a document that makes clear clinical recommendations while involving the public and their elected members takes time and many iterations – transformation is a stoical process that requires patience and I am grateful for her guidance.

3pm – My final stop of the day is at a Clinical Commissioning Group membership council in an area where I’m currently supporting some clinical design work for acute services. The membership council consists of primary care leaders. No acute system can be sustainable without the support of primary care so I’m spending as much time with the Primary Care clinical community as I am with clinical staff in hospitals. Alongside a Consultant Cardiologist I discuss our current transformation work with primary care colleagues. We have a fascinating and useful debate on how to provide the best clinical care for their population and I’m pleased to see positive relationships forming.

4.45pm – The final job of the day is to write down my learning from my visit to Trafford General Hospital while it’s still fresh. Rota arrangements, key challenges, admission criteria, patient experience and much more that I need to share with the wider team so we can use this knowledge across all our transformation work.

5.15pm – Finally I head home to collect my children from after school club. Cuddles, bedtime stories and baths.