An opportunity for members of the public to make statements or ask questions in accordance with the rules as to public participation
Minutes:
Philip Aylett asked the following question and read a statement:
When writing to the Integrated Care Board about the continued refusal of the West Herts Trust to attend your meetings, could you please note that the Trust is doing worse than its peers on a range of key measures? These include four hour waits for serious cases, inpatient satisfaction and financial performance - with the current year deficit likely to be £21 million. Could you please emphasise that these failings make it more important than ever that the Trust makes itself available and accountable to the Committee?
I understand that the chair has written to, or is intending to write to the integrated care board about the persistent failure of the West Herts hospitals trust to attend meetings of this committee.
In this context I just wanted to ensure that the committee is aware of the following performance measures on which the trust is doing poorly:
dealing with the most serious a and e cases - type one – within four hour: in august the West Herts trust was 110th out of 110 in the English NHS on this measure, with just 39 % being dealt with within four hours. the national average is nearly 60 % and Bedfordshire hospitals including Luton and Dunstable hit 65%.
Inpatient experience: inpatients rated their experience in Hest Herts at 7.7 out of 10, placing the trust 130th out of about 140 English NHS hospitals. the survey was carried out by the care quality commission in November last year
Finance: the trust is forecasting a deficit of £21 million for 2023-24, with a possible £33 million deficit if cost reduction measures don’t work. This appears to be worse than other local trusts, and could make it difficult for the business case for West Herts redevelopment to go forward – the treasury does not like it when trusts with major spending plans have serious deficits.
Other issues with the trust include a very critical regulatory report on mortuary services, with descriptions of:
· Bodies that had deteriorated due to lack of long-term storage
· Bodies kept on the floor of mortuaries
· Perished door seals on a freezer
· A risk to infection control from the transfer of bodies through carpeted areas of the hospital, past wards and main reception, through car park traffic, over kerbstones, and broken pavements.
Philip noted that a new mortuary unit was being built at the back of Watford, but that there was a lack of staff. In regard to ward safety, it was identified that the
Watford Hospital ward kitchens had a food safety record of one out of five, the worst in the NHS, with one of the main issues highlighted the failure to note allergy issues. It was acknowledged that improvements might have taken place, but that this couldn't be confirmed without a re-inspection by the Borough Council. Finally, it was stated that the Trust Board had nine non-executive directors, but suggested that it might not be representative of the communities being served, with no indication or confirmation from the Trust that there was anyone from Dacorum on the Board, and no mention of Hemel or St Albans hospitals in the job description. It was noted that four of the nine non-executive directors lived within five miles of Watford General. It was requested that the ICB's assistance be sought to determine whether the Trust Board was representative or not.
Cllr Bhinder agreed that there was a pattern of Dacorum being under-represented. He wondered if there had been the chance to compare the Trust's finances with other Trusts. It was confirmed that of the other Trusts in the ICB area, Lister and Harlow, one would be £5 million down and the other £2.5 million down by the end of the year, although Lister had been warned by auditors about the presentation of figures, and noted that the ICB would have to bail out any Trusts in difficulty, or go to central government.
Cllr Tindall noted that since the new administration had taken over in May efforts to rekindle communications with the hospital Trusts had been ongoing, but so far there had been nothing in writing other than the announcement by government several months previously. The hospital administration were stated to have promised improved facilities for Hemel Hempstead, but there were no details, and Cllr Tindall added that he had arranged a meeting with the Chair of the ICB in November which might provide more answers, emphasising that he didn't think the hospitals had much extra information from government or the Department of Health regarding the makeup of the money and who was going to get it.
Cllr Pringle stated that she would be giving a Hertfordshire-wide update later in the agenda, but confirmed that some relevant recommendations had been made under the West Hertfordshire Teaching Hospitals Trust, and that the draft minutes of the meeting on the 19th July were available through the calendar for Hertfordshire County Council. She explained that scrutiny over the finances had been declared sound after years of severe budgetary pressures, with details requested around the £16 million in efficiency savings and how they would be achieved without negative impacts, as well as a bulletin about recruitment processes and how representation was handled. Cllr Bhinder wondered if representation by location was explicitly mentioned, but Cllr Pringle admitted it was implicit, so Cllr Bhinder suggested the point be raised explicitly at the next meeting.
Action: A letter to be written to the Trust raising the comments of the Scrutiny Committee and the point of Phil's report regarding a possible lack of Dacorum representation, and requesting transparency regarding efforts and failures to recruit people from Dacorum and other diversities at the next scrutiny meeting.