Agenda item

Rachael Corser and Esther Moors, Deputy Directors from WHHT, to provide members with presentation.

Rachel Courtan (RC) Esther Moors (EM), Deputy Directors West Hertfordshire Hospitals NHS Trust; presented a series of slides updating the committee on the current position. The slides covered areas such as

·         How the services did in the inspection

·         What the inspectors saw

·         Minor Injuries / Caring

·         Safety of patients

·         Hospital Management

·         Responsiveness

·         Simpson Ward

·         Key Findings and proposed responses

The headlines were:

•       West Hertfordshire Hospitals NHS Trust has moved from ‘inadequate’ to ‘requires improvement’ and has seen a leap in the number of services graded as ‘good’

•       The number of services rated ‘good’ is almost double that in 2015 and the number rated ‘inadequate’ has more than halved

•       There are 40 individual quality ratings of ‘good’ from the 2016 inspection, compared to 25 in 2015

•       The number of services rated ‘inadequate’ is less than half that of the previous year, was 31, now 15

•       The CQC inspection in September 2016 involved around 50 inspectors who visited all three of the trust’s sites

•       They interviewed frontline staff and the leadership team, spoke to patients and relatives and took soundings from key stakeholders

•       Before, during and after the inspection, inspectors considered nearly 1,000 documents; policies; patient notes; medical records and additional information in relation to specific questions.

•       The staff are doing amazing things!

Councillor Birnie questioned the title Urgent Care Centre (UCC) as he had examples of patients turned away because they did not have an appointment. RC admitted this may have occurred however the UCC is not an appointment based service. Councillor Maddern also called into question the ‘established’ status of the UCC as it is only open 10.00 pm – she contended that it will not be established until it is open for 24 hrs as originally promised.

This prompted a discussion on communicating to the general public that the current closing of the UCC at 10.00pm is not a temporary measure and has no end date in view.

There then followed a short discussion on bed allocation.

RC went through the operation of the A rated ‘Stroke service’. The move towards early discharge and recovery at home was considered. Marion Dunstone (MD), Director of Operations, Hertfordshire Community NHS Trust advised that this is an evidence based approach; it will free up beds and decrease the need for hospital stays.

RC and EM advised the committee that through the Quality Improvement Plan they have identified and addressed areas which were rated as inadequate or requiring improvement. They are embedding changes and will continue to monitor the impact through audit and governance.  They will make further changes as required. The team aims to continue to develop and grow to support changes.

Cllr Maddern asked if any services had gone down in the ratings. She was informed that Medical Care Services needed improvement and Children Services went down from ‘outstanding’ to ‘good’. K Minier asked when the report will be finally released – RC and EM agreed to bring the results to the December meeting of the committee.

Councillor Birnie asked that this report in December contain an update on the equipment in use at the UCC and Hemel (e.g. X-ray machine; CT Scanner, etc.).

The committee then moved on to a short discussion on staffing levels and were informed by (EM) that there may be a reduction in nursing staff coming from Europe and that they are working on recruitment from India and the Philippines. There is also a good deal of work being done to invest in home grown recruitment and training for British staff.

Kathryn Magson (K Magson) NHS Herts Valleys CCG Chief Executive Officer then moved on to the subject of ‘delayed discharges and how they are dealing with this problem. Part of this is to try to reduce instances of Social Care delays and at the time of the meeting there are still 45 to be resolved. The target is to have these reduced by half (22) by the end of August.

KM pressed her on the £41m over budget last year and how she intends to bring this in budget without cutting care. K Magson suggested there could be a 6% reduction by cutting out the shunting of patients / problems around the system. Councillor Maddern suggested she have a look at work done by an earlier Topic Group that had already considered this issue.