Agenda item

Siobhan Harrington, Chief Executive, Whittington NHS Trust and Michelle Thompson, Director of Nursing, was present for discussion of this item.

During consideration of the report the following main points were made –

·         The Trust had 101,814 visits to A&E in 2017/18

·         There were 2.269 elective admissions and the maternity staff delivered 3,761 babies

·         There were also 797,634 contacts with patients in the community

·         The Trust had an annual turnover of £323 million and employs 4,200 staff and work with 150 volunteers who support the Trust

·         In June 2017, the Trust received the CHKS Hospital award for the best performing Trust quality of care across the UK

·         The Trust were winners of the 2018 HSJ Value awards for the Community health service redesign, for the implementation of the eCommunity paperless system. Also winners in the HPMA award for HR innovation

·         The Trust had the second highest take up rate for flu vaccine by staff across London

·         The proportion of staff taking part in the annual staff survey rose to 42%

·         A patient self-management partner partnership has been formed with Tottenham Hotspur

·         Staff and supporters raised over £21,000 in the London Marathon for the Whittington charity

·         In 2017/18 the Whittington NHS Trust set itself 26 quality priorities covering 13 domains. The domains covered Patient safety, patient experience and Clinical effectiveness. Priorities were identified after consultation with staff, stakeholders and managers

·         The Trust successfully met 16 out of the quality priorities and moved forward significantly with the remainder (some are refreshed in the 2018/19 priorities)

·         Statements of assurance had been received from the Independent Auditors Limited Assurance on the Quality Account

·         Priorities for improvement in 2018/19 have been developed, following consultation with staff and stakeholders, and are based on both national and local priority areas. Each target has been specifically developed by clinicians and managers, following stakeholder engagement and will be approved by senior managers. Work will be taking place to align the target/benchmark with operational plan objectives. These priorities are as follows –

Patient Safety Domains – Falls, pressure ulcers, AKI, Care of Older People, Mental Health and Learning Disabilities, Podiatry

Patient Experience Domains – Patient Information, Quality of Food, Transport, Outpatient cancellations, District Nursing continuity of care

Clinical Effectiveness Domains – Patient Flow, Clinical Research, Education and Learning

·         Reference was made to the fact that there had been a 40% increase in attendances at A&E and the Trust had one of the lowest mortality rates in England

·         Whilst the Trust did not meet the 95% A&E 4 hour target, it did reach 89.4%, which was an increase of 3% over the previous year

·         Work has taken place to improve waiting times for community services

·         The Trust has substantially improved its financial position, and it is hoped to clear the underlying deficit within the next 18 months

·         It was noted that there were 200 referrals to the District Nursing service per day

·         In response to a question on the number of deaths, it was stated that work is taking place to look at avoidable deaths. There are mortality review boards in place that look at all unexpected deaths. There is also a less rigorous review of planned deaths

·         With regard to staff engagement, it was stated that there needed to be a focus on recruitment and retention and that the culture of the organisation was important in this. The leadership team had made efforts to become more visible and engage with front line staff and it was recognised that the organisation needed to continue to improve

·         In terms of recruitment and retention,the Trust were focusing on recruiting newly qualified nurses and there has been an improvement in this

·         Reference was made to the increase in asthma and whether this is being linked to air pollution. The Trust stated that it would forward details to the Committee

·         A Member referred to transport bookings, and enquired how many missed appointments there were as a result of transport bookings not being kept. The Trust stated that they would provide details of this to the Committee

·         In response to a question on community nursing, it was stated that whilst it is recognised that agency staff will always be required, there is a need to ensure that the right staff get to the right patients. In addition, it was felt that there could be more utilisation of the local workforce in terms of recruitment and the Trust were looking to build on volunteering. Digital technology is also being employed and staff can go from home to work, using iPads for the information needed

·         In terms of readmissions this is looked at on a monthly basis by a clinical team, and there are quarterly performance reviews to pick up issues that need to be addressed

·         It was stated that there is a full complement of nursing staff in A&E

·         In response to a question it was stated that with regard to Learning Disabled, the Trust recognised the need for community engagement, and there is a focus group for parents/carers, and that there is a need to ensure that their views are recognised and taken on board

·         Members congratulated the Trust on the quality account and that Simmons House ligature risk assessment has been reviewed and updated to ensure that all ward areas are included. However, it was noted that Simmons House is not a secure unit and therefore the risk of ligature will always be possible

·         Reference was made to the memory clinic and that the Trust were looking at how staff could become more ‘dementia friendly’, and all staff needed to be aware of how to recognise cognitive impairment

·         Members welcomed the re-opening of the LUTS clinic, and noted that this will be a phased re-opening and the Trust would shortly be interviewing for a consultant

·         In response to a question as to whether NHS Trusts were centrally directed to value NHS estate property that was to be sold at historic valuations. The Trust stated that they were not aware of this but would inform Members thereon

RESOLVED:

That the report be noted and the Trust be requested to provide the following information to the Committee –

(a)  The number of missed appointments due to transport bookings not being kept

(b)  Whether the increase in asthma numbers is thought to be linked to air pollution

(c)   Whether there is a central Government directive on valuations for NHS Estate property

(d)  Details on the memory clinic

The Chair thanked Siobhan Harrington and Michelle Thompson for attending