Agenda item

This report has been requested to enable the new Chief Executive, Lesley Dwyer, to attend her first meeting, with the Chair of the Trust, Shena Winning and the Chief Operating Officer, Morag Jackson, to update the successive Committee on progress against the implementation plan put in place following the inspections by the Care Quality Commission.

Discussion:

The Committee extended a warm welcome to Lesley Dwyer, the newly appointed Chief Executive of Medway NHS Foundation Trust (MFT) and also paid tribute to the sterling work of the Acting Chief Executive, Dr Phil Barnes, for all he had achieved whilst covering the post including his expertise in bridging the gap between clinical and managerial staff.  They requested their thanks to be passed to him.

The Chair of MFT gave a brief update on progress and explained that while the new Chief Executive had only been in post since May she had been kept involved in developments at the hospital.  She also stated that Dr Barnes would continue at the Trust as Medical Director.

The Chief Executive of MFT then set out the background to her being appointed to the Trust and explained the experience she brought to the role in tackling similar issues in Australia with a failing Trust and undertaking a journey of improvement.  She stated that it would be important to plan beyond the 18 month Improvement Plan and to bring partners, stakeholders, service users and staff with them, and to embed a spirit of optimism in what was being achieved.  This was particularly important leading into a further inspection in August by the Care Quality Commission.

In response to a request, an offer of a visit to the hospital by Committee Members was agreed and the Chief Executive of MFT undertook to contact Democratic Services to plan the event.

The Chief Operating Officer of MFT referred to improvements at the Trust over the past few months in particular:

·         There had been improvement and stabilisation of the senior team at the hospital

·         With regard to the four hour waiting target at Accident and Emergency, since the introduction of a frailty pathway, this had improved considerably and the Trust was now in the top 30% in the country in achieving this target

·         The new paediatric unit at the hospital was open and well received

·         The Trust had engaged a new “super-buddy”, one of the London teaching hospitals, Guy’s and St Thomas’ Hospital, to assist them in areas where it had been identified help was needed

·         There were still some workforce shortage issues and this was being addressed partly by considering some overseas recruitment and supporting local staff by creating a hospital based ‘bank’

The Chief Executive of MFT responded to a number of questions as follows:

Relationship between clinicians and management

·         Although the troubled relationship between clinicians and management at the hospital had improved this area still required further work.  The appointment of a Chief Quality Officer at the hospital was helpful in this regard. 

·         The Trust was at the forefront of most hospitals in appointing a Chief Quality Officer and part of her role would be to identify useful information (rather than data) to enable the Trust to understand what worked and what did not and to learn from best practice

New Patient Administration System

·         The new Patient Administration System was working very successfully and this was, in part, due to the fact there was now no alternative to the system

Government announcement in relation to overseas recruitment restrictions

·         It had yet to be seen how the recent government announcement in relation to overseas recruitment would impact on the Trust’s plans to recruit some overseas staff

Impact of the continued 24/7 MedOCC service on reducing numbers of people accessing Accident and Emergency

·         The continued 24/7 MedOCC service had directly impacted on reducing numbers of people accessing Accident and Emergency by 27-28%

Comments about progress in the Improvement Plan p35

·         The comments in the Improvement Plan were correct at the time of publication but things set out in the Plan attached to the agenda had now improved

·         Work was ongoing to improve ambulance handover times

Resident and Councillor engagement

·         Engagement with residents and Councillors in the improvements at the hospital would be welcomed

Number and cost of agency staff at the hospital and retention of staff

·         A briefing note would be provided outside of the meeting to explain the number of agency staff used at the hospital and the associated costs

·         Exit interviews were offered to staff who leave the Trust

The usefulness of work undertaken by Medway Pensioners Forum in relation to the frailty pathway

·         As a result of the new frailty pathway, the length of stay in hospital for frail elderly patients had reduced from 17 days to 6 days.  It was hoped this could be reduced further as it was better for their recovery for them to be returned home as speedily as possible

·         It was stated that the work of Medway Pensioners Forum with the hospital Trust had been very valuable in relation to frail elderly patients

Progress made with improving mortality figures

·         Mortality figures at the hospital had improved and were now closer to what would be expected

Attempts by MFT to gather feedback from patients

·         Responding to a comment about the method of gathering feedback by texting patients about their choices it was stated that more needed to be done about the Trust’s communication with patients to ensure an appropriate balance of consultation methods was achieved

The Committee made clear to MFT that the Trust had the support of Members and thanked the Trust for attending the meeting and responding to questions.

The Chief Clinical Officer of NHS Medway CCG, following a question previously notified to him, explained that while NHS England had turned down the application from the CCG for joint commissioning, a new application for full delegated commissioning would be made to NHS England in July.

The Healthwatch Medway representative, also responding to a question sent to him prior to the meeting, updated the Committee on the views of service users of the hospital which in the main had been positive.  He stated that

Healthwatch Medway had fortnightly engagement events in the foyer of the hospital where they spoke to patients, families and staff.  Staff in particular were now more confident in speaking to them and the patients expressed particular positive comments about Accident and Emergency and the new paediatric department.  The comment was made that not everyone was happy to be pursued for their feedback.

Decision:

The report was noted.