Agenda item

This report is to inform the Committee of the latest Care Quality Commission inspection of Medway NHS Foundation Trust and to update Members on collaborative action being taken across the local healthcare system to support Medway NHS Foundation Trust since that inspection.

Discussion:

The Chief Nurse, Medway NHS Foundation Trust introduced the report on the Care Quality Commission (CQC) inspection which took place in August.  He explained the measures which had been put in place to divert some ambulances from the hospital between 7am and 12 noon on two days to allow the Trust to recalibrate and put in place some group training.  The exercise had been carefully managed and a strict criteria adhered to for those people who were diverted elsewhere to ensure patient safety.  No further diversions had taken place.

He stated that the full Care Quality Commission report was due in mid October, following which the Trust would be permitted to challenge the findings if necessary, so the report would be likely to become publicly available in November 2015.

Some Members expressed their concern and put forward the following comments and questions:

·           bearing in mind the latest visit by the CQC had been an announced one, the comment was made that the outcome had been disappointing;

·           questions were asked as to the cost of the diversions of ambulances.  The Chief Clinical Officer, NHS Medway CCG stated that details of resourcing costs for the diversions would emerge once there was a debriefing meeting.  Members requested these details as and when they were available;

·           the handling of media coverage was queried as some Members considered could have been handled better. The Chief Nurse stated that it had been a system-wide response to the hospital’s request for mutual aid and that NHS England  had managed communications;

·           questions were asked about the stability of the new leadership and disappointment was expressed by some Members that the Chief Executive of the hospital had not been able to attend this meeting.  It was hoped she would be present at the next meeting when the full CQC report would be discussed;

·           discussion took place about the meaning of the term ‘medically fit for discharge’.  The Chief Clinical Officer, NHS Medway CCG explained that this term meant different things to different groups and as such a stakeholder event had recently been held to attempt to define the meaning and to set down clear procedures for planning for discharge at the point at which someone was admitted to hospital in order to streamline the process and avoid delay;

·           in response to questions about the buddying of the Trust by other Trusts the Chief Nurse referred to links with Guys and St Thomas’s Hospital in London and the Chief Clinical Officer, NHS Medway CCG referred to the support which the CCG had put in place which included regularly observing processes taking place at the hospital and feeding back any comments to the Trust;

·           the Chief Nurse undertook to discuss with the representative from Medway Pensioners Forum, outside of the meeting, some concerns shared with her by a family using the new Children’s Emergency department;

·           further to concerns expressed about improving public perception of the hospital and also improving the morale at the hospital, the Chief Nurse stated that increased communication was going on at the hospital to encourage the staff who were very committed to working there.  He stated that a communications plan was being developed in order that a more proactive stance could be taken with regards to positive messages about the hospital.

The Deputy Director, Children and Adults Services set out for the Committee the measures which the Council had taken in response to the request for mutual aid and stated that by putting in additional staff to assist the Integrated

Discharge Team, along with other measures internal to the Trust, 50 more than usual medical discharges had taken place.  Delays in discharge from the hospital had reduced during that period from 41 to 25, one third of the delayed discharges related to social care issues, two thirds to health issues.  He emphasised the need to learn from the exercise and ensure an embedding of this to bring about continual improvement.

Decision:

The Committee noted the report and requested the attendance of the Chief Executive of Medway NHS Foundation Trust to the next meeting of the Committee to consider the full CQC report.