Agenda item

This report is to inform the Committee of the latest position with regards to the progress against the Care Quality Commission’s last report on Medway NHS Foundation Trust and an update on mortality rates at the hospital.

Discussion:

The Chief Executive and the Director of Clinical Operations, Acute and Continuing Care from Medway NHS Foundation Trust (MFT) introduced a report on progress against the Care Quality Commission (CQC) Improvement Plan and progress with regards to mortality rates at the hospital.  In particular the following points were raised:

·         Mortality rates

The Chief Executive of MFT explained there was a sustained decrease in the Hospital Standardised Mortality Ratio (HSMR) but there was still more work to be done.  Responding to a question she confirmed that the Emergency Department and Surgical Department were now involved in collating the data and mortality and morbidity meetings took place monthly with good attendance from specialities sharing learning and good practice.

·         Care Quality Commission report

In relation to the CQC inspection report this had now been received by the Trust as a draft on which comments were now being made.  The report was, however, embargoed, so the Chief Executive, MFT explained that she could not discuss it.  She stated that it should be available publicly a few days prior to the Quality Summit, which was now scheduled for 8 January 2016.

The Chief Executive, MFT did refer to changes to the management structure in that she had set up 12 clinical directors which have entailed the removal of a layer to those providing direct care to senior management and this involved the inclusion of a senior matron role.  A new clinical governance strategy was being developed to ensure care of a high calibre was delivered across the hospital.  It was important for those departments which were working well to share their good practice and learning to replicate in other sections.  The buddying with Guys and St Thomas’ Hospital was ongoing.

The Committee was notified that the hospital had been successful, in applying for and receiving funding from the Emergency Care Improvement Programme, supported by the CCG.

Reference was made to financial pressures at the hospital and problems retaining and now recruiting staff which meant that more agency and locum staff were needed, increasing costs incurred by the hospital.  The Chief Executive, MFT referred to the fact that staff were unsure of the direction of the hospital and more work was being done in this regard.

Members felt that the CQC report would be unlikely to contain any surprises but may well conclude that more needed to be done particularly to ensure better lines of communication across the hospital.  The renovated minor injuries unit and children’s emergency department were commended by Members as being much improved.

Responding to a query the Chief Executive, MFT welcomed the revised guidelines in respect of end of life care and stated that the Liverpool Care Pathway had not been used for some time.  She agreed to send further details of the prevalence of chronic obstructive pulmonary disease (COPD) and stroke to the Committee as a briefing note.

Some Members expressed concern about the handover arrangements at Medway Maritime often involving agency staff which sometimes lead to delays.  The Chief Executive, MFT acknowledged that there had been such difficulties but work was ongoing with staff in an attempt to improve this situation.  She also responded to a question on endoscopy and stated that there were good clinical leads in this area.

A question was put forward about staff morale and the Chief Executive, MFT stated that there had been a 32% response from staff on the last survey.  She confirmed that there was a zero tolerance policy on bullying in the Trust but there could be areas where staff perceived they were being bullied at times when their performance was being managed.

Reference was made to the presence at the hospital of two Labradors who had been used as therapy dogs at the hospital. Members thanked the representatives of MFT for their attendance.

Decision:

The Committee requested:

(a)   a report to the 26 January 2016 meeting on the CQC inspection findings and next steps;

(b)  further details of the prevalence of chronic obstructive pulmonary disease (COPD) and stroke to the Committee as a briefing note.