Agenda item

This report sets out progress against the agreed Action Plan following the Care Quality Commission’s inspection of Medway Maritime Hospital.  The Chief Executive and Chair of the Trust will be in attendance.

Discussion:

The Chairman welcomed the representatives from the hospital and, referring to the previous item, stated that he welcomed as much joined up working as possible.  He stated that the Committee would be interested to have a copy of the implementation plan and the key parameters which the Trust was measuring on a weekly basis, to check progress.

The Chief Executive, Medway NHS Foundation Trust (MFT) explained that she had not been able to share the implementation plan with the Committee at this stage as although it had been submitted to the Care Quality Commission (CQC) on 8 February 2016 it had not yet been signed off.  She anticipated that she would be able to share the details with the Committee by the end of March 2016.

The Chief Executive, MFT then made the following points:

·         The attendance at Accident and Emergency over a two day period in the last fortnight had been almost 400 people which was unprecedented.  The building had been built for 50% less capacity than the current intake.  Responding to a question she stated that she did not know the cause of this unprecedented demand but that it seemed to match what was going on elsewhere in the country

·         Staffing – at present there was a 50% vacancy rate for nurses in the Emergency department and 28% vacancy rate for nurses overall, hence an over reliance on agency staff remained in order to ensure patient safety

·         The mortality rates at the hospital were now much more in line with other hospitals across the country

·         She was confident that the information gleaned across the Trust was now much more accurate and that learning from serious incidents was taking place

·         The Trust were disappointed by the letter from the Chief Inspector of Hospitals at the Care Quality Commission to the Secretary of State, Jeremy Hunt, MP, implying a lack of progress, particularly after the Quality Summit which had been positive

·         Very recently the Trust had been able to shut one of the escalation wards in the hospital which was encouraging

·         An outbreak of the Norovirus had required the closure of a couple of wards but this outbreak was also being felt in the community as well as the hospital

·         The Trust was now going to be re-inspected on 29 and 30 March by 11 inspectors who would predominantly be looking at the Emergency Department, frailty pathway, staffing and safety, to see how the hospital establish who goes where and what systems were in place to ensure patient safety

·         Each patient in the Emergency Department now has a named nurse, even if they have to be seen in corridors and they are being provided with a bell to signal for assistance if needed.  This did not mean the hospital condoned the practice of using corridors for patients but reflected the need to do so on occasion

·         From Monday 21 March there would be a single phone number for General Practitioners (GPs) to call to allow them to speak to a consultant at the hospital

·         Responding to a comment from the representative from Medway Pensioners Forum she stated that particular attention was being paid to cleanliness at the hospital to avoid infection and that new machinery had been purchased to assist with this.  She added that it was entirely appropriate for patients to insist on ensuring that anyone treating them had washed their hands prior to coming into contact with them

·         Further to a question about cancer referral waiting times it was stated that the CCG had agreed six remedial actions for the Trust and where they were unable to meet the deadlines those people were contacted personally

Members then made a number of comments including:

·         Reservations were expressed about the letter to the Secretary of State by Sir Mike Richards which was felt to be unhelpful

·         It was also stated that it was less than helpful for the Care Quality Commission to take so long to approve the improvement plan submitted by MFT 

·         Staff at the hospital were commended for their work in trying to put in place improvements at a time of great pressure and demand

·         There was a need to address the shortage of GPs in Medway in order to take pressure off the hospital

·         The Quality Summit, which is set up by the Care Quality Commission after an inspection for all stakeholders, had been very positive and there had been an upbeat attitude from everyone involved in it

·         The view was expressed that the new management structure had been a positive move

The Accountable Officer, CCG explained that in order to develop primary care in Medway a Director of Primary and Community Care had been appointed and it would be their responsibility to take forward some of the issues raised during the meeting in an attempt to reduce demand on the hospital.  She stated that the CCG’s Five Year Plan contained a number of initiatives as the current model of care could not continue.  More work would be done to try to work with people in the community in order to identify issues early on, to work with regular attenders of the hospital and those at high risk of being admitted.

The Chairman stated that consideration would be given outside of the meeting as to whether or not an invitation needed to be extended to the Chief Executive and Chairman of MFT to attend the June meeting to give a further update.

Decision:

The Committee:

(a)  Noted that the implementation plan and the key parameters against which MFT were being measured weekly would be shared with Members by the end of March 2016;

(b)  Consideration would be given, outside of the meeting, to whether the Chief Executive and Chairman of MFT needed to be invited to the June 2016 meeting of the Committee to give a further update.