Agenda item

The report provides an update on progress since the Trust last attended the Committee in October 2018.

Discussion

A presentation was given to the Committee, the key points of which were as follows:

·      The hospital’s transformation programme was ‘Better, Best, Brilliant.’ Individual transformation projects were showcased, such as what staff were doing to improve the hospital, improvements to patient flows and discharge processes and work with community partners. An Outpatient transformation programme was due to take place over the next year.

·      Ensuring financial stability was a key priority. The deficit for the previous year was £66million and the Trust would hit its control total of £46million for the current year. The £21 million savings target had been achieved, helped by reductions in expenditure on agency staff.

·      In relation to Emergency Department performance, 82.8% of patients were seen within the target of four hours. This was 8% below the trajectory figure. There were challenges associated with patient outflows from the hospital which highlighted why integrated discharge was important.

·      In relation to the 18 week standard for referral to treatment time, the figure was 80% for the current month, down slightly from 81% in the previous month. Work was taking place with commissioners to identify how to improve performance to 92%. The percentage for cancer patients in December was 83.6%, which was below target by 2.1%. Significant specialist work was being undertaken, including looking at constraints for each pathway.

·      Performance for diagnostics was ahead of trajectory but below the constitutional standard. An additional MRI and CT scanner would be provided which would help to improve performance.

·      The Trust had managed to fully comply with the limits of the NHS Agency Staff Cost Cap and was one of the only trusts in Kent and Medway to have achieved this.

·      The response rate to the staff survey was 40%, which was below the national average of 44%. Three of the metrics had the same performance as previously while figures for six had declined. Responses indicated above average performance for appraisals and provision of a safe environment. Morale was a new national indicator with work taking place to understand what influenced this measure.

·      The ‘You are the Difference Programme’ was ensuring that staff had the tools to deliver high quality care and create the right culture at Medway.

A Committee Member said that the results of the staff survey were mixed. She asked how much awareness there was of the issues faced and how the Trust was addressing them. She highlighted national concerns about access to cancer care and treatment and asked how much confidence there was that Medway would be able to avoid some of the difficulties that other areas were experiencing, particularly in view of Medway having relatively low take-up rates of cancer screening. The Member also asked how the savings made had been achieved, for the Trust’s view on the decision of the Kent and Medway Stroke Review not to establish a Hyper Acute Stroke Unit (HASU) in Medway and whether the Trust was ready to deliver a HASU should the decision be changed, in view of the Council’s referral to the Secretary of State. In relation to the gender pay gap recently reported at the hospital, the Member asked whether the Trust was aware of the gap and what was being done to make senior appointments equitable.

The Director of Planning and Partnerships at the Trust said that consistency of approach was important. The ‘You are the Difference’ programme had been established to ensure this. The strategic objectives had been unchanged for three years, which provided further consistency. In relation to performance for cancer care, there was confidence that the hospital would, in the future, be able to achieve targets consistently.

MFT had achieved its cost improvement target for the first time and its budget control total for the first time in a significant time period. Quality Impact Assessments were undertaken on every cost improvement programme undertaken by the Trust. Plans were regularly shared with commissioners and regulators for scrutiny to take place. The Programme Management Office and Transformation team were central to the improvement programme and substantive recruitment had started to roles in these teams.

The Trust considered it had made a strong case to be selected as a HASU site and was disappointed that it had not been chosen. The current stroke service would need to be provided for at least another year and it would be important to maintain and support this. There was awareness of the gender pay gap. A contributory factor was that medic pay was based on the number of years the medic had been in post. The Trust was looking at how to ensure it was an attractive employer to senior female clinicians and there was an active programme of equality and diversity inclusion across the organisation. This was supported at Board level and the Trust was represented on a number of national groups relating to equality and diversity.

A Committee Member said it was pleasing that there was less reliance on agency staff, while another Member commented on the lack of detail in the report in relation to the staff survey. He asked what challenges had been identified by the survey. In relation to the gender pay gap, he noted that the Trust only had one female non-executive director. The Committee was advised that the results of the staff survey had been under embargo when the report was produced. Full details would be sent to the Committee when available. It was considered that the ‘You are the Difference’ campaign was helping to improve staff morale. Staff ambassadors were meeting with groups of staff and staff attending organised workshops were able to attend follow up sessions. The programme was introduced to staff at induction. Staff briefings hosted by the Chief Executive now took place each month. These had previously only been held following identification of a particular concern.

A Committee Member asked if the savings made in the current year would help the Trust to make further savings next year. It was confirmed that this would help the financial situation next year and that 80% of the required savings had already been identified. Staff morale within the new Emergency Department was particularly good while the dedicated dementia garden in the Frailty Assessment Unit was also helping to boost morale.

Decision

The Committee noted and commented on the report and requested that staff survey data be provided to the Committee.