Agenda item

This report provides an update on improvements at Medway NHS Foundation Trust, and the Trust’s Patient First strategy for further improvements. It also covers recent performance in emergency care, elective surgery, cancer care, and diagnostics.

Discussion:

Members considered a report which provided an update on improvements at Medway NHS Foundation Trust, and the Trust’s Patient First strategy for further improvements. The report also covered recent performance in emergency care, elective surgery, cancer care, and diagnostics.

The following issues were discussed:

·      Stability at senior leadership level – Members welcomed the recent appointment of Jayne Black as Chief Executive of the Trust. An assurance was sought that the new Chief Executive of the Trust understood the need for stability at a senior level, given there had been 4 different Chief Executives in recent years. The Chief Medical Officer assured Members that the new Chief Executive would bring stability and continuity as she had significant NHS leadership experience and had worked across acute, community and the wider system throughout her career, in a variety of roles.

·       Staff morale – in response to a point that the report did not include an update on staff morale, the Chief Medical Officer undertook to provide an update on this in the next report. She acknowledged there were areas where staff morale was not where it should be and the Trust was looking at how to capture staff morale more regularly outside the annual survey. She added that the Leadership Team were keen to start to change the culture immediately and needed to underhand where low morale was an issue and how to respond to this.

·       Improvement journey – some surprise was expressed that the Trust’s CQC rating had increased in the last 3 years at a time of greater population pressures, the pandemic and difficulties in accessing GPs. What confidence the Trust had in this assessment process was questioned and whether the target for 2023 was to be assessed as outstanding by CQC. The Chief Medical Officer responded that CQC were the regulators and had their own timetable for inspections so there may not be a visit in 2023. However, the Trust was committed to improving its services regardless and intended to get to outstanding for all services.

·       Patient First – an assurance was sought that this programme was meaningful and would be long lasting. The Chief Medical Officer commented that the Patient First programme resonated with staff and was based on data. It meant patients would receive the best treatment by the best people. It was part of a culture of continuous improvement and led by front line staff, focusing on the issues which would make the biggest difference. Patient First also helped with patient flow.

·       Waiting times and treatment targets – in response to a query how these were being tackled, Members were advised that the Trust recognised waiting times for treatment were too long. A risk based approach had been adopted where those with the greatest need were seen first. No patients were waiting longer than 52 works and the focus now was the average was now around 40 weeks.

·       Shortage of GP appointments – a point was made that this was placing significant pressure on the hospital. Whether this was sustainable and what was being done to relieve the pressures on primary care was queried, the Chief Medical Officer commented that the whole system needed to all work together. Regular meetings took place with MedOCC. The Trust was committed to making Medway an attractive option for GPs and tried to ensure GP trainees at the hospital had a positive experience so they would remain in Medway.

·       Data – the lack of data in the report was noted by Members and a request was made for data on ambulance handover times. The Chief Medical Officer stated the next report would have more data.

·       The Trust’s finances – the lack of information on this was noted. The extent of the Trust’s deficit and whether there was enough capital funding to tackle backlogs were queried. The Chief Medical Officer commented that the Trust has to operate within its budget and therefore needed to prioritise. If the Trust provided high quality services and got things right first time then it would become financially efficient. There was a transformation and efficiency programme. There was also a need for more resources for adult social care. Capital funding was prioritised according to risk. Any opportunities for national funding would also be considered.

·       NHS Pay settlement and potential strike action – in response to a query about the effect on recruitment and the potential for strike action, the Chief Medical Officer commented that she had sympathy with colleagues facing problems due to increases in the cost of living. The Trust would work with national colleagues to understand the impact of any strike action. The Trust wanted to work to make the hospital a place where staff could be recruited and retained.

·       Member visit – members welcomed an offer to visit the hospital.

Decision:

The Committee agreed to note the report and requested a briefing paper on the Trust’s finances and deficit position and that future reports include more data and information about staff morale.