Agenda item

The report seeks to update the Committee on progress at Medway NHS Foundation Trust.

Discussion:

Members considered a report on progress at Medway NHS Foundation Trust, since the last update in January 2023.

The following issues were discussed:

·       Mortuaryarrangements - reference was made to the recent court case regarding the abuse of bodies at the mortuary at Tunbridge Wells hospital and an assurance was sought that the learning from the inquiry into this had been carefully considered. The Chief Executive of the Trust advised that following the release of the inquiry’s report, an analysis of who had access to the mortuary had taken place and measures had been strengthened. She assured Members that the Trust was confident the right measures were in place.

·       Industrial action – regarding improvements to the conditions of junior doctors, it was clarified that the industrial action related to their pay and conditions of employment, not workplace conditions. When the junior doctors had been on strike the medical teams had been flexible in covering shifts. The Trust had been clear on the significant impact this action was having and representations to the Government were being made via the Integrated Care Board.

·       Tele-tracking – in response to why there had been a delay in introducing this bed management system, the Trust’s Chief Executive advised this had been part of the strategic plan. The delay had been caused by wating for funding. The system was now making a significant difference in turnaround times.

·       No criteria to reside (NCTR) – regarding what the solution was to the pressures caused by patients with NCTR, the Chief Executive commented some of this was about what preventative measures the wider system could put in place to prevent admission. The Trust was also looking at discharge processes at a high level. There was a need to make sure the community model helped to minimise admissions and help to discharge effectively. The Assistant Director – Adult Social Care added that the low number of beds in care homes was also an issue as these affected discharges from the hospital.  The Council had been awarded some funding which had been used to secure assessment beds where long-term care needs could be assessed. If successful, the Council would bid for additional funding to expand this.

·       MedOCC – the Chief Executive clarified that this service was run by Medway Community Health Care and visits were included in the statistics for the Trust. On arrival at either MedOCC or the Emergency Department, patients were triaged to make sure they were in the right place. The Chief Executive agreed with a comment that anyone repeatedly visiting MedOCC should indicate to the team that something was wrong. There was a need to look at how primary care was supported and how it could work differently.

In response to comments from Members about experiences of a poor service at MedOCC, the Chief Executive commented that work to improve emergency care included MedOCC. This was a priority, and it was important to improve the pathways. There was an opportunity to work much more closely with MedOCC and improve flows. Whilst difficult, if MedOCC had staff shortages, the Trust has sometimes offered their own staff to help.

·       Patient Liaison Service – a suggestion was made that the next update include details of the types of complaints made and their outcomes.

·       Endoscopy – the new facilities were welcomed. The Chief Executive advised there had only been two endoscopy rooms while five were needed. A business case for additional rooms was being drawn up. In the short term there would be mobile units which would help to reduce waiting times. The longer-term plan was set out in the Trust’s clinical strategy.

·       Rehabilitation centres – noting the rehabilitation unit for the elderly before they returned home, that used to be located in Gillingham, whether there were any plans for a new unit was questioned. The Assistant Director – Adult Social Care advised there was a different model now where rehabilitation services were provided in a person’s home or in their care home.

·       Hospital pharmacy – a point was made that discharges could be delayed while a patient waited for medicines from the pharmacy. The Chief Executive commented that the pharmacy process had improved significantly.

·       Winter pressures – in response to questions about how severe this would be and how prepared the Trust was, the Chief Executive acknowledged winter would be challenging. The Emergency Department had been under extreme pressure and the Trust was planning for Christmas and New Year. This had not been helped by industrial action. She was confident patient safety would be maintained.

·       Support on discharges – regarding whether the Trust was being sufficiently supported, the Chief Executive felt this was the case, but the system had to work together. The Director of Public Health added the Council could support the hospital by promoting vaccinations and connecting people to services outside acute services.

In conclusion, remarks were made about the need for the staff survey results; the need for a conversation about community services joining up and the good care at the hospital in spite of long waiting times in the hospital.

Decision:

The Committee agreed to note the report.