Agenda item

The purpose of this report is to update the Committee on the findings of the most recent inspection of urgent and emergency care services at Medway Maritime Hospital, the work underway to act on its findings and improve services for patients.

Discussion:

The Interim Deputy Chief Executive and the Chief Nursing Officer from Medway NHS Foundation Trust (MFT) introduced the report which updated the Committee on its most recent published report of the inspection of the hospital’s Emergency Department (ED) by the Care Quality Commission (CQC).

Members then raised a number of questions and comments, which included:

• Corridor care – in response to a question as to whether the hospital had found itself providing corridor care in recent weeks, it was confirmed that at the beginning of 2026, it had found demand to be so great that it had been required to use some corridor care within ED. The expansion of the Virtual Hospital to provide 24/7 out of hospital care had been helping in preventing the need for corridor care and reducing the number of patients waiting for more than 12 hours in ED, however the end of December and beginning of the year had been incredibly challenging.
• Patient dignity – in response to a question about how patient dignity was upheld for patients in the context of high demand and corridor care, it was confirmed that extra screens and blankets had been made available and roaming care support staff had been put in place to assist with supporting patients that had any toileting needs and to provide general observation.
• Alternatives to corridor care – it was confirmed that without implementing a level of corridor care, the alternative would be for patients to be held in ambulances which would then not be available to respond to other emergencies.
• Virtual Ward – the representatives from MFT explained that although the Virtual Hospital had been launched some time ago, expanding it to a 24/7 service with more beds was new.  They had deliberately approached the expansion slowly and carefully to ensure safety and good clinical oversight and it was hoped it would be rolled out further in February 2026. Training and recruiting staff to support and work within the Virtual Hospital took time. In terms of cost savings, the Interim CE explained that the introduction of the Virtual Ward was more about providing more effective and safe care where possible, reducing the risks of infections and freeing up hospital beds to help manage demand, as well as providing a better experience for patients who were safe to recover at home with the relevant monitoring in place. The MFT representatives undertook to provide a further update on progress with the Virtual Hospital in the summer months.
• System wide approach – reference was made to the work ongoing with all partners to support patients in the community and reduce the need for them to end up in the ED. In addition, the local authority was reviewing its offer to carers to bolster families abilities to remain at home where possible.
• Delays in discharge – reference was made about a potential delay in discharging patients from ED due to a lack of pharmaceutical support and whether this was a particular issue. The Chief Nursing Officer explained that pharmacy technicians were on duty to help assist with timely discharges. Regular meetings were also held to understand barriers that were preventing patients from being discharged and how these can be managed and addressed. In terms of delayed discharges due to the demand of beds within adult social care system, the Assistant Director for Adult Social Care explained that in recent months the local authority and MFT were working far more effectively and jointly to tackle the issue. Availability of beds remained a significant challenge but the partners were working far more as partners than they had previously which was a welcome step.
• Healthwatch feedback – in response to a query as to how MFT used data provided from Healthwatch Medway on engagement it carried out with patients in the hospital, the Chief Nursing Officer confirmed that all feedback, collected internally and externally was used to identify potential themes and issues and ways to address them.
• Ambitions for the next year – in response to a question about what MFT’s ambitions were for the year ahead, the Interim Deputy CE explained that they would be striving for a joined up system wide frailty model with partners, maximising the use of Community Diagnostic Centres and making progress towards the radical change in pathways that was needed. In addition, a better use of staff skills and upskilling and developing staff to ensure patients are seen quickly, effectively and receive good care.
• Staff recruitment to ED – MFT representatives confirmed that had been extensive recruitment of staff into ED and undertook to provide a breakdown of the numbers and positions to the Members.
• Staff huddles – in response to a question about team huddles and how they would operate to support improvement, the Chief Nursing Officer confirmed that in ED, staff huddles were much less focussed on data but instead were an opportunity for staff to talk freely about the shift, the needs of the patients, the equipment required and provided an opportunity for staff to share how they were feeling about their shift.

Decision:

The Committee noted the report and requested the following:

·       a briefing paper on MFT’s use of corridor care,

·       an update on extension of the Virtual Hospital and data relating to its use,

·       data relating to the numbers of doctors, nurses and other staff recruited to Emergency Department since the Care Quality Commission’s inspection.