Agenda item

The purpose of this report is to update the Committee on the next steps with the development of the Group between Medway NHS Foundation Trust and Dartford and Gravesham NHS Trust, and leadership arrangements for Medway NHS Foundation Trust.

Discussion:

The Chair, Medway NHS Foundation Trust (MFT) introduced the report which provided an update on progress of establishing a group between MFT and Dartford and Gravesham NHS Trust (DGT) and also updated on leadership arrangements at MFT.

Members raised concerns regarding the reasoning behind the decision to revert to two separate Chief Executive Officers (CEOs), one at each Trust. The Committee had raised concerns about the previous decision to have one CEO for both hospitals, due to capacity issues and continuation of service improvement. At the time, assurance was provided that the model would ensure greater collaboration, improved partnership and better outcomes. The Committee was informed that the principle of developing the group model remained the same but due to issues that had become apparent in terms of managing finances and the work that needed to be undertaken, it was realised that the undertaking would currently be too much for one CEO. Over time, once the plans had been embedded, a review would take place as to when to move to one CEO model.

Members raised further concerns that the decision making behind having one CEO had not been as robust as it should have been and that the decision had been high risk, and it was asked what new information had transpired. The Committee was informed that one of the findings had been that some of the collaborative work undertaken had not gone as well as it should have and whilst some services would still welcome collaboration, there was extensive work to be undertaken to establish more formal structures to enable more seamless collaboration. It was vital to keep up momentum on the work that was being undertaken and there had been success in some areas, such as waiting times for urgent emergency care and cancer care, which had significantly improved and was the second best of any hospital Trust in the country.

Members challenged that there had been a significant CEO turnover at MFT in recent years and whilst the hospital may be in an improved position, there had been too much time and effort spent on changes to management and leadership issues and not enough on the provision and delivery of excellent patient care. There were also concerns about staff welfare and what consideration had been given to them amidst significant changes.  It was also considered that further information was needed on the thoughts of the ICB and NHS England on this proposed group model.

In response to a question on how patients would access services and if there would be movement of patients from one hospital to the other for treatment, the Committee was assured that, where possible, patients would receive treatment locally. There would however be instances where patients may have to attend another hospital for specialist services, but with the move to digital platforms, it was expected that more treatment would be available locally.

It was commented that whilst it was evident that officers continued to work on issues, it was difficult to determine from the report what the next steps were, what was in place to improve outcomes for the residents of Medway and the financial aspects of the proposed transformation. In response, the Chair of MFT undertook to present to the Committee the integrated improvement plan to evidence the planned programme of works.

Decision:

The Committee noted the report and agreed that:

a)    The Chairperson write to the Department of Health on behalf of the Committee to raise concerns about the leadership arrangements at MFT.

b)    The three local MPs be approached for a roundtable discussion to raise concerns regarding the decision making and lack of trust between the local authority and MFT.

c)     A report be brought back to a future meeting on progress of the recruitment of the new CEO and the transformation plan.