Agenda item

This report sets out an update on mortality figures for Medway Maritime Hospital.  The Chief Executive of Medway NHS Foundation Trust will be present to introduce the report.

Discussion:

The Medical Director, Medway NHS Foundation Trust, introducedan update on mortality issues and the hospital trust’s improvement programme.

He stated that it was important for the Trust to measure and look for improvement rather than compliance, particularly following on from the Francis inquiry recommendations.  He said it was vital for leaders to value staff and enable them to value themselves.  Unless this happened staff could become hardened to the needs of patients. 

As far as mortality figures were concerned he referred to page 49 of the report, which illustrated that the crude mortality rates at the hospital had fallen significantly over time.  He also urged a note of caution in putting too much weight on the mortality rates and said that good performance in Hospital Standardised Mortality Rates (HSMR) did not necessarily signify good performance at a Trust.  In fact one London hospital, which had low HSMR rates, was recently found to have areas of concern.

He then referred to ongoing work at the hospital to make it easier to do the right thing and to simplify procedures to standardise the response to certain conditions such as pneumonia to ensure that everyone involved was aware of the agreed procedures to follow.  Responding to a question he confirmed that the method chosen as the ‘Medway’ way to deal with a condition would be as a result of proven good outcomes and that this would need to be modified as further good practice emerged.

The Medical Director then gave details of the focus of the hospital around the emergency care pathway and emerging plans for a large assessment area, consisting of around 80 – 90 beds, for all medical admissions close to the A&E department, imaging (x-ray) and intensive care.  This would be fully staffed 7 days a week and would ensure a proper flow of patients to the appropriate clinical areas following assessment by senior clinicians.  This was recognised as good practice for improving lengths of stay, patient experience and A&E performance.  It also ensured that all patients were in the best part of the hospital for their particular condition as soon as they were admitted, and there was increasing evidence that implementing such a system reduced mortality.  In terms of timescales he confirmed that the hope was for there to be 58 beds in the assessment area by Christmas 2014 possibly 80 if it was possible to make moves within the hospital of the dermatology and sexual health clinics.  The plans had received approval from Medway CCG, from the hospital board and Council of governors.

Responding to a question he stated that in the majority of cases the hospital preferred to use its own bank of nurses rather than relying on agency staff.  As far as local medical staff were concerned there was a group of locums used, and they were familiar with the hospital’s style and procedures, but he admitted there would always be occasions when agency staff had to be used.

The services of Healthwatch Medway were offered towards the programme of Transforming Medway and it was accepted that shared learning was

important particularly as one of the work streams related to patient experience.

Decision: 

The Medical Director, Medway NHS Foundation Trust, was thanked for his report, which was noted.