Sir David Dalton, Interim Chief Executive, Pennine Acute NHS Trust will report at the meeting.
Minutes:
Sir David Dalton, Interim Chief Executive Director attended the meeting to provide members with an update on the Pennine Acute NHS Trust. The presentation contained the following information:
The Pennine Improvement Plan has identified six key themes for service improvement these are; improving the four fragile services, Urgent Care, Maternity Care, Paediatric Care and Critical care. As well as improving quality, risk and governance, operations and performance, workforce and safe staffing and Leadership and Strategic relations.
Each area now has its own site leadership team as well as support via a five year management contract with Salford Royal Hospital.
The Interim Chief Executive reported that a three year Quality Improvement Strategy has been developed. There has been evidence of small shoots of improvement for example, in reductions in length of stays and the number of patients dying with end of life care plan in place.
Work has been underway in relation to addressing problem areas within the four fragile services. Within NMGH, there has been an increase to 48 to 58 consultant direct clinical care sessions per week as well as Primary care GP seeing circa 30 patients.
In respect of Pediatrics, 5 additional consultant pediatricians have been recruited as well as a reduction in the numbers of paediatric transfers out of PAHT.
The Interim Chief Executive reported that in respect of risk, governance and leadership a new Board Assurance Framework has been put in place, as well as risk management training and new Directors of Governance and Patient Safety. Executive Safety walkrounds and ‘Work Withs’ have commenced across all sites.
In respect of the financial arrangements, the Interim Chief Executive reported that the following financial investment and support has been agreed:
• £9.2m secured in October 2016 – to support improvement plan.
- 50 new midwives
- Recruitment of nurses and doctors
• £20.5 million secured – recurrent investment
- Strengthening frontline medical and nurse workforce
- 285 more nurses
- IT and information systems
- NASS – nursing assessment system
- Equipment
• £10 million secured – capital
- £5m allocated each to NMGH and Royal Oldham sites for essential site works
- On top of £5m being spent on building new 24-bed intermediate care unit at NMGH
Questions were invited from those present and the following issues were raised:
Members raised concerns in respect of increasing instability for the Trust as a result of the development of the City of Manchester Single Hospital Service. The Interim Chief Executive reported that it will be necessary to re-distribute some services. Closer working arrangements with Salford Royal Hospital Trust will increase the choices available for patients. It is envisaged that residents of Bury, Rochdale and Oldham will be able to access some services closer to home.
In response to a Member’s question, the Interim Chief Executive reported that the success of the Trust is not down to one person. A team has been put in place to support the Trust which includes the establishment of and the appointment to individual site management posts.
Members of the Committee raised concerns in respect of the large amount spent by the Trust on agency and bank staff. The interim Chief Executive reported that there is a national shortage of medical staff and this is particularly apparent in emergency and critical care services.
The Interim Chief Executive reported that the Royal Oldham Hospital will become a High Aquity Centre and elective surgery may be transferred to another site. Responding to a Member’s question, the Interim Chief Executive reported that there are no plans to close A&E at Fairfield Hospital. There are wards within Fairfield Hospital that are not currently used and it may be possible to transfer services in to underutilised wards.
With regards to the recruitment of Middle Grade Doctors, the Interim Chief Executive reported that this continues to be problematic, due in part to immigration restrictions. The Trust has established links with Edge Hill University and other Trusts in the Greater Manchester area to assist with the recruitment process. The Trust has also launched a recruitment drive in the South East of England to encourage staff (including nursing staff) to relocate to the northwest.
The Interim Chief Executive reported that Salford Royal have agreed a Management Contract with the CCGs and the Pennine Acute NHS Trust to provide support to the Trust for a period of five years.
In respect of the Healthier Together implementation the Interim Chief Executive reported that the Trust will need a minimum of £25 million to progress these proposals and this may take two to three years.
The Interim Chief Executive reported that working with four different Clinical Commissioning Groups within PAT can sometimes slow down the decision making process. A Clinical Transformation Group has been established as well as a Clinical Service Strategy. The Greater Manchester Health and Social Care Integrated Board will want to unify commissioning arrangements across the area.
With regards to the financial position at the Trust, the Interim Chief Executive reported that the financial position at the Trust has improved and the Trust will meet its financial plan. There has been additional investment in to the Trust.
It was agreed:
That Sir David Dalton, Interim Chief Executive, Pennine Acute NHS Trust be thanked for his attendance.