Agenda item

Jude Adams, Chief Delivery Officer, Pennine Acute NHS Trust will attend the meeting and provide an update on the improvement plan and will include the Care Quality Commission Action plan and workforce update.

Jude Adams, Chief Delivery Officer attended the meeting to provide members with a further update in respect of the Pennine Improvement Plan.  An accompanying report had been circulated to elected members in advance of the meeting which contained information in respect of the key areas for improvement identified in addition to the fragile services were:

·         Patient safety, harm and outcomes

·         Systems of assurance and governance arrangements

·         Operational Management and data quality

·         Workforce capacity and capability

·         Leadership and external relations

The Chief Delivery Officer reported that one of the overarching aims of the improvement work was to avoid harm and reduce mortality rates.  Improvement work has been successful in reducing the mortality rate, the rate currently is 96 (compared to a previous high of 106) this is now below the national average.

The Chief Delivery Officer reported that one of the most fragile services was NMGH accident and emergency.  There was 1.5 consultants covering the service 24/7, a significant number of patients waiting over 12 hours on hospital trollies as no beds were available. 

In respect of paediatric services due to problems with staffing in particular in the high dependency unit a number of children were being placed out of area. 

Since the CQC visit there has been significant improvements in the consultant cover in A&E, there has been a reduction in the number of patients waiting over 12 hours for a hospital bed and there has been fewer out of area placements.

In respect of maternity services 1.2 million pounds has been invested and recruitment of additional midwives has been a priority. 

Questions were invited from those present and the following issues were raised:

In response to a Member’s question, the Chief Delivery Officer reported that the NursingAssessment and Accreditation System has been introduced within the Pennine Acute Trust following a successful roll-out across Salford Royal Hospital Trust.  Information gained from the assessment will identify incidents of pressure ulcers and falls, this information will help to ascertain problems across the Trust.

The CQC will undertake a further un-announced inspection between September and December, the inspections will include staff focus groups with staff within the Trust from all areas and all disciplines.  The CQC inspection findings will be made available in December 2017.

In response to a member’s question, the Chief Delivery Officer reported that data collated in respect of the number of falls, pressure ulcers and infections are all strong indicators in respect of how well a Trust is performing.  It is imperative that community services are developed as alternative to acute care.

With regards to Consultant session, the Chief Delivery Officer reported that the Trust has been stabilised in terms of Consultant cover with support from Consultants whose primary place of work is Central Manchester or Salford Royal Hospital Trust.  An additional three consultants have now been recruited and all will be in post shortly.  Recruitment continues to be a problem within the Trust and in some disciplines vacancy rates are as high as 10%.

The Chief Delivery Officer confirmed that engagement is improving with the local authorities with regards to the additional funding they have received to ease pressures in social care.

In response to a Member’s question, the Chief Delivery Officer confirmed that the CQC inspection highlighted problems in respect of how the Trust responded to complaints and also serious incidence reporting.  Systems have been put in place to address the issues identified, including immediate action where appropriate, root cause analysis all complaints shared with Directors.

With regards to the four hour waiting times in Accident and Emergency, the Chief Delivery Officer reported that this target is indicative of how the hospital is performing over all in particular how patients flow through the hospital.  Problems still persistent with regards to recruitment of middle grade doctors, significant improvements have been made at Fairfield General Hospital and this site is now the best performing hospital in Greater Manchester. 

It was agreed:

1.   A further update in respect of the most recent Care Quality Commission visit will be provided at a future meeting of the JHOSC for Pennine Acute.

2.   Sir David Dalton will be invited to attend a future meeting of the JHOSC for Pennine Acute.

The Chair agreed that items 6 & 7 would be considered as one item