Issue - meetings

To scrutinise the plans of Barts Health NHS Trust in light of the recent inspection of Whipps Cross Hospital by the Care Quality Commission (CQC).

The Barts Health NHS Trust chief executive explained that an inspection of Whipps Cross hospital by the Care Quality Commission (CQC) had taken place in November 2014 and had revealed significant concerns in a number of areas including A&E patient flow, staffing and bullying. Following the inspection, a risk summit was organised with stakeholders in March 2015 and Barts Health wished to be inclusive with other organisations as part of its improvement plan.

Significant concerns raised by the CQC included issues of staffing, morale & culture, the routine delivery of standards such as keeping to timetables for treatment and the lack of safety policies and embedding of safety etc. The Trust management believed that the public would still get good outcomes and care at Whipps Cross but accepted that patients had been let down. While there were good aspects of care at Whipps Cross, improvements were also required.

The Trust Medical Director explained that immediate recovery action was agreed with the Trust Development Agency, local Clinical Commissioning Group (CCGs) and Healthwatch Waltham Forest.  Significant progress had been made around improving the quality and safety of clinical care. Daily meetings were held where nurses could share any concerns around patient care. The number of medical patients treated on surgical wards had been reduced and the seven-day site presence of senior management had also been improved.

As regards staffing levels, improvements had been made but there was still a reliance on use of agency staff on some wards. The budgeting process for the nursing establishment was currently in progress and the Trust aimed to reduce its need for agency staff. On safeguarding, the introduction of a babytracking system at Whipps Cross maternity had not been concluded and the Trust accepted that this needed to be actioned. Recruitment had taken place to the senior leadership team whose visibility had improved, making it easier for staff to escalate issues if necessary.

The Trust and hospital leadership were keen that staff understood and engaged with the hospital improvement plan. On outpatient issues, the Trust wished to meet waiting time targets, avoid duplication of appointment letters and ensure patient records were available at appointments. In A & E, the objectives were to ensure patients were seen and assessed promptly, admitted to the correct ward and discharged safely.

Trust officers felt that recruitment had improved with the ratio of permanent, agency and bank staff being looked at. A new eight-bed High Dependency Unit was due to open was due to open at Whipps Cross by December. It was accepted that communication around the hospital improvement plan had to be improved both with stakeholders and the general public and also with the hospital’s own staff.

It was also important that staff were engaged in delivering better care and a clinical senate had been established to manage the hospital at a local level. A quality and safety committee would also be set up to allow safety issues and complaints to be dealt with on site at Whipps Cross.

The final  ...  view the full minutes text for item 39