Agenda and minutes

(If any) – receive

Apologies were noted and no substitute members were received.

Members are invited to disclose any pecuniary interest in any of the items on the agenda at this point of the meeting.  Members may still disclose any pecuniary interest in any item at any time prior to the consideration of the matter.

None disclosed.

To approve as a correct record the minutes of the Health and Wellbeing Board meeting held on 10 July 2013 and to authorise the Chairman to sign them.

The Board considered and agreed the minutes of the meeting held on 10 July which were signed by the Chairman. 

Presentation by and discussion with representatives from the Trust – Sir Peter Dixon, Trust Chairman and Dame Professor Donna Kinnair, Clinical Director for Emergency Care.

Following quality and performance issues at Queen’s Hospital A & E, and in particular, two recent Care Quality Commission (CQC) inspections, the Health and Wellbeing Board had invited representatives of BHRUT to discuss the following:

§    In the light of the CQC reports, what the key issues were for the Trust and how it was planning to make further improvements in patient care and safety

§    Effective patient flow through the hospital, particularly A&E, and compliance towards the 95% 4-hour A&E waiting time target

§    How the Trust planned to improve its staffing capacity in the hospital, with particular reference to A&E

§    What were the process issues to ensure effective and timely discharge of patients

§    What the Trust’s plans were in relation to winter pressures and how it intended to work with relevant partners to effect integrated care

§    An update on the three work streams that the Urgent Care Board (UCB) had given BHRUT to lead on:

i)             A&E recruitment 

ii)            Urgent Care Centre (UCC) at Queens (including redirection to primary care)

iii)           Seven day working

§    Further explanation of the BHRUT Chief Executive’s letter of 18 July in relation to:

i)             The strategic drivers, including risk assessments, underpinning the proposals outlined in the letter

ii)         The approval process for the letter

§    Whether BHRUT had any issues or concerns that it would like to raise with the Board.

The Chairman of BHRUT gave a presentation to the Board covering the following points.  During the course of the presentation, various

issues were raised by HWB Board members, the Chairman of BHRUT welcomed this interactive approach.

Accident & Emergency – Queens Hospital

It was acknowledged by BHRUT that there had been long standing concerns about the emergency care pathway and that BHRUT’s performance was among the poorest in London for patients completing their care within 4 hours. The target performance percentage for the year was 95% however the first quarter of 2013/14 was 88.59%.  Performance had increased over the last four weeks to 93% although this was usual during the summer months.  In summary, BHRUT stated that too many patients were waiting too long in the Emergency Department which was undesirable and could become clinically unsafe. The main reasons for this were assessment delays, bed waits and specialty response delays.

Care Quality Commission (CQC) Inspection

The result of the CQC inspection in May came as no surprise as the Trust had been aware of their shortcomings. The CQC had concerns about shortage of permanent medical staff and delays in the Emergency Department affecting the care and welfare of patients. Some improvements were noted in the report such as the provision of hot meals for patients awaiting hospital admission. The CQC had recommended radical thinking in order to tackle the reasons behind the poor performance and the Trust would have to submit revised plans to the CQC by September 2013.

It was brought to the attention of the Board that attendances at Queens’s A & E had  ...  view the full minutes text for item 39.

The Board is asked to note that the date of the next meeting is scheduled for 11 September 2013 at 1.30 pm

The Board was asked to note that the date of the next meeting was scheduled for 11 September 2013.