To receive a presentation from Pam Strange, BHRUT on the Trust’s Quality Account.
Minutes:
The Clinical Governance Director from Barking, Havering and Redbridge University Hospitals’ NHS Trust (BHRUT) thanked the Committee for the opportunity to present the Trust’s Quality Account. The Trust had undergone a number of changes in the last year including a new Chief Executive and new Interim Chair. A new Director of Transformation would also be starting shortly. As Members were aware, many parts of the Trust’s operations had recently been reviewed by the Care Quality Commission and a lot of improvement had been required in maternity, A&E and vascular services. An 81-point action plan had been developed in response to the Care Quality Commission report and this was reviewed on a weekly basis.
The Care Quality Commission had emphasised partnership working and the Trust’s partners had felt that the main priority should be to achieve an improvement in the attitude of hospital staff. The BHRUT Director of Transformation would lead on this work and other priorities for the year included patient safety and clinical effectiveness.
The Clinical Governance Director explained that some areas had improved their performance with for example reduced waiting times in the stroke unit and improved midwife ratios for women in labour. The Trust’s mortality ratio had also reduced. It was accepted that MRSA targets had been narrowly missed and work was underway to reduce pressure ulcers and numbers of falls. Real time patient surveys had been introduced leading to the receipt of very helpful feedback from patients.
It was clarified that the reduction in length of patient stay in hospital was done safely with treatment administered in a timely way. The required 1:29 midwife to patient ratio had been maintained even during the recent reintroduction of elective caesarean section deliveries at the Trust as midwife recruitment had been continued successfully.
Members were pleased that the Trust had taken on board a number of issues raised by the committee although further progress was needed in several areas. It was confirmed that all midwives recruited from overseas were interviewed by Trust staff and sat language and other examinations. Midwives were mainly recruited overseas by the Trust from Ireland and Italy.
Members were concerned at feedback from a representative of Havering Local Involvement Network (LINk) that the butterfly scheme for identifying patients with dementia had not yet been implemented. The Clinical Governance Director agreed to check when the Trust was due to implement this.
The Health for North East London (H4NEL) lead reported that the midwife-led unit at Barking was now taking bookings with the first deliveries expected by December. Services at the unit would be provided by the Barts Health NHS Trust. Officers would clarify whether midwives recruited to the Barking unit would also be required to undertake tests in English language. Members felt it would be useful to undertake a scrutiny visit to the Barking unit.
The Committee noted the improvements presented in waiting times in A&E but felt that considerable further progress was needed in this area. Members were also concerned that the Queen’s A&E department would be unable to cope with the rising population in the local area as seen in several large local property developments that were currently being constructed. The H4NEL lead assured the Committee that the rising population was taken into account during the planning process but agreed to give details on this process when she next attended the Committee.
Officers felt that there were now fewer diversions of ambulances away from Queen’s Hospital but Members were also concerned at reports of patients waiting long periods in ambulances before they could be admitted to A&E. Reviews were undertaken by the Trust if patients were waiting in ambulances for more than an hour. It was also clarified that ambulance staff could not leave a patient until a formal clinical handover with hospital staff had taken place.
It was confirmed that the resuscitation area in A&E was a mixed-sex area with seven adult bays and one child bay. Dignity was however always maintained via the use of screens etc.
The Committee noted the presentation and agreed that the Committee Officer should draft a letter summarising the views expressed which could be included in the final version of the Trust Quality Account.