To receive an update on developments at BHRUT from a senior Trust officer.
Minutes:
The BHRUT officer explained that there had been a number of new appointments to the Trust Board including to the positions of Medical Director, Director of Nursing and Chairman.
The Queen’s Birthing Centre was now complete and would comprise eight delivery rooms and six post-natal beds. Two open days would be held in December and the unit would be open from 8 January 2013. The unit would gradually expand to a final capacity of 2,500 beds per year.
The development was part of wider commissioner-led changes to maternity arrangements in North East London. Approximately 200 women booked with BHRUT would be transferred to a Barts Health hospital closer to their home. Thirteen midwives would also be transferred to Barts Health under the TUPE regulations.
Officers confirmed that priority would be given to local women who wished to give birth at Queen’s and it was now expected that maternity at King George Hospital would close at the end of March 2013.
The junior endoscopy suite at King George was now in use and a formal opening was planned for December 2012. The Redbridge renal unit was also now open at King George and conversion work on Foxglove ward had now been completed.
The Rapid Assessment and Treatment (RAT-ing) system had now been implemented in Queen’s A&E. Improved streaming of cases had also been introduced including better use of the Urgent Care Centre and more referral of A&E attendees to their GPs. A new medical rota had also been introduced to match the seven-day demand pattern.
Staff development had been improved for nursing staff and more advanced Nurse Practitioner posts had been introduced in A&E who could see some patients independently. Four new A&E consultants had been recruited as well as a new Lead Nurse and additional junior doctors.
As regards other areas of Queen’s Hospital, new professional standards had been introduced for medical cover. There were now weekly performance management meetings as well as the planning and structuring of weekend discharges. There was also continued intensive support for patients who stayed in hospital for longer periods.
The BHRUT officer added that there was now greater clinical engagement with GPs and Social Care in order to reduce instances of inappropriate admissions and delayed discharge. Audits had been carried out with GPs in an attempt to reduce admissions although no drop in attendances had been seen as yet.
The Trust had recently undertaken a travel survey which had shown car parking to be the major complaint for both patients and staff. Work on these issues was ongoing with local representatives of the Greater London Authority and the Trust also enjoyed a good relationship with Council transport planners. The BHRUT staff travel plan would be updated in light of the results of the survey. It was clarified that oncology car park was free for patients receiving radiotherapy and chemotherapy treatment but not for follow up outpatients. This was due to the limited capacity of the car park. Surface parking was free for holders of Blue Badges.
A new Rapid Arc radiotherapy machine had recently been installed at Queen’s paid for by the Trust’s charity. This would allow more accurate and faster treatment as well as a higher throughput of patients. The issue of charging for prescriptions issued in A&E had been considered but with around 70% of patients exempt from payment, it had not been felt that this would generate sufficient revenue to be viable.
Two wards had been affected by outbreaks of Norovirus in recent weeks and the Trust’s new Director of Infection and Control was meeting with all BHRUT clinical teams. The Trust’s charity was now operating under a new name and had raised £800k in the last year. The charity’s recent re-launch event had been attended by the Mayor.
The BHRUT officer emphasised that there was a need to treat more patients in the community in order to release capacity at the hospital. He confirmed that a higher proportion of category A patients had been seen at Queen’s in recent months. Higher A&E attendances were seen on a Monday and it was felt that this may be due to a lack of access to other healthcare services at weekends. The BHRUT officer would check if anti-social behaviour or alcohol-related cases also led to a rise in A&E attendances on a Monday.
Members felt that an advertising campaign would be useful to make people aware that they could go to other services such as a pharmacy or the polyclinic as alternatives to A&E. Officers agreed, explaining that a national campaign to this effect was currently running on buses and shelters. It was agreed that the communications teams at NHS NELC and the Council would draw up a form of wards on alternatives to A&E for use in Members’ newsletters etc.
The Committee noted the presentation.