Issue - meetings

Report attached.

A programme to improve the financial position at BHRUT was under way with a target of £28m savings in the current financial year. It was anticipated that approximately half of this would be achieved on schedule. Work to reduce costs included improving the planned flow of elective procedures so that the current 50-60% use of theatres was increased to 85-90%. Achievement of this target would generate financial improvement of around £25m.

Work was also in progress to reduce outpatient activities of which the trust saw around 2,000 each day at Queen’s Hospital alone. It was felt that up to half of outpatients could be treated in other ways including by phone or in primary care. There was a target to reduce outpatient numbers at the Trust by 30% over the next three years. Reducing spend on agency staff would also save as much as £12m.

The Trust was continuing to fail to meet targets for the ‘four hour rule’ in A & E although the Trust had seen a 10.2% rise in attendances over the last year. The Trust saw up to 1,100 A & E patients per day as well as up to 200 ambulance transfers. Internal processes and systems at A & E were being reviewed although there were also space constraints on the department.

Initiatives to improve performance had included recruitment of Advanced Care Practitioners and the Red2Green system to allow clinical staff to highlight delays in patient care. A new frail elderly unit had been opened at King George Hospital to support winter pressures as well as new short stay elderly care beds. 

Referrals for hospital treatment had grown in recent years and BHRUT was working with the CCGs to better understand referral patterns. The longest waiting patients were reviewed on a twice weekly basis. Improvement work was also focussing on improving booking processes and clinic utilisation.

The Trust had struggled recently to meet targets for starting cancer treatment for some specialities within 62 days. A cancer services recovery plan was in place with a target to return the Trust to compliance by March 2020. Standards for diagnostics had been met in October & November 2019 and waiting lists, which would continue to be monitored, had reduced from 14,000 to 8,000.

Net recruitment to the Trust had increased and officers were pleased that there had been an increase in the response rate at the Trust to the NHS Staff Survey. The establishment of an Academy of Surgery had shortened the time to recruit and a senior intern programme had improved nursing retention rates.

Patient experience scores for maternity were still below target although ratings for both inpatients and the Emergency Department were both exceeding targets. Uniforms had recently been introduced for hospital volunteers and work was in progress to improve accessibility for deaf and blind patients. Changing Places toilet facilities were scheduled to be installed at both Trust hospitals.

A Care Quality Commission inspection had taken place between September and November 2019 and the Trust had been rated as good  ...  view the full minutes text for item 28