Scrutiny of BHRUT response to report of Care Quality Commission. Discussion with Averil Dongworth, BHRUT.
Minutes:
The Director of Planning and Performance at BHRUT confirmed that the Trust took the findings of the Care Quality Commission (CQC) report extremely seriously. Some actions were already underway but the Trust was keen to speed up the pace of change. The latest action plan in response to the CQC recommendations had been circulated to the Committee.
Management of the maternity department had been strengthened with the recruitment of a new director of midwifery who was due to start in three months. The Trust was now operating a 1:29 midwives to women ratio, one of the highest in London.
The diversion of planned caesarean section deliveries to the Homerton Hospital was intended to be for a period of eight weeks but it had been decided to continue this until the end of the current financial year. It was then planned to move deliveries of this type to King George Hospital.
A study of staff behaviour in maternity had been undertaken as well as a large exercise in staff engagement. A zero tolerance approach was now being taken to poor staff behaviour. A new complaints system had also been introduced. The details of the co-located Midwife Led Unit at Queen’s were currently being worked on.
Emergency care had also been raised by the CQC and the JONAH computer system had recently been implemented to facilitate A&E patients’ journeies through the whole of the health sector, not just the acute hospital. It was planned to expand the majors, resuscitation and intensive care sections of Queen’s A&E in light of the extra work expected when the A&E at King George was closed.
Officers accepted that, given the large size of the maternity unit, some serious incidents would still unfortunately occur. A recently publicised case was reported promptly as a serious incident and the midwife concerned was not a Trust employee. The Trust was only able to respond publicly to such cases when the family involved chose to put the matter in the public domain. The Trust action plan in response to the CQC report was available on its website and there had been a lot of positive work undertaken with both Councillors and the Local Involvement Networks. It was agreed that any incident notifications that were able to be shared publicly would be passed to the clerk to the Committee for forwarding on to Members. Maternity reports to the Trust board were also available to view on the website.
It was confirmed that Essex women with due dates of 1 April 2012 onwards were now able to again book deliveries at Queen’s if they wished. Trust officers agreed that the behaviour of drunks in A & E continued to cause problems. A recent incident was reported quite quickly but it was accepted that reception staff should have reported this at an earlier stage.
Replacing hospital signage was an expensive project but officers accepted that a solution needed to be found on an interim basis. This issue had also been raised by the CQC and LINk representatives had been invited onto a group looking at hospital signage. The H4NEL programme manager reiterated that health officers were keen to receive any feedback, whether positive or negative, and use this as a lever for change.
Officers noted Member concerns about inadequate information kiosks and screens at A&E and agreed to pass these to the appropriate department.