Agenda item

Report attached.

It was noted that some data due to be presented had been delayed as this had to be validated with other hospitals. The 95% ‘four hour rule’ target for A & E had not been met by any London trust although it was noted that BHRUT had not met this target since July 2015. It was also noted that the Trust had seen an increase of 6% in A & E attendance which was in line with increases across London and England. Performance on referral to treatment timescales had also deteriorated.

Performance on the 62 day target from the receipt of a GP referral had been fairly consistent at around the local and national targets. Performance on the two week wait target from GP referral to first diagnostic appointment had deteriorated recently due principally to problems with the treatment of cervical cancers etc.

As regards treatments waits, only 16 patients had been waiting for more than a year. This had recently reduced to 8 patients, all of whom were on a pathway of some kind. Delays of this length were often due to pain issues. The main referral to treatment waiting list at the Trust had reduced by 1,230 patients and BHRUT was hoping that this could be reduced further by streamlining processes such as the introduction of a virtual fracture clinic.

It had proven difficult to meet targets for 7 day length of stay but the introduction of the Red2Green national initiative had allowed all clinical staff access to highlight why a patient was in hospital and any delays to their care. Weekly review meetings were held for all patients although it should be noted that long stays were often expected in areas such as stroke or neurological rehab.

Vacancies at the Trust were currently running at 13%. Recent initiatives to address tis had included the setting up by the Trust of an Academy of Surgery which had seen a lot of doctors recruited by the Trust from overseas. The time to hire for medical staff had reduced by half in the last 12 months.

A senior intern programme had been introduced to support new nurses and this had led to an increase in nurse retention rates. Around 23 nurses from the Philippines were due to join the Trust each month for the next six months. The possible reintroduction of nursing bursaries could also assist with recruitment.

The Trust was keen to recruit local people and worked with local colleges and schools. The Trust also supported social care staff who may wish to move into nursing. Twitter was already used but it was accepted the Trust could also use Instagram for recruitment. It was suggested that the Trust could also link with National Apprenticships Week.

The Trust had a target end of year deficit of around £51 million and currently approximately £5 million off target for this. Trust finances had however improved by £7 million in the last year. The Trust’s target was also to break even by March 2021.

Measures taken to reduce the deficit included reducing waste from the elective process such as reducing cancelled operations and using theatres more efficiently. It was also planned to reduce the number of unwarranted outpatient appointments and to reduce spending on agency staff.

Officers could provide full details of the amount of health tourism but the Trust was proactive in seeking to recover income from this. The current health tourism funding recovery rate at the Trust was 40-50%. It was noted that cases could not be turned away from e.g. maternity, even if there was a health tourism issue.

Officers agreed that family issues often meant older people had to stay in hospital longer than was necessary and felt recovery was normally better in a patient’s own home than in hospital.

The Sub-Committee agreed that performance data on A & E and on referral to treatment times although these may be presented in a different format. It was suggested that patient stories could also be scrutinised in addition to the data itself.