Priority 8: Improve the quality of services to ensure that patient experience and long-term health outcomes are the best they can be.
Presentation by Alan Steward
Minutes:
The Chief Operating Officer of Havering Clinical Commissioning Group gave a presentation on progress on Priority 8 of the strategy - improvement of quality of health services, patient experience and best possible long-term health outcomes across Barking and Havering University Hospitals NHS Trust (BHRUT). Six key objectives were outlined as follows:-
1. Bring about big improvements in quality of care and patient safety, especially maternity services in Queen’s Hospital
Key improvements in Maternity had been made and the cap on the number of maternity patients had now been lifted.
There were key issues namely pressure ulcers, falls, Urinary Tract Infections (UTIs) and Venus Thromboembolism (VTE). These would be monitored closely during 2013/2014 as well as Accident and Emergency with Key Performance Indicators embedded within the contract to cover this period.
Serious Incident Management had improved significantly at BHRUT with the number of cases down from 143 in May 2012 to 11 in May 2013.
2. Ensure patient experience in A&E is improved by reducing waiting times and diverting people away from A&E where appropriate
The quality and performance in Accident and Emergency needed to improve. It was acknowledged that the Trust had to achieve a significantly higher performance level on the national standard of patient waiting times – i.e. 95% of patients should wait no longer than 4 hours for treatment. As at 26 May 2013, BHRUT achieved 84.12% although attendances remained relatively static. It was noted that King George Hospital had met the target but had recently dipped and Queens Hospital had rarely met the target since April 12013.
An improvement plan had been implemented which comprised of the following:
An Integrated Care Plan to reduce attendances and support discharged patients at home.
Community Treatment Teams to provide a rapid response type service so as to reduce attendances and admissions
To promote use of Urgent Care Centres from 30% patient usage to 50%.
GP alignment to care homes in the borough so as to reduce reliance on Accident and Emergency.
Directory of services to increase use of community alternatives to A&E.
Following the CQC visit to BHRUT, the Trust had submitted an updated improvement plan taking account of acute reconfiguration, plans for each work stream, leads, actions and Key Performance Indicators as well as the focus on patient experience and best practice suggestions itemised in the Department of Health checklist. The plan has been signed off and the Trust will be held to account.
3 Improved quality of care in community residential settings and increase primary medical care in nursing homes
The Nursing Homes scheme went live on March 12013. The scheme matches named GP practices with each of Havering’s Nursing and Residential Care homes ensuring regular visits are made to all residents.
4 Risk is managed systematically and accurately to reduce likelihood of occurrence of serious incidents
The Clinical Quality Review meetings consider the risks to quality and patient safety as well as the Quality Risk profile around welfare of service users, staff support and service quality. The overall risks considered at the CCG’s Quality and Safety Committee Audits for 2013/2014 include A&E, integrated care pathways and Consultant to Consultant referrals.
5 Ensure sound financial management of the NHS budget for Havering so that quality of services is not compromised
There would be monthly management of major providers through contractual arrangements and detailed financial information shared with practices to allow monitoring. Quality Innovation, Productivity and Prevention (QIPP) plans agreed to deliver 11 million financial savings and a commitment to work closely with the Council to develop community budgets for 2014/2015.
6 Commission and performance manage Health Watch to high levels to ensure patient and public engagement activity that can affect improvement
A joint process between Havering CCG and Havering Council had led to the establishment of Health Watch with a number of priorities
areas and a model agreed.
The Board agreed that page 6 of the presentation depicting the BHR System Improvement Plan be translated into a briefing document for circulation to Councillors.
The Board noted the report as an honest and straightforward account and thanked the CCG Chief Operating Officer.