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Agenda item

Agenda item

PHT update including the Care Quality Commission's Inspection report on Queen Alexandra Hospital

Ursula Ward, Chief Executive Portsmouth Hospitals' NHS Trust will present the attached letter.

Minutes:

Ursula Ward, Chief Executive of Portsmouth Hospitals' NHS Trust introduced her report and added the following points:

·         There was a planned CQC inspection February 2015, which involved 60 inspectors over four days.  It was a very detailed process and they were vigorously assessed. The CQC's draft report was received in May which gave the hospital trust the opportunity to respond to any factual inaccuracies.  There were a number of misinterpretations and the CQC had accepted 75-80% of these changes.

·         The main reason for the overall rating of 'requires improvement' was due to unscheduled care, which was particularly busy during February when the inspection had taken place. 

·         PHT were very pleased to be rated outstanding on caring as only 4% of hospitals had received this rating so far. 75% of hospitals inspected had been rated as 'requires improvement' overall and 20-25% of hospitals had been put into the special measures bracket.

·         PHT received a follow up visit from the CQC on 25 April to view progress on improvements made to date and a report on this is expected in the next couple of weeks.  This will be circulated to the panel once received.

·         A number of improvements had already been implemented since February and during the next 6-12 months there would be another inspection.

·         A quality summit was held on 2 July which a number of partners, commissioners, the Trust Development Agency, Healthwatch etc. were invited to.  The quality improvement plan setting out the key themes and issues will be circulated for comment prior to submission to the CQC on 6 August.

·         The annual hospital open day is being held on Saturday 3 October which would give the opportunity to get behind the scenes which she encouraged the panel to attend if possible.  Some members said they were planning to attend this.

In response to questions the following points were clarified:

·         Attracting nursing staff is a big issue at PHT and also internationally. There are currently 300 unfilled nursing vacancies at PHT and they are recruiting nurses from Portugal and Spain to try to fill these.  Nurses training in Portugal in particular are of an incredibly high standard and the attrition rate is very low.  There is also a shortage of middle grade doctors with eight vacancies presently.

·         The practice of nursing is now more complex and there is evidence of young people wanting to get into nursing who do not want to go to university due to the large debt they will incur. PHT are trying to develop other roles based on experience of working with military staff who use medical assistants who carry out complex procedures and this has made a big difference.  They are also working on an education programme with Solent University to ensure good development programmes with a clear progression.

·         With regard to the impact on the ED once the 20,000 plus additional homes are built in the QAH catchment area, Ursula Ward said are all in the local health economy are recognising that a step change is needed to work cohesively together.   There is a system wide plan in place which all partners have signed up to.  There is an issue with how to manage the frail and elderly and those with long term conditions. Going to hospital should be seen as the last point of referral and PHT are working with community providers to promote this message.

·         With regard to end of life care, the Liverpool pathway was the standard set at a national level however there were concerns with its interpretation.  Previously there was a dedicated end of life ward which provided outstanding care however physically this ward area was unable to accommodate all those patients requiring this care, In April 2015 following extensive consultation, the End of Life Palliative Consultant, the Specialist Palliative Care Team and the End of Life Care Team have been co-located into one CSC, Medicine for Older People, Rehabilitation and Stroke. From 1 July the Trust wide End of Life Strategy was formally launched.  Ursula advised she would be happy to provide more information or a visit for the panel to see this new team.

·         Councillor Keast said he was shocked with the numbers of patients waiting for discharge for various reasons and asked as a councillor at Hampshire County Council could help improve this situation.  Ursula Ward advised that there are approximately 120 patients occupying beds who do not need to be there.  She said that part of the reason is down to the hospital that need to be more consistent and further work is needed.  Additionally partners need to work with PHT.  Portsmouth city council are able to respond quicker with care packages as have integrated teams with Solent.  Councillor Keast said he would take this back to Hampshire County Council to see if a situation could be improved.

·         Councillor Ferrett said that both Portsmouth City Council and Hampshire County Council will be facing big cuts to Health and Social Care budgets and he hoped that PHT would be consulted on the possible impacts of cuts. Ursula Ward said that the whole of the health and social care resources needed to be reviewed and PHT are aware that resources could be used more effectively.

·         With regard to recognition awards for staff, Ursula Ward advised that PHT run a 'best employee of the month' award.  They also work with The News on the Healthcare Award which is internally a prestigious award ceremony where individuals and teams are recognised.  There are also long service awards for the very dedicated and loyal staff working for PHT.

 

RESOLVED that the report be noted.

 

Supporting documents: