Minutes:
The Sub-Committee received a presentation from Matthew Trainer, Managing Director for the Princess Royal University Hospital (PRUH) and South Sites and Sarah Middleton, Stakeholder Relations Manager, King’s College Hospital NHS Foundation Trust providing an update on the progress of the Trust and the PRUH Improvement Plan.
Although it continued to be extremely challenging to meet emergency performance targets, there had been significant improvement in the performance of the Emergency Department during April and May 2017. Referral to Treatment times remained an area for improvement, but overall it had been identified that the quality of care at the PRUH remained very high and that the Trust continued to perform well against key outcomes and safety measures. Patient experience across the Trust had been reported as being good for 2016/17, and the King’s Way Programme which aimed to increase the quality of services and make them more efficient and productive continued to be implemented. The review of the Outpatients’ Service was also ongoing and it was planned to improve patient experience, efficiency and productivity through a range of measures including digital transformation. Six major areas of work had been developed in response to the annual staff survey results which comprised strengthening relationships between staff and senior leaderships, improving support for managers, value and recognition, diversity and inclusion, career and talent development, and health and wellbeing. Priorities for the coming year included improving access, finance, recruitment, quality and safety and end of life care. The Trust had delivered a £49m full year deficit in line with the mid-year forecast and had a target of a full-year deficit of £39m for 2017/18.
In considering the update, a Member was pleased to note the significant improvement in Emergency Department performance in April and May 2017 and underlined the need for this to be sustained. The Managing Director for the PRUH confirmed that work to manage the usage of the Emergency Department would continue. Inpatient admissions and bed management remained an area of key focus including regular meetings to review bed availability, and a London Borough of Bexley social worker had been placed in the Transfer of Care Bureau to support Bexley residents to move into more appropriate provision when hospital care was no longer required.
With regard to a query from a Member about the significant cost of agency staff, the Managing Director for the PRUH advised that there continued to be a significant shortage of skilled staff in some specialist areas, such as dermatology and that this made it difficult to recruit permanent staff. A range of measures would be used to support recruitment and retention including the block-hiring of housing and relocation packages for doctors where this was cost effective. The PRUH was working with other hospital trusts across London to set standard agency rates for staff in particular specialisms to help contain agency spend.
Members generally discussed the importance of ensuring that patients received appropriate end-of-life care, particularly in relation to nursing and care homes. In response to this, the Managing Director for the PRUH confirmed that a pilot scheme had been introduced which placed experienced Geriatricians in the Emergency Department between 8.00am-4.00pm to identify patients requiring end-of-life care and ensure they received the necessary care and support. A representative from St Christopher’s Hospice was also located at the PRUH and was able to provide advice to ward staff. There was a need for a wider conversation to be undertaken across all key partners to ensure an holistic approach to end-of-life care and for nursing and care homes to be included in these discussions.
In reporting other issues, the Managing Director for the PRUH was pleased to announce that one of the hospital’s two CT scanners had recently been replaced and that the backlog of CT scans had now been cleared. The King’s College Hospital NHS Foundation Trust had not been amongst the hospitals affected in the global cyber-attack in May 2017, and the PRUH remained on track to move to the new cross-site Electronic Patient Record system in October 2017. In response to concerns raised around the capacity of the PRUH car park, the Managing Director for the PRUH advised Members that this had been identified as a priority and that he would be writing to the Local Authority in June 2017 setting out the PRUH’s plans to phase in additional parking on site.
The Chairman led Members in thanking Matthew Trainer and Sarah Middleton for their presentation which is attached at Appendix A.
RESOLVED that the update be noted.