Agenda item

Jacqui Scott, Chief Executive Officer and Janet Ettridge, Director: Operations, Bromley Healthcare presented the Bromley Healthcare Quality Account 2017/18 to the Sub-Committee, which outlined the findings of a review into the quality priorities and performance during 2017/18, and looked forward to a planned improvement in the quality of services across five priority areas for 2018/19.  There was a statutory requirement for all NHS publicly funded bodies to provide their Annual Quality accounts to NHS England and for this to contain a supporting statement from the Health Scrutiny Sub-Committee.

During 2017/18, Bromley Healthcare had launched the Care Coordination Centre which went live on 1^st January 2018 and offered a single point of access for all patients, carers and referrers into community services, proactively supporting the management of 25,000 Bromley Healthcare patients.  Significant progress had also been made in achieving Bromley Healthcare’s quality objectives including a 59% reduction in avoidable pressure ulcers, enhanced clinical record sharing with Bromley General Practitioners and implementation of Therapy Outcomes Measures.  The National Audit of Intermediate Care had highlighted Bromley Healthcare’s Rehabilitation Service as delivering some of the best outcomes for patients both regionally and nationally, and 98.14% of patients responding to the National Friends and Family test had stated they were ‘Likely’ or ‘Extremely Likely’ to recommend Bromley Healthcare’s services.  A number of innovative outcome-based contracts commissioned by the Bromley Clinical Commissioning Group had also been successfully implemented.  Five priority areas had been identified for improvement for 2018/19 which reflected learning from Care Quality Commission (CQC) inspections undertaken since 2016/17 and were underpinned by the five CQC core standards for a healthcare organisation comprising Safe, Caring, Responsive, Effective and Well Led.  This would include a focus on Bromley Healthcare staff following a significant period of change.

In considering the quality priorities for 2018/19, the Chief Executive Officer, Bromley Healthcare confirmed that the target of 3% for patient engagement was one of the measures by which Bromley Healthcare aimed to place patients at the centre of their care, and would be achieved by encouraging patients to provide feedback relating to their patient experience.  A Member queried the total direct cost per service user assessed by Bromley Healthcare which, at £175 per user appeared to be considerably more cost effective than the London and England average costs, and the Chief Executive Officer, Bromley Healthcare would provide further details to Members following the meeting.

In response to a series of questions from Members, the Chief Executive Officer, Bromley Healthcare advised that recruitment continued to be a concern in some areas of service provision but that work was underway to embed robust recruitment and retention practices across Bromley Healthcare and reduce the use of bank and agency staff, which had already proved effective for service areas such as the Rapid Response Team which was now fully-staffed.  Bromley Healthcare was currently developing a sustainable response to ongoing recruitment difficulties within the District Nursing service which had included a highly successful open day for newly qualified nurses and the introduction of nursing associate apprenticeships to encourage young people to build a career in the service.  Apprenticeships would be a key part of the future recruitment strategy of Bromley Healthcare, with four apprentices already placed within the Care Coordination Centre and plans to introduce further nursing associate apprenticeship opportunities across wider health and care services.  Consideration was being given to whether the high cost of housing in the London Borough of Bromley was affecting recruitment and retention and how this might be addressed, such as by promoting key worker housing schemes.

The Interim Director: Programmes highlighted the Proactive Care Pathway, which had been developed by Bromley Clinical Commissioning Group with a range of partners including Bromley Healthcare, as an example of best practice.  Delivered as part of the Bromley Out of Hospital Transformation Strategy, the Pathway had provided proactive, coordinated care to over 1600 patients since the launch of the scheme which aimed to support the health and care needs of service users through integrated services, reducing unnecessary emergency admission in the system.  The Chief Executive Officer, Bromley Healthcare confirmed that Care Navigators were now based with the three Integrated Care Networks and worked to assist patients and carers with identifying and accessing the systems and support available to meet their individual care needs.

A Co-opted Member suggested that Bromley Healthcare attend a future meeting of the Health Scrutiny Sub-Committee to provide an update on the outcomes of the Care Coordination Centre.  The Chairman suggested that it might also be useful to arrange a Member visit to the Centre.

The Chairman led Members in thanking Bromley Healthcare for an excellent report and was pleased to note that patient experience had been placed at the heart of the Bromley Healthcare Quality Account 2017/18.

RESOLVED that the Bromley Healthcare Quality Account 2017/18 be supported by the Health Scrutiny Sub-Committee.