Report of the Executive Chief Nurse and Director of Governance and Communications
Tosca Fairchild-Moyo, Director of Governance and Communications and Mike Carr, Divisional Manager of University Hospitals of Derby and Burton (UHDB) gave a presentation to the Committee on the recent merger of the two hospitals and the progress being made towards integrating services to benefit patients. The presentation also covered information on the Cancer performance targets which the Committee had requested at the Accountability session in July 2018.
The presentation covered:
· The story so far – the ‘Big Conversation’; investing in maternity services; Joint Advisory Group (JAG) accreditation; and increased capacity over winter.
· The Merger principles – Sustaining clinical services at Queens Hospital Burton: Developing tertiary (specialist) services at Royal Derby; and Making the best use of community hospitals in Lichfield, Tamworth and Derby.
· Six clinical deep dives – Cardiology, Trauma and Outpatients, Stroke, Renal, Urology (Cancer) and Radiology.
· Next stages – A further six deep dives into Ophthalmology, Dermatology, Gynaecology, Vascular Surgery, Critical Care and Head and neck.
· The development on the Outwood’s site (Queens Hospital) and the capital funding of £21.88m received from the Department of Health and Social Care.
· Cancer performance – the 62 day cancer referral standard remained a challenging target.
Following the presentation, a Member asked how much choice a GP had when referring patients to hospitals and speed at which information was transferred between Community Hospitals and Acute hospitals. In response Members were informed that a new digital website was being developed and one aspect of this incorporated more choice for GP’s and patients. It was acknowledged that integrated communication between the community and acute hospitals was a particular issue and was a valid concern which officers would take back to the trust.
A Member felt that transport between Burton and Derby Hospitals was problematic for some patients. A bus service between both sites was in place and car parking was increasing with an additional 517 parking spaces on the Derby site provided for staff with further car parking development planned for the Burton site which would facilitate additional spaces for patients.
A question was asked on the cancer service and screening for cancers such as prostate cancer and how this was a challenge to get people to take up screening. Imaginative ways were already happening led by Miss Shah – Consultant Urologist and this had been covered nationally in the press such as attending football matches to carry out screening.
A Member asked how the hospitals were managing their financial deficit, and how they were managing recruitment and retention of staff. In response, it was agreed that the deficit was very challenging, and services were being reviewed all the time to ensure that services were operating as efficiently as possible. The STPs for both Derbyshire and Staffordshire were also working together to drive efficiency. With regard to recruitment/retention and budget pressures, it was explained that during the merger, there had been no redundancies with all staff finding a position in the new organisation and the Hospitals were continually recruiting into all posts. The Committee were pleased to hear this and asked if they could have sight of the Trusts financial plan, for information.
A Member noted that the development strategies employed by UHDB were very different to that of the Staffordshire Hospitals. For example, UHDB were increasing Accident and Emergencies capacity; additional car parking; increasing modular wards to accommodate more patients through the winter. There also seemed to be a move to repatriate patients in areas such as Cardiology which nationally, was moving to specialist centres as opposed to local provision. In response, the Director of Governance and Communications informed Members that emphasis was on quality care close to home and that activity levels were planned with Commissioners, but its delivery was affected, and challenged by any actual attendances which were quite high and delayed transfers of care. It was felt that the move to repatriate specialisms was a question for the Medical Director.
The Committee was informed that one of the main areas of concern for UHDB in relation to the 4 hour emergency target was the 12 hour breaches for mental health patients as one patient that could not be transferred from UHDB to a more appropriate service provider could result in a whole ward being closed and used by that one patient, dependant on safety/care issues. The Committee requested more information on how this was being managed with the Midlands Partnership Foundation Trust.
A Member asked if information could be shared to demonstrate real patient benefit that had been delivered because of the merger. The Director of Governance & Communications gave an example of the significant positive outcomes for patients with Acute Kidney Injury (AKI) and agreed to share the data that had been shared with UHDB’s Council of Governors
The Chairman thanked officers for attending the meeting and their informative presentation.
RESOLVED: That the following information/action be requested:
a) It was acknowledged that integrated communication between the community and acute hospitals was a particular issue and was a valid concern which officers would take back to the Trust.
b) The Committee asked if they could have sight of the Trusts financial plan, for information.
c) The rationale behind the move to repatriate specialism services.
d) More information on how patients with mental health issues were being managed in order to transfer them to the most appropriate service provider.
e) Data relating to the AKI outcomes to be shared with the Committee.