Agenda item

To receive an update from the Chief Executive of Heatherwood and Wexham Park Hospitals NHS Foundation Trust on the financial position, with reference to the Trust’s response to the Panel’s written questions, and the action being taken by the Trust on:

            a.      The statutory intervention notice issued by MONITOR; and

            b.      The Ratings of the Trust’s performance by the Care Quality Commission

John Jones, Director of Corporate Affairs, and Clare Culpin, Director of Nursing, from Heatherwood and Wexham Park Hospitals Trust attended the meeting in place of Julie Burgess, Chief Executive, who had been called away to a meeting with the Strategic Health Authority. They gave an update on the financial position at H&WPH, and indicated that documents showing the statutory intervention notice issued by MONITOR and the CQC rating had been circulated with the Agenda. A letter to the Chairman of HOSP, dated 14 October, had also been circulated.

In response to these recent developments, Christopher Langley had been appointed directly as Chairman, and a Medical Director had been sought; interviews were held and two applicants turned down the post, and there was now a temporary Medical Director in post. Mr Jones indicated that Monitor had made it clear that they had no concerns about patient care at the Trust. A major transformation programme was underway, with 150 cost improvement plans in place. The Trust was now working more effectively and the plans had been risk assessed to ensure safety of patients. Procurement contracts had been reviewed, and resources were being used more effectively. There would be a four year plan in January, and it was hoped to improve the Trust’s financial position and to turn around the organisation so that it became viable once again.

With regard to the declaration to the Care Quality Commission , which covered health and social care, 35 out of 42 standards had been met. There would be a formal declaration in the new year, and continuous assessment. The CQC had asked for mid-year declarations in April and October, following comprehensive review against all the standards. The Trust was working closely with the CQC and sharing detailed information in a bid to move forward.

The Chairman thanked the Trust representatives, and asked whether they were on track for licensing. The response was that they were working towards it and had had meetings with CQC who were reviewing progress, that a conditional licence was possible, but a decision would not be known until 2010. The Trust had undergone a very detailed assessment on core standards across the whole organisation, and they had reviewed all the evidence to assure themselves that it was robust. The conclusion was that they were now in a much better position.

Councillor Thompson asked about Monitor’s role, and whether there was continued contact. Mr Jones replied that the Trust needed to prove viability; the main difference in the plans was over governance and finance to ensure that the Trust made a surplus in two years’ time. Monitor had not rejected the whole plan, and Cllr Thompson was assured that there would be consultation about any major service changes.

With regard to the employment of agency staff, and the significant cost involved, Cllr Mrs Shillcock asked whether the Trust had examined its Terms and Conditions of employment to discover why staff did not want permanent contracts. Clare Culpin told the meeting that there had been a lack of process in terms of booking agency staff. Nurses and midwives were very difficult to recruit because of the close proximity to London, and the high cost of living in the area. The Trust offered a good deal to nurses in terms of career pathways. However, sometimes it was impossible to recruit specialist nurses, so there was a need to use agency staff.

Councillor Virgo asked whether Clostridium difficile figures could be brought to the meeting, and was told that C.dif rates last year were lower than expected, as they were for the current year. The Trust was working hard to reduce these figures, and every case had been examined to determine the root cause, and lessons were being learned.

In response to a question about redundancies, Mr Jones told the meeting that these were not clinical or nursing posts, that the Trust was looking at staffing issues with a view to working more efficiently, and it was hoped that with a recruitment freeze and redeployment of existing staff would obviate the need for many redundancies.

Councillor Harrison asked about IT projects which had reportedly overrun, and asked whether these were outsourced or internal, and what project management procedures were in place. He was told it was in-house, and the Trust was about to launch an updated patient record system with a view to automating more of the work which was currently done manually.

The Chairman congratulated the Trust on the frankness of their Chief Executive’s letter to the Panel, and summed up by reminding the Trust that as a panel they had been highly supportive of the Trust in its provision for Bracknell Forest residents. He asked for an assurance that the management of the organisation had taken on board the accusation of past complacency and that the reduction of PCT funding would not impact on services to patients – this was the panel’s prime concern, and he wanted to know that this concern was being conveyed to all staff. Mr Jones responded by saying that a new Board was in place now, and it was totally focused on making the trust successful. Councillor Birch reassured the panel by saying that at his last meeting with the Chief Executive of the Trust this assurance had been given.

The Chairman thanked Mr Jones and Ms Culpin for their reports to the meeting, and reminded them that the Council had previously signed a protocol with the Trust on the exchange of information, and urged them to read and comply with this.

[Mr Jones and Ms Culpin left the meeting]