Agenda item

To receive an update from the Chief Executive of Heatherwood and Wexham Park Hospitals Trust on the Trust’s Turnaround Plan

The Chief Executive for Heatherwood and Wexham Park Hospital Trust gave a presentation which updated the Committee on the Turnaround Recovery Plan 2010/11 to 2012/13.

In 2009/10 the Trust delivered savings of over £10 million, as planned. To ensure financial viability reduction costs of £46.3 million per annum were required from 2012/13. During 2010/11 a fundamental review of services would be undertaken and changes made to increase efficiency, with the Trust aiming to be in the top 15% of Trusts’ performance. To achieve this 7 workstreams had been launched in the following areas:

• Clinical services
• Clinical workforce management
• Clinical support services
• Back office support services
• Estate management
• Maximising the Trust’s income
• Cost improvement plans

The aim was to create benefits for patients with services delivered in line with recognised standards of clinical best practice such as not admitting to hospital when care could be provided as a day case, patients spending less time in hospital and being discharged promptly, expert treatment and care and continued excellent infection control rates. The Trust held daily meetings to discuss any issues of clinical risk or patient safety, which was not compromised.

As services became more efficient fewer staff posts would be required. 470 posts had been identified as at risk. As there were currently 320 vacancies in the at risk posts, 150 staff would require redeployment or redundancy. A redeployment bureau has been established to help staff find alternative employment in the Trust or wider NHS.

90-day staff consultations had been launched in Finance and Divisional Management with consultations being launched in 2 further staffing areas over the coming weeks. Staff briefings would be held on the proposed new structures with an opportunity for them to comment. It was expected that the new structures would be brought into place in October 2010.

Arising from members questions and comments the following points were noted:

• The Trust was following national guidelines to promote best practice across the organisation, where practice had previously been varied.
• Best practice was often the most cost efficient services. Savings made would be invested back into the Trust.
• The loss of staffing posts would not impact on clinical services. Changes in structure would be monitored to ensure services could be sustained.
• The Trust has invested in a new IT system, with further IT investment identified in the Turnaround Plan. Currently administration was electronic with hard copies of notes.
• Services at Heatherwood Hospital were to operate from a smaller land ‘footprint’, continuing to be consolidated with a view to moving more elective services to the site in 2011/12.
• The Trust’s discharge procedures were being tightened as they were previously not as organised as they could have been. The Trust was working with partners to ensure an efficient discharge pathway particularly for older and vulnerable groups.
• The inherited shortcomings in governance and business processes were at the heart of the Trust’s difficulties, and were being dealt with.
• Discharge of patients would be closely monitored as the Trust was accessed on 28 day re-admission rates.
• Some areas of bad practice had been uncovered in the Trust’s Accident & Emergency Department. A national intensive support team had been working with the Trust to review the service. Care delivery had now been reshaped with the department considered a role model for best practice. A&E were not achieving all its targets each day due to a bed bottle neck, which was now in the process of being resolves and surges of patients that did not show a pattern, however it was hoped active management would resolve this.
• The Trust did not have a problem with consultants not wishing to work out of hours.