Agenda item

To receive an update from Sir Andrew Morris OBE, Chief Executive of Frimley Health NHS Foundation Trust on the Trust’s progress, with particular reference to overcoming the weaknesses found by the Care Quality Commission at Heatherwood and Wexham Park Hospitals.

Sir Andrew Morris, Chief Executive of Frimley Health NHS Foundation Trust gave a presentation in respect of the Trust’s work to improve standards at Heatherwood and Wexham Park Hospitals.

The presentation included an overview of the Trust’s objectives, performance and values as well as a summary of the work taking place at Heatherwood and Wexham Park Hospitals to improve staff morale and productivity and planned improvements to the Trust’s estate and infrastructure.  The Trust employed 8,000 people and had the fourth busiest Accident and Emergency department in England.  Approximately one million people used the Trust’s services each year.  To facilitate the acquisition, and related works, the Department of Health had provided some £300 million to Frimley Health Trust.

As part of work to improve patient experiences at Heatherwood and Wexham Park Hospitals the Trust had implemented a number of changes including: a new governance structure, a new serious incident process, WHO checklists for operations and the introduction of new guidelines and training for infection control, sepsis, falls and pressure sores.  The hospitals’ mortality and morbidity rates had been reviewed, cleanliness at the hospitals had been improved and work had taken place to free staff up to enable them to focus on caring more for patients. Work to improve staffing standards and raise staff morale was also underway.  This work was starting to pay dividends and the number of complaints received had halved since the Trust had been created (Currently 35 complaints a month were received compared to 70-80 a month in May 2014).

Work to improve the physical estate had taken place including roofing repairs, improving the security of Wexham Park Hospital at night and improving the signage across all sites.  There were also plans to create five hundred additional car parking spaces at Wexham Park and Frimley Hospitals.

Major infrastructure projects planned for the Trust included the development of a new Emergency Department, redevelopment of the maternity unit and the development of a Paediatric Critical Care Unit at Wexham Park Hospital.  Plans for a £63million redevelopment of Heatherwood Hospital which would see the creation of 6 operating theatres, 48 beds, 16 day case beds and new outpatients and diagnostics facilities had also been drawn up.  To enable these developments to occur it would be necessary to reconfigure the Wexham Park site and land would need to be sold from both sites to help fund any work.  It was expected that the modernisation of the Maternity unit would start in May 2016 and be completed within nine months.  The Emergency Department redevelopment at Wexham Park Hospital would, once underway, take between eighteen months and two years to complete and work was expected to start in autumn 2016.

It was acknowledged that there was more still to be done to improve standards at both hospitals however it was hoped that standards at Wexham Park had improved sufficiently for the hospital’s grading to move from Inadequate to Requires Improvement when the Care Quality Commission (CQC) inspected the Hospital on 13 October 2015.

Arising from the Panel’s questions and comments the following points were noted:

·         Agency staff were employed via NHS Professionals, a specialist organisation within the NHS recruiting and supplying temporary doctors, nurses and other staff.  The agency was responsible for ensuring that all staff employed by them held the appropriate mandatory qualifications and had completed any additional training required e.g. safeguarding

·         There was a national shortage of nurses and GPs.  The Trust experienced few problems recruiting trained nurses from overseas, with Philippino nurses being particularly keen to work in the United Kingdom.  However new work permit restrictions requiring overseas staff to earn over a certain amount were making recruitment harder

·         The Trust was 95% compliant on its Harm Free Care bundle

·         During their inspections the CQC interviewed staff about their understanding of a range of matters including safeguarding and infection control procedures.  If staff are unable to adequately respond to these questions then the hospital would be marked down

·         CQC inspections focused on five areas.  If two areas were graded as being Requires Improvement and three were graded as being Good then your overall grading would be at the lowest level i.e. Requires Improvement

·         80% of all foundation hospitals were currently operating with a financial deficit.  The Frimley Trust still need to save £26million this year

·         Aspirations for a dedicated dementia ward had been put on hold when it was discovered that the selected site was unsuitable

·         Discharges into social care services continued to be an issue for the Trust

·         It was acknowledged that the current arrangements for cancer patients attending outpatients appointments were not ideal and the Trust was exploring the possibility of developing a bespoke area for outpatient treatment of some cancers so that they would no longer have to receive treatment in the general outpatient clinics.  Clinical staff were sent on ‘Breaking Bad News’ courses and the Trust was working to set up a one stop shop for cancer patients.

·         The Trust had to meet set standards in a number of areas and was subject to peer reviews to ensure there was oversight of the Trust’s compliance in these areas.  The outcomes of peer reviews were sent to commissioners to help inform their decisions over where to send patients

·         £32million was being spent on the development of a new integrated IT system.  The new system was already operational in the radiology, pathology, and emergency departments and operating theatres.  Funding had also been secured to roll out an electronic patient record system

·         Wexham Park Hospital had traditionally had training links with Middlesex University.  However once students qualified they had a tendency to elect to work in London. To address this, the link with Middlesex University had been removed and a new link was being developed with Buckinghamshire University.  A move that it was hoped would result in more students staying on at Wexham Park Hospital after they qualified

From Healthwatch’s perspective some services needed improving but there were many positives, such as the improvements to A&E at Wexham Park Hospital  and they welcomed the increased openness of the Trust.

The Panel thanked Sir Andrew Morris for his update and commended the improvements being made by the Trust.