Minutes:
Frances Howie explained that this issue had first been considered by the HWB in May 2015 when concerns had been raised by routine monitoring and some whistle-blowing by staff. Action plans had been put in place but concerns were still live this winter and had culminated in risk summits in December and January following the CQC re-inspection in November, and the Section 29a enforcement notice. The Trust was now in the consultation period for the Future of Acute Hospital Services, Sustainability and Transformation planning was underway and there were high levels of scrutiny. It is the duty of the HWB to improve the health and well-being of the local population, lead integration, influence commissioning across the system and seek assurance about risks to the safety of the population.
Sarah Smith from the Acute trust clarified that the CQC had not yet issued its report. Following the re-inspection in November a risk summit, convened by NHS Improvement had taken place at the recommendation of the CQC. Certain actions were taken immediately, such as creating 2 extra medical wards from surgical wards, and capacity had been increased at Aconbury East to support patients who were ready to move on from their acute hospital stay. This enabled safety to be improved. There had been on-going communication with the CQC and a response was being prepared to the Section 29A letter detailing a rapid action plan covering: the safety and effectiveness of care, urgent care and patient flow, governance and safety. The immediate response to the CQC was required by 10 March.
During the discussion various points were made:
· In order to make the immediate changes and identify the priorities a programme team had been created with a Director of Performance. The Chairman had been honest with staff and stakeholders
· In order to reverse the public loss of confidence it would be necessary to follow through on the plan and show improvements,
· There had been a lot of changes in leadership, but now a new Chief Executive, Chief Nurse and Finance and Medical Officers had been appointed. This would support other levels of staff and help with morale
· The wider Health environment was being supportive
· In order to prioritise what needed to be done the actions required had been grouped into themes such as safety. Children's safeguarding risk management was being checked to ensure that the Trust was not becoming too used to risk. The CCG were also becoming more vigilant about safety and quality at Worcestershire Acute and twice monthly assurance meetings were now being held
· The number of hospital beds had fallen since the NHS had been created whilst population had risen. Bed capacity was a major issue with Worcestershire Royal sometimes running at 100% occupancy. Changes needed to be implemented by the STP to enable the NHS to cope with an increasing ageing population by increasing community services. Hospital is not the right place for frail people and necessary stays should be as short as possible. Capacity in terms of staffing was more of an issue rather than the physical number of beds
· The term frailty should be used rather than elderly
· Healthwatch were going to be doing some surveys with patients in hospitals
· An environment of openness and transparency was being cultivated and the Trust wanted to hear from people who had specific concerns.
It was accepted that a lot needed to be done and the improvements could only be started by 10 March deadline.
It was agreed that once the Chief Executive had started she would be invited to attend a future HWB with the Chairman.
RESOLVED that the Health and Well-being Board:
a) thank Sarah Smith and Gareth Robinson for attending the meeting to discuss the current situation at the Worcestershire Acute Hospital Trust, and
b) invite the new Chief Executive to attend a future meeting of the Board to give a further update.