Agendas, Meetings and Minutes - Agenda item

Agenda item

Worcestershire Acute Hospitals NHS Trust Clinical Services Strategy

Minutes:

The Committee received an update on the development of the Trust’s Clinical Services Strategy. The Trust was developing this strategy in line with its strategic purpose of ‘Putting Patients first’ and to support its overall strategic objectives. The aim of the strategy was to help secure the safest, highest quality, sustainable hospital services for patients from across Worcestershire and neighbouring counties.

 

The Chief Executive of the Trust gave a presentation of the key aspects of the development process:

 

·         Referring to the pyramid diagram of ‘Putting Patients First’ he explained that this demonstrated the way in which services would become financially and clinically sustainable in the future.

·         Whilst the overall focus of the Strategy was based on a 5-year plan, it was also underpinned by 3 year and 12-month plans.

·         In response to a query, the Chief Executive explained that the usual annual planning process would still be continued and would be the process by which a refresh of these plans was carried out. The Trust would continue to be scrutinised through various means, including through the Non-Executive Directors on the Board, the Kings Fund and through confirm and challenge conversations between the services.

·         The Chief Executive wanted to make it clear that this process was not about closing sites or services, but instead was about recognising the need to be responsive to the changing needs of the population. This would mean that there would be some changes particularly around ensuring more integrated care taking place outside of the main hospitals. The ambition was to reduce outpatient appointments by a third. The changes could also involve highly specialised care being managed as part of a network/partnership arrangement where appropriate. It would be crucial to make the most of the hospitals and the 42 service areas that the Trust currently had, but also to future proof the service. Details of any proposals in this regard would be brought to HOSC.

·         In terms of the out of county specialist care, referred to above, which was an area that had grown over the years, the Chief Executive advised that the current arrangements were currently being reviewed to establish what worked best for patient outcomes and ease of access. Once this had been completed a view would be taken as to future arrangements.

·         Staff had responded very positively to the development of the Clinical Services Strategy and had been proactive in drawing up plans for their areas and taking back control.

·         The stakeholder and public engagement events in August and September had proved to be very well attended and the Board received useful feedback to help them shape future services. The next key stage was consideration of the strategy at a private Trust Board meeting in October, to be followed by a public Trust Board meeting in November, where detailed plans would become available.

·         The Chief Executive set out the 3 key drivers to this process, and 4 imperatives, based on Frailty, Access, Cancer care and End of Life care. The Chief Executive explained that it was crucial that end of life care was planned for, to ensure it was provided in the right place. If a patient was on an End of Life plan in a care home, it was inappropriate that they should be hospitalised. On an occasion when such patients were admitted to hospital, a stay of more than a couple of days was not helpful. Where a patient had no relatives, continued work with community and social care colleagues was looking to improve the situation for these patients.

 

The Chairman referred to the capital expenditure proposals at Worcestershire Royal and Alexandra hospital sites totalling £29M:

 

Worcestershire Royal Hospital

 

Area of cost

Estimated Cost  £M

 

Maternity Services (including 2nd Obstetric Theatre)     

Paediatric services (including PAU)                                      

General and acute bed capacity

Car parking                           

 

2.3

 

1.7

 

16.9

0.5

 

Alexandra Hospital

 

Area of cost

Estimated Cost  £M

 

Elective Care centre (including Ophthalmology theatre)       

Endoscopy                 

Paediatric ambulatory care centre (outpatients)               

Theatres                     

 

2.8

 

1.7

0.3

 

3.3

 

 

 

One of the projects, included in the total general and acute bed capacity at Worcestershire Royal, was nearing completion and he asked about progress with the others.  The Chief Executive responded that the business case for endoscopy at the Alexandra Hospital would be considered at the Trust Board shortly and the other 3 projects there were out to procurement. 

 

The Chairman invited the Health Watch representative to address the Committee. Mr Pinfield reported that he and his colleagues were very regular visitors to the Trust’s sites as part of their role. He advised that the view from the public was that improvements were being seen across services, but that there was still much to be done.  The public engagement exercises had been positively received and worked well. It was hoped this would continue to be built on in the future.

 

A Member queried whether the strategy included dealing with new areas of development? The Chief Executive advised that they had tried to use the Sustainability and Transformation Partnership’s future projection data to future proof their plans. It was understood that the population of Worcestershire was expected to increase by 100,000 by 2025. It was suggested that the Trust might wish to be closer to the discussions that took place regarding future developments. In response to a further query, the Director of Communication confirmed that the PFI projected growth projection calculations had had to be readjusted in recent years.

 

The Chairman thanked the WHAT Representatives for their attendance and the detailed presentation, which was much appreciated. Members congratulated the staff on their achievements and expressed support for the progress made.  It was noted that the Trust would provide updates to the Committee as required.

 

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