Agenda item

Report of the Director of Nursing, Royal National Orthopaedic Hospital.

The Sub-Committee received a report of the Director of Nursing, Royal National Orthopaedic Hospital (RNOH) NHS Trust, which set out the Quality Account for the RNOH for 2018-19.  The report set priorities for the RNOH for 2019-20 and identified the progress against the quality priorities set in 2017?18.  It also identified performance against key indicators set by National Health (NH) Improvement.

The representative of the RNOH introduced the report and summarised the progress made against priorities set for 2018/19.  She referred to the quality priorities set for 2019/20 as follows:

-               develop and embed safety hurdles across all in-patient areas;

-               develop and implement a Ward Accreditation Programme

-               procure, develop and roll-out Electronic Prescribing and Medicines.

The representative was pleased to report that the RNOH had been rated ‘good’ by the Care Quality Commission (CQC).

Members of the Sub-Committee asked the following questions which were responded to:

Q -Construction of the new inpatient Stanmore Building was completed and opened for patients in December 2018.  How had the first six months been, were there any emerging issues or improvements needed?  What had been the impact of the new building on the quality of care that could be offered by the Trust?

In terms of the new building, a number of issues with the building needed to be resolved with the contractor.  However, the new building provided a better environment for patients who had given positive feedback.  Staff were settling into the new building.

Q -The Trust had been visited by the Care Quality Commission (CQC) in 2018.  Overall the Trust had improved from a ‘Requires Improvement’ to a ‘Good’ rating.  Had this helped maintain RNOH’s position as the country’s leading specialist musculoskeletal centre?

A – The Trust had improved vastly.  Staff culture and experiences had both been improved but the Trust was not complacent and had recognised that there was room for further improvement.  Staff morale was good and confidence needed to be improved.

In response to further questions from Members on the improvements made in the severe infection area and the outcomes of the clinical audits relating to the pharmacy department, the representative from the RNOH agreed to consult her colleagues and provide responses separately.  She explained that audits were carried out with clinicians and with the support of the Corporate Management Team.  Audits were conducted on a regular basis but there was always room for improvement.

Members’ attention was drawn to pages 62 and 63 of the agenda which made reference to the conduct of various local audits, such as ‘audit of anaemia and transfusion in spinal surgery’, ‘audit on the effectiveness of the green bag scheme’ and ‘audit on the pharmacy endorsements on drug charts’.  The representative from the RNOH responded to further questions relating to the audits and reported that audits were carried out on a monthly basis and reported quarterly.  In addition, observational audits were carried out.  She explained that audits were carried out to measure compliance against the national guidance set by the World Health Organisation WHO) and that compliance had been high.

Q –Could the Trust elaborate on performance against quality priorities for 2018-19, such as improving length of stay and developing staff capability and capacity in quality improvement?  Could the Trust outline the experiences of staff working at the RNOH and the development opportunities provided to them?  What measures had been put in place to retain staff?

A – One of the priorities of the Trust was to ensure that patients did not remain in the hospital longer than necessary.  The Trust worked with various services and partners to ensure a smooth transition.  It was intended to maximise the flow of patients.

In terms of staffing, various initiatives had been put in place such as the VAL-YOU Programme which was intended to engage with staff and provide development opportunities.  Staff experiences within the Trust continued to be a priority.  By embedding Values:  Patient First always, Excellence in all we do, Trust, Honesty and Respect for each other, and Equality for all, the Trust had continued to develop a culture within the organisation to help reach the goal of becoming the best place to work in the NHS, as detailed in our vision.  Various taster sessions had been provided, including serving on the Board. Management Programmes had also been put in place.

The representative of Healthwatch Harrow reported that his organisation had carried out a patient survey at the RNOH.  The results had been positive and he would circulate the ‘Experience of Services – RNOH’ report to the Sub-Committee.  The feedback from patients had identified strong themes around staff attitude, quality of treatment and care, administration and levels of communication, involvement and support.  The vast majority of feedback indicated an excellent level of service across the criteria tested.  Members welcomed this positive feedback.

RESOLVED:  That an assurance letter from the Chair stating that the draft Quality Account was reviewed by Members of the Health and Social Care Scrutiny Sub-Committee to their satisfaction be sent to the RNOH.