Report of the Medical Director, Imperial College Healthcare NHS Trust.
The Sub-Committee received a report of the Medical Director, Imperial College Healthcare NHS Trust, which set out the Quality Account 2018/19 for the Trust. Quality Accounts were annual reports to the public from NHS Healthcare providers about the quality of services they delivered. Their purpose was to encourage Boards and Leaders of healthcare organisations to demonstrate their commitment to continuous, evidence-based quality improvement, to assess quality across all of the services offered and to explain their progress to the public.
The representative of the Trust (Deputy Medical Director) introduced the report and outlined the vision ‘Better Health for Life” and the values, which were being embedded in everything the Trust did. He added that the Trust had worked with staff to co-design the vision and values and these had been linked to behaviours expected of all A behaviours framework had been developed which set out how the Trust expected staff to behave in order to put the values – Kind, Expert, Collaborative and Aspirational – into practice. Overarching strategic goals to create a stronger connection to the delivery of vision had been articulated.
The representative added that staff were encouraged to be curious about what was happening across the country and the world in relation to healthcare. Many improvements had been made but the Trust was very aware of how much work there was still to do and was on a journey of continuous improvement. For example, the Trust had launched a flow coaching academy, in partnership with Sheffield Teaching Hospitals NHS Foundation Trust, to improve care which had resulted in improvements for patients in several pathways, such as Sepsis and Diabetes. He outlined the work in relation to keeping mortality as low as possible, the establishment of a Strategic Lay Forum to involve patients in the strategic work of the Trust, and supporting improvements in patient care through innovation and by working with and learning from other Trusts.
Members of the Sub-Committee asked the following questions which were responded to:
Q -Was the A&E reaching its targets?
A - The Trust had been through a challenging period during the 2017/18 winter months and had set up a Care Journey and Capacity Collaborative which had helped to make significant improvements. Despite record numbers of ED attendances, there had been a reduction in ‘black alerts’ by over one third (169 in 2017/18, 11 in 2018/19). The Trust was also working with the Primary Care sector and nursing homes to improve patient experience.
Q -What were the Trust’s priorities and what challenges was it facing? What improvements had been identified during 2019/20?
A - The Trust had a large number of priorities of which the following were key: continuing to improve patient safety, values and behaviours, improvements in patient flow through A&E, collaboration with other organisations such as GPs and the emerging Primary Care networks. The creation of an integrated care system, outstanding and sustainable services, learning and innovation were at the heart of the Trust’s three strategic goals.
Q - What percentage of patients using the Trust’s services were Harrow residents? Were these patients predominantly accessing any particular services?
A - The users of the Trust were mainly from the tri-borough and also the boroughs of Ealing and Brent. A little under 5% (3.6% last year) were from Harrow and these were largely people needing specific specialist services. The representative from the Trust gave a brief example of some collaborative working between paediatricians and the renal team from North West London Hospital NHS Trust.
Q -What was the performance against quality priorities for 2018-19?
A - A number of improvements had been made both with staff and the environment they worked in, details of which were set out in full within the report. The demand on services was high and more work was required to ensure continuous improvements. The Trust was also targeting specific areas such as hand hygiene deteriorating patients and falls as part of its safety stream work. Observational audits were carried out on a regular basis.
Q -VTE – venous thromboembolism – had the targets been met? Had the infection prevention and control targets been met?
A - With regards to VTE, from April 2018, the Trust had met the 95 per cent target consistently until December 2018, with average compliance across the year of 95.42 per cent. The Trust was currently working with the areas that were below target to support staff to complete the assessment, including additional training for staff, and introducing VTE ‘champions’.
Overall, infection prevention and control targets had not been met as set out on page 172 of the agenda (page 56 of the Quality Account).
The representative from the Trust noted the correction required to the figure relating to the ‘turnover’ on page 122 of the agenda (page 6 of the Quality Account) where a comma had been used instead of a full stop and it was
RESOLVED: That the report be noted and the representative be thanked for attending the meeting.