Agenda item

Report of the Deputy Chief Executive, London North West University Healthcare NHS Trust

Members received the report with an introduction from the Deputy Chief Executive of London North West Healthcare NHS Trust, Mr Simon Crawford.  The report and supporting appendix set out the progress with the Trust’s development of its new five-year strategy with the following highlights:

·                 A three phased approach had been adopted to help build a strategy to overcome the critical obstacles facing LNWH; diagnose any issues, develop a focused response and actions.

·                 The strategy had been informed by extensive input from our employees, patients and the local population and input was gathered through online events, in person events and a multilingual community survey. A diverse set of respondents completed the survey which showed they valued the latest treatments, improved timeliness of follow ups and results.

Members asked the following questions:

A Member questioned if more administrative staff would be needed when the new patient record system was implemented or would doctors access patients’ information directly.  It was explained that the information would be on an electronic system and easy to access.  A completely integrated process that would be updated with every step of the patient’s journey that would feed into bed management and share the discharge list everyday with partners.  In future this would reduce the demand for administrative resources but create different roles.

The chair questioned how implementation of the strategy would affect the backlog and waiting lists.  It was explained that the backlog was already being dealt with and the Trust was already delivering more activity month on month than it was PreCovid, there were more elective operations, more first outpatients and diagnostic activity, national targets were yet to be achieved but activity was over 100% of pre-Covid levels.  There was a lot being done to reduce inefficiencies, improve, effectiveness, quality, and communication.  This should lead to more outpatient appointments, diagnostic testing, and elective care operations.

A Member asked and received clarity on the diversity of the survey response statistics.  It was explained that efforts were made to increase representation from underrepresented groups through community partners which led to a significant increase.

The Chair asked about the timing for training staff for the new systems and the challenges facing the Trust in the attraction, support, and retention of staff.  Simon explained overall vacancy rates compare favourably with other Trusts in North north-west London, they were not significantly better, but neither were they significantly worse at staff retention.  A big focus in the Strategy was the health and wellbeing of staff and support and career development.  Improvement was needed with staff retention and there were efforts being made such as recruiting staff from the local population, improving the ethnicity representation of our staffing profile, access to apprenticeships, and development programmes, collaborative appointments for more senior staff such as secondment, training or joint working or joint appointments so that staff do not necessarily need to leave the Trust to get that experience.

A Member raised concerns that the impact of Covid-19 had on hospital staff especially doctors and nurses could not be underestimated.  It was horrific experiencing frontline work during the pandemic and burnout would be a real issue.  It was explained that staff were provided with access to health and well-being counselling and psychological services too.  There were also some bespoke initiatives in place to try and alleviate some of the pressure and impact on staff.

The Chair asked if there were any key learnings from previous strategies were applied to this strategy especially maternity services.  Simon explained lessons learned included, not to use external consultants to develop the Strategy, improve staff engagement, ensure there was clarity and effective communication on actions needed to deliver the strategy.  Continued efforts were being made to address the impacts of the pandemic as part of the on-going strategy development and improvement.

In respect of CQC ratings of the Trust Simon commented that some of these for individual services or sites dated back to 2017 due to the infrequent nature of CQC inspections.  The Trust was optimistic that such ratings were expected to improve once the CQC re-inspects.  The Trust had recently been subject to a number of reviews and visits where, the Trust has performed well, mainly as a result of all the improvements that had been put in place over the last 18 months such as the recruitment of many new senior staff into the leadership of the Trust.  Also, there had been a lot of focus on the improvement of maternity services over the past 18 months to improve the quality of the patient experience, staffing levels, interaction with patients, and address language barriers.  As a result, there was now an increase in referrals and mothers booking in at Northwick Park so the maternity service was in an improving position and delivering a better service with improved patient feedback.

A Member asked that since the CQC rarely conducted inspections if there was a process of internal inspection.  It was explained that there were quality reviews undertaken within the Trust that report into the Trust Board level Quality Committee, and the Trust Board received bi-monthly reports in terms of quality and key metrics it reviewed.  These included areas such as; A&E performance, waiting lists, risks, lesson learned from incidents and benchmarking against other Trusts and external support was sought if particular concerns were identified.

The chair thanked the Deputy Chief Executive for the reports and commended the identified improvements.

RESOLVED:  That the progress with the Trust’s strategy development be noted.