Agenda item

Report of Director of Strategy, London North West Healthcare NHS Trust.

The Sub-Committee received a report of the Director of Strategy at the London North West Healthcare Trust (LNWHT) which set out the priorities and challenges faced by LNWHT during its first year as a new Trust.

Following a brief overview of the report, the Trust’s Director of Strategy responded to questions and comments as follows:

·                     staff perception of the merger between Ealing Hospital and North West Hospitals varied across the organisation.  On the whole, most now saw the merger as a beneficial and positive move and morale had improved across the trust. There had been a few redundancies in managerial and clinical services.  In terms of staffing, the introduction of key specialties meant that some roles had been enhanced and consequently were easier to recruit to;

·                     A&E services at Northwick Park continued to be an area of challenge.  Significant support for frontline staff and close working with the CCG (Clinical Commissioning Group) in relation to out-of-hospital care, delayed transfer, and looking at how other wards and services could further support the A&E function had led to improvements;

·                     the Executive Board, six main sub-committees and other sub-committees had responsibility for identifying and reporting risk and ensuring follow-up learning was fed back and governance actions implemented – all of which would contribute to improved board-to-ward visibility and responsiveness;

·                     he did not have to hand data relating to the reasons for the delays in the impact of the CG and Social Care Better Care Fund Plans and how this would be resolved.  He undertook to circulate this information to Members after the meeting;

·                     Northwick Park Hospital had been operating at maximum bed occupancy levels for the past two years, often with medical patients occupying surgical beds and vice versa.  Additional bed capacity in wards and in A&E would relieve existing pressures and measures to ensure patients were allocated the right beds would lead to better patient care and patient experience and would enable staff to deliver the appropriate care;

·                     patient care was tailored to individual needs and there was a dedicated staff member to deal with patients with learning disabilities, although this post may be currently vacant.  He undertook to confirm this to Members after the meeting.  On the whole, the Trust had received positive feedback from patients with learning disabilities, their carers and families regarding their experiences at the hospital;

·                     provision of care for the elderly would be offered at each of the three hospital sites so that patients would be able to access care at their nearest hospital.  However, patients may on occasion be required to visit different sites in order to access specific types of treatment.  For example, Ealing hospital was a focus for wellbeing and diagnostics;

·                     the reduction in the birth rate in the north west London had allowed the closure of maternity services at Ealing and moving these to Northwick Park.  Currently the workloads in Maternity services at Northwick Park were manageable.  Any issues relating to maternity services arising from the previous Care Quality Commission (CQC) inspection had since been addressed;

·                     with regard to partnership working – the creation of the new Director of Strategy post and wide-ranging discussions to build effective relationships and collaborative working with partners, stakeholders and the local authority were being undertaken;

·                     informal verbal feedback received from the CQC regarding the latest inspection would be communicated to Members after the meeting.  The Trust was considered to be good in the following areas:

-          caring and dedicated staff, acute medical provision at Ealing, research and development programme, the quality of patient care, local management and frontline services.  Areas requiring improvement included:

-          strategy ad vision, non-delivery of recent services changes following the merger, staff not fully integrated, workforce planning, A&E waiting times, inappropriate surgical referrals. 

It was likely that the CQC would make a number of unannounced visits over coming weeks.  Its findings would be available in January 2016.  The Trust would ensure compliance actions and issues were dealt with.  A number of improvements and compliance actions had been implemented following the previous inspection and he cited improvements to the children’s unit, Jack’s Place, improved staffing levels in the maternity unit and a new post created of Quality & Patient Experience Manager and other measures to deal with issues raised at during the last inspection of the maternity unit.  Monthly performance review meetings would ensure that the maternity unit was compliant with the complaints process;

·                     seasonal pressures last winter had been unprecedented in both London and nationally.  With regard to anticipated winter pressures on the service in 2015, this was an area of challenge and there were resource issues.  However, timely winter planning, good engagement with partners, discharge planning and dialogue with the LAS (London Ambulance Service), learning from the experience from last winter would help to mitigate against this.  Good working relationships with Brent primary care, social care providers, acute services, the LAS, the CCG to help increase capacity;

·                     the levels of parking charges and the availability of disabled parking spaces at Northwick Park Hospital would be reviewed shortly.

RESOLVED:  That the report be noted.