Central & North West London Board Meeting on 13th September 2016
Improvement in Hillingdon performance: The Director of Strategy and Performance reported that, after previous concern about Hillingdon services, there had been recent improvement and it was confidently expected that services would be back on track within two to three months. In answer to a question during public question-time, it was confirmed that Hillingdon Clinical Commissioning Group has begun to improve its allocation of funding for mental health, which has allowed improvements in the services that CNWL provide and it is believed that further improvements in funding will be likely in the years ahead.
Mental Health Crisis Line: The introduction of a single point of access telephone line had proved very popular, with double the number of calls expected.
Use of agency staff: From September agency staff will only be employed if two executive directors agree, which it is hoped will have significant impact. The use of bank staff has increased and this is expected to continue.
Finance: The Trust is obliged to save £25m per year in the years ahead, which is a big pressure on its options and activities. Its current forecast for year end is a deficit of £1.03m, after receipt of an expected allocation from the Sustainability and Transformation Fund. There was much Board discussion confirming that the Trust does not see itself as one that tolerates deficits, although they are now common in the NHS.
Restraint: This issue led to considerable discussion. The Trust does not use restraints, unlike some of its continental colleagues. Unfortunately sometimes physical restraint is necessary in the best interest of the patient, but this is always a last resort, when other options have failed.
Bed pressure: The trust has recently faced great pressure on its beds after a quieter period.
Children looked after: CNWL provides this service for Harrow, Hillingdon, Camden and Milton Keynes. For Harrow, this is a new service. In Hillingdon the CLA team has saved Hillingdon CCG £42,099 by bringing back into Hillingdon children previously placed out of borough. Both Harrow and Hillingdon CLA teams operate from the Westmead Clinic in Hillingdon.
Serious incidents: The Quarter 1 Report for 2016-17 had 4.689 reports of incidents, showing a positive reporting culture within the Trust, but 94% resulted either in no harm or low harm, with only 5% rated as of moderate severity. Learning from incidents is integral to improving patient safety and patient experience across the Trust. There is also work with other trusts to share benchmarking information.
Deaths at Woodhill Prison: Over the last four years there has been a general increase in deaths in prison. CNWL provides services in Woodhill Prison where there have been 17 deaths since 2013, including a number of suicides which has caused concern in the Trust. A number of remedial actions are underway.