Board meeting of The Hillingdon Hospitals NHS FT on 23rd March 2016
- 1. National A&E performance: 175,000 more A&E attendances were seen in January 2016 than in the same period last year, an increase of over 10%.
- 2. National NHS finances: To end of December 2015 the NHS deficit was £2.26bn, £622m worse than plan. Of 240 providers, 179 reported a deficit. The poor performance was driven by use of agency staff, delayed transfers of care and failure to deliver planned cost improvement schemes.
- 3. Approach to openness: The Department of Health has published a league table and rated each trust against a criteria; this Trust was rated as Good.
- 4. Variation in NHS Trust Boards: 68% hold monthly Board meetings, which means about one in three do not meet monthly. The typical Trust has five Board Committees.
- 1. Junior doctors’ strike: The two day strike on 9th and 10th March led to cancellation of 300 outpatient appointments, of the 3000 usually seen in that time, and six day case operations were rescheduled.
- 2. Staffing levels: Mount Vernon Hospital has achieved both day and night staffing levels and has no vacancies for Registered Nurses, Registered Midwives and Health Care Assistants. In contrast Hillingdon Hospital has 98 vacancies for RN/RMs and 15 HCAs.
Between January and February the overall vacancy rate fell from 10.26% to 9.18%. The total bank / agency spend in February decreased by 12% versus the same period in 2015.
- 3. Pressure ulcers: The year to date rate for February was slightly above target. The tissue Viability Nurse is arranging study sessions with Bucks New University, to start in May.
- 4. Patient falls: With 4.8 falls per 1000 bed days, the target of 3.9 falls was not achieved in February, but the Trust’s rate remains lower than the national average of 6.6, which was reported by the Royal College of Physicians in 2015 .
- 5. Clostridium difficile infections: Of the 12 cases reported by the Trust only one has been attributed to a lapse in care due to antimicrobial prescribing, with one other case still to be agreed - only cases due to such lapses are counted against the Trust by its commissioners.
- 6. A&E target to treat, admit or discharge 95% of patients within four hours: Only 85% was achieved in February, with a year to date position of 92.78%. On average there were 178 type 1 attendances per day, an increase of 22% compared with last year, including more patients aged over 65 years and over 80 years. There was a 53% increase in blue light ambulance activity, which is being reviewed in detail. Despite using all escalation capacity, patients were regularly lodged in the department waiting for beds to become available.
- 7. Finances: The year-end revenue forecast remains a deficit of £1.5m. The February year to date deficit was £1,396k, driven by £4.2m adverse pay expenditure. Compared to February 2015 there was an increase of 159 whole time equivalent staff. Due to closure of Edmunds Ward, fewer beds were open, but the transfer of maternity activity from Ealing and the sharp increase in the use of 1:1 Nurses for higher risk patients contributed to the need for more staff as well as CQC and shaping a Healthier future related quality investments.
Year-end forecast capital expenditure has been reduced by £900k, to reflect slippage on the paediatric scheme - expenditure is moved from this year into the first half of 2016/17.
- 8. Births: At end of February births to date were 547 higher than last year, of which 525 were attributed to the transfer of maternity services from Ealing Hospital.
- 9. Charitable Funds: There are 49 funds totalling £919k of which £876k relates to patients, £43k to staff and £26k is restricted to specific purposes. £25k has been approved for refurbishment of staff rest areas. The policy of ethical investment excludes investment in either the tobacco industry or the production or sale of alcohol.