Board meeting of The Hillingdon Hospitals NHS FT on 26th October 2016
National Items1. .Third Runway at Heathrow: The Chairman made clear that his Board has no views on the merit of the Government’s recent decision to build a third Heathrow runway, but it will cite that decision as an additional justification for a rebuild of Hillingdon Hospital, which is in any case in dire need of rebuilding due to age and estate inadequacies. He noted that the hospital will face all the demands of a bigger local workforce both during and after the runway’s construction.
2. NHS Finances 2015-1 6: The NHS budget of £116.4billion had to cope with nearly 23million A&E attendances (the highest number ever), 14 million GP referrals to acute hospitals, almost 6 million hospital admissions, 19 million first outpatient attendances and more than 9 million calls to ambulance switchboards. Local authorities spent £13.8 billion on adult social care services, covering short and long term care for more than a million people By the end of 2015-16 NHS providers had overspent their budgets by £2.45 billion. Local authorities were reported to have spent £168 million more than they budgeted for.
3. Nursing Home beds: In the past the growth in people needing care has been met by the growth in bed numbers in nursing homes, but this has come to a halt in the last 16 months. Profit margins have reduced due to pressures on fees available, compounded by the impact of the national living wage.- so the number of available beds has reduced with knockon effects across the whole health and care system - more emergency admissions to A&E, more delays for people ready to leave hospital and more pressure on other services.
4. Training places for doctors: The number of medical training places is to be expanded from September 2018 with the government funding an additional 1,500 student places each year, but there may be a requirement to work a minimum period in the NHS following graduation.
Hillingdon Hospital Items1. Opening of the Peter Pan Ward Extension: The official opening on 22nd October was performed by Boris Johnson MP for Uxbridge and South Ruislip. It was followed by a tour of the new Pharmacy and the new Paediatric A&E.
2. Increased car parking charges: The new parking fees are in the process of implementation. There have been no resultant problems.
3. A&E Performance: The 95% four hour standard could not be met in September. A&E arrivals increased by 7.6% compared with a year ago, paediatric activity was up 14% and blue light ambulances were up by 19.9%. Since 2013 the average number of patients per day has risen from 148 to 178 and the number of blue light ambulances from 5.3 to 10 – all with no expansion of physical capacity.
4. Improvements in A&E: There is now a supernumerary band 7 clinician on every A&E shift and two new triage rooms. Significant investment has been provided to expand the Clinical Decision Unit, due to open in December 2016, and to increase staffing. Other schemes are planned but are still to be implemented. A key constraint is bed availability. By reducing length of stay on wards it is hoped to increase capacity by the equivalent of 43 beds.
5. 7 Day Service Pilot: As part of the Trust’s North West London early adopter status for 7 day standards, it has put in a proposal to run a pilot about the number of consultants needed to meet the standard for ongoing consultant review. This project will take place on Grange Ward.
6. Proposed new role for Edmunds Ward: If agreed this step-down project will be run by GPs and Social Services, providing the equivalent of nursing home care for patients on discharge.
7. Finance: The Trust ended September with a year to date surplus of £61k, £84k behind plan. The Finance Director noted that if everything went well The Trust might break even at year end in March 2017 but it risked a deficit in excess of £6m, particularly as some possible funding depends on achieving very challenging targets.
Published in Hillingdon Hospital FT on 02 November 2016. Updated on 14 November 2016