Board meeting of The Hillingdon Hospitals NHS FT on 28th September 2016
1. Operation of NHS Improvement’s Single Oversight Framework: This will start on 1st October 2016, using the Care Quality Commission’s most recent assessments of whether a provider’s care is safe, effective, caring and responsive, and where available, delivery of the four priority standards for 7-day hospital services.
There will be four possible outcomes:
1. Maximum autonomy 2. Targeted support 3. Mandated support 4. Special measures. Finance assessment will include use of agency staff.
2. Health Research: The Dept. of Health has announced a five year, £816 million investment in health research – the largest ever investment into health research. Mental health research will get nearly £70million, dementia over £45 million and deafness over £15million. It is estimated that for every £1 the Dept. of Health invests, hospitals / universities will generate £6 from public research funders, charities and industry. The UK is already a world leader in pioneering medical breakthroughs and this record investment will ensure this strong tradition continues.
Hillingdon General Items
1. Services for children / young people with mental illness: Hillingdon Healthwatch has published “Listen to Me”, a report on young people’s mental illness, noting that uncertain funding, lack of early intervention and fragmentation reduce the effectivenss of services and it calls for a joint approach to provide improvements. Hillingdon Clinical Commissioning Group and London Borough of Hillingdon have incorporated various “Listen to Me” recommendations into the Joint Social Emotional Wellbeing and Mental Health Strategy 2015-2018.
Hillingdon Hospital Items
1. Staffing: In common with many other providers the Trust has high vacancy and turnover rates. The Trust aims to become an employer of choice by transforming the way it attracts high quality safe and compassionate staff. In August the Trust had 2,944 staff in post, an increase of 3% over the last year. In August the Trust was unable to achieve the £985,400 ceiling target for agency expenditure set by NHS Improvement – the actual cost was £1,300,237. Compared to last year there was a net increase of 268 whole time equivalent staff.
2. Infections: No cases of clostridium difficile were reported in August but two had been reported in September – they will be reviewed with commissioners to determine whether or not they were avoidable, which impacts on the Monitor quality governance rating.
3. The post 48 hours MRSA bacteraemia reported and attributed to the Trust in June was the first such case since July 2014.
4. Pressure ulcers: The rate in August was 1.2 per 1000 bed-days, which is above the hospital’s target of 1.0 but the year to date rate remains on track.
5. Patient falls: The August rate reached 4.7 per 1000 bed-days against the Trust target of 3.9. The year to date rate of 4.4 is also outside the Trust’s own target, but is lower than the most recently published national figures. Movement sensors are to be trialled on high risk wards.
6. Finance: In August the deficit was £439k, £52k worse than plan, with year to date a deficit of £2,705k, £65k better than plan. Medical, nursing and health care assistant pay causes particular concern.
7. Births: At 385 these were 6 less than August last year and year to date 211 higher, including 153 more births from Ealing. Maternity transferred from Ealing Hospital in July last year.
8. New GP outpatient referrals: At 476 these were 8.4% higher than August last year.
9. A&E attendances: An increase of 271 was 3.9% up on August last year and 2678, 7.6% higher year to date, an average of an additional 18 patients per day compared with last year and 28 additional patients per day compared with 2014. Expansion of ambulatory care has prevented more emergency admissions.