West Herts Hospital Board Meeting ay 2015
Following a CQC inspection in late April the private obstetric service was suspended from 1st May in order for the resources to be focused on the NHS service. It is likely to remain closed for the foreseeable future.
The triage system in Accident & Emergency has also been strengthened following the CQC visit.
St Albans hospital is to undergo a £900,000 upgrade. Day surgery facilities will be improved and there will probably be more day surgery cases transferred to that site. Work is being undertaken to improve performance as the 4 hour wait times for A&E, Referral to Treatment targets, Diagnostic wait times, ambulance turnaround times and number of cancelled operations were consistently missed in the past year. The theatres on the Watford site are to be upgraded as they are not fully compliant with modern recommendations for ventilation etc. The theatres will be closed while this work is undertaken, but the situation will be managed by forward planning, day surgery where possible and the hire of a mobile theatre.
Interviews for the position of Chief Executive were held, but no appointment has been made. The job description and person spec are being tightened with assistance from the Trust Development Authority and the post re advertised. In the meantime Ms Jac Kelly will remain in post.
Finance: The Trust ended the year 2014/2015 with a deficit of £13 million, slightly better than forecast, however the projected deficit for 2015/16 is £32.8 million, a figure that the TDA does not like!! The problems are manifold: the physical hospital estate is wholly inadequate for modern healthcare with over half in a poor or bad condition. Watford Hospital is crowded and dominated by emergency and unplanned care, while significant parts of St Albans and Hemel Hempstead sites are under utilised and costly to maintain,
IT infrastructure and systems are underdeveloped and outdated. This impacts operationally and creates inefficiencies in how care is delivered. Staff experience delays due to limited access to IT and out of date technology with clinicians queuing to view test results, complete discharge summaries or make requests.
The above paragraph is copied from the report almost verbatim. It is a credit to the dedication of the staff that the hospital functions as well as it does. A large chunk of overspend is agency staff - the Francis Report following the Stafford Hospital debacle recommends a minimum number of qualified nursing staff per number of patient beds. This has led to a shortage of RGNs nationally, the attraction of agency working to qualified staff as pay is better, working hours are of choice and there is no lack of demand for staff.
There are plans:
to redesign services to meet targets, including developing a GP led urgent care centre for those patients who really require primary care
to develop a “pit stop” area where senior clinicians can assess ambulance arrivals and start treatment planning early
to develop and expand emergency and ambulatory care services for children and young people
plus serveral other measures which should help meet A&E targets and ambulance turnaround times.