Agenda item

To consider the draft Quality Account of East Cheshire NHS Trust (to follow).

Kath Senior and Julie Green attended from East Cheshire Hospital Trust, to present the Quality Account. 

The Trust’s mission was “to provide high quality integrated services, as specified locally by Commissioners and delivered by highly motivated staff” with their vision being to deliver the best care in the right place. 

A new Quality Strategy was being devised for 2012 – 15 with quality being at the forefront.  The overarching priorities for improvement in community and acute settings for the next 4 years were as below:

      Safe – to deliver a year on year reduction in patient harm – this would cover areas such as pressure ulcers, surgical site infections, MRSA and C diff infections, medication errors/prescribing;

      Personal – to improve patient experience – this would include areas such as end of life care, oncology services and patient/public engagement;

      Effective – to improve patient outcomes – this would cover acute stroke care, nutrition, mortality review and dementia screening.

The Strategy outlined how progress to achieve priorities identified would be monitored and what evidence of improvement would be sought.  The Trust provided services in both an acute setting and in the community, which gave rise to opportunities for partnership working.  The Trust had also met with GPs to enable joint working around providing appropriate support for patients with long term conditions.

The Quality Account also reviewed priorities from 2011/12 and assessed whether they were achieved, on track to achieve or behind schedule.  For priorities that were behind schedule, action taken or proposed was outlined.

In discussing the Quality Account, Members of the Committee made the following comments:

      The Trust is commended in achieving or being on track to achieve its targets in relation to :

    - reducing the number of injurious falls per thousand bed days;

    - protecting patients within the Trust’s care from hospital acquired

      infection;

    - maintaining or reducing the Hospital Standardised Mortality Ratio

      (HSMR);

    - reducing Hospital acquired venous thromboembolism (VTE);

    - improving the quality of care for stroke patients;

    - reducing the average length of stay for patients who are medically fit

      for discharge;

    - delivery of same sex accommodation through the provision of same

      sex designated bays and bathing facilities in all inpatient areas;

    - complaints are acknowledged and responded to in agreed timescales;

    - an increase in the number of clinical staff trained in basic dementia 

      care awareness.

In particular, the Committee notes and commends:

      the work done to deliver same sex accommodation in the day surgery and endoscopy unit through the introduction of all female and all male lists;

      the work carried out around falls reduction including the introduction of “comfort rounding” ie regular checks on in-patient’s needs; 

      the reduction in cases of hospital acquired infection including there being no cases of MRSA occurring in April – November 2011, and only one case in each of December, January and February – the Committee suggests that this success is highlighted and publicised to address any misconceptions around infection rates; 

The Committee suggests the following:

      in relation to the improvements in stroke care quality, the Committee suggests that more evidence is included in the Quality Account to demonstrate these improvements;

      in relation to the Safety Thermometer, which the Committee understands is a monthly assessment on each patient (either an in-patient or a patient in the community) – whereby the patient is assessed in relation to risk of harm or incident from falls, catheter use, pressure ulcer or deep vein clot (in patient only) – the Committee suggests that a fuller explanation is included in the Quality Account;

      in relation to page 42 onwards that covers the Trust’s involvement in Audits in 2011/12, the Committee suggests that the final column listing “Conclusions/Actions to be taken” is amended to ensure information is listed consistently;

      in relation to page 49 that refers to the Oncology Audit, the Committee is concerned that the National Confidential Enquiry judged care to be “good” in only 35% of cases.  The Committee hopes the recent appointment of an Acute Oncology Nurse and other actions outlined at the meeting will address this low rate and suggests that further information on the action taken to address this low rate is included in the Account.  In addition, it is noted that a re-audit is to be conducted within one year which is hoped will demonstrate a greater number of judgements of care as “good”;

      the Committee notes that the target to reduce the number of cancelled operations has not been met and numbers of cancelled operations has risen over recent months – the Committee notes action taken to address this and hopes the target to reduce this in line with national benchmarks of 2% or under is achieved during the forthcoming year;

      the Committee supports the introduction of a Patient Experience Group which is hoped will improved communication with both patients and carers;

      the Committee commends the Trust for achieving the target of reducing the average length of stay for patients who are medically fit for discharge, but suggests that readmission rates should be included to give a fuller picture.    

RESOLVED:  that the above comments be forwarded to East Cheshire Hospital Trust for inclusion in their Quality Account.