Issue - meetings

In High Quality Care for All, published in June 2008, Ministers set out the Government’s vision for putting quality at the heart of everything the NHS does. A key component of the new Quality Framework was a requirement for all providers of NHS services to publish Quality Accounts – aimed at improving public accountability and engaging NHS Boards in understanding and improving quality in their organisations.  

Both the Scrutiny Committee and the Local Involvement Network (LINk) have an important role in developing these Accounts through being given the opportunity to see and comment on the draft account prior to publication.

The draft Quality Account from Mid Cheshire Hospitals NHS Foundation Trust is attached for the Committee’s consideration and comment.  The document is currently undergoing a 30 day consultation period prior to publication of the final Quality Account document in June 2010. 

Tracy Bullock, Deputy Chief Executive/Director of Nursing and Elizabeth Kanwar, Quality and Clinical Outcomes Project Manager, will attend the meeting to address the Committee and answer any questions.  Tracy Bullock will also give a brief outline of the work undertaken over the past year in relation to the Healthcheck process and the process for registration with the Care Quality Commission.

Tracy Bullock, Deputy Chief Executive/Director of Nursing, Mid Cheshire Hospitals NHS Foundation Trust (MCHFT), briefed the Committee on the draft Quality Account 2009 -2010 produced by MCHFT. 

Last year MCHFT had produced a Quality Report that outlined quality areas that would be measured in 2009 – 10 and how it would take forward its aspiration to be a World Class Provider through the implementation of the five year “10 out of Ten” quality strategy.  This strategy aimed to identify the top ten quality indicators and establish the measurements that would be used to monitor effectiveness against these.

The Trust had agreed a definition of Quality:

“Effective and efficient delivery, a positive experience by both service users and staff, the best possible clinical and patient outcomes”.

The Trust also recognised the reduction of avoidable harm as a key imperative and had outlined a number of values –

·        Commitment to quality and safety;

·        Respect, dignity and compassion;

·        Listening, learning and leading;

·        Creating the best outcomes together;

·        Every1Matters

The Trust Board had established an Executive Committee as recognition of the priority given to quality and safety.  The Committee was known as QuESt (Quality, Effectiveness and Safety) and met bi-monthly, was chaired by the Chief Executive and reported to the Board of Directors.

The Quality Account listed the top ten indicators agreed in the previous year, to be progressed over five years, and outlined how progress would be monitored, measured and reported:

Outcomes

• Cardiovascular – the aim was to reduce mortality rates in patients who suffered an Acute Myocardial Infarction (heart attack) within a 30 day period.  The data was not currently routinely collected but work was underway with Dr Foster (a performance benchmarking tool) to measure mortality rates and these would be reported to the QuESt Committee;
• Cancer – the aim was to improve survival rates for patients diagnosed with cancer.  Monitoring would be carried out on an annual basis and measured by the Primary Care Trust and North West Cancer Intelligence Service.  Survival rates would be reported to the QuESt Committee;
• Infections – the aim was to reduce the rates of healthcare acquired infections – MRSA, Clostridium Difficile and Urinary Tract Infections. 

Safety

• Mortality – the aim was to reduce mortality rates by 10% in patient groups where death was not expected.  A Hospital Mortality Reduction Group had been established to review health records and develop Action Plans;
• Patient Safety – the aim was to monitor and reduce the number of consultant episodes (unnecessary patient moves) during each patient admission;
• Harm caused – the aim was to monitor and reduce the number of patients who suffered avoidable harm by 10% annually;

Experience

• Environment – the aim was to monitor and virtually eliminate mixed sex accommodation for all patients admitted to the trust (unless based on clinical need).  All wards were mixed sex but bays were single sex because to introduce single sex wards would require joining services which would result in poorer outcomes.  The Committee was advised that in cases where there  ...  view the full minutes text for item 27