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4.1 Chief Executives Report to the Trust Board Trust Board in Public Date: 25 March 2010 Item No 4.1 Item: Chief Executive’s Report to the Trust Board Synopsis: The report updates the Board on key developments and initiatives across the Trust and the local health economy since the January 2010 Trust Board meeting. Author: Gail Wannell, Chief Executive Action Required: For information Chief Executive’s Report – 25 March 2010 1. Care Quality Commission Inspection An inspection by the Care Quality Commission (CQC) on 28 January 2010 saw East Surrey Hospital meet 13 out of 16 measures of the Code of Practice on Healthcare Associated Infections. The CQC sought immediate action on the breach of two hygiene measures of the code. It also made recommendations for improvements on an infection policy. Immediately following the inspection the Trust took action including: • Expediting our mattress and patient furniture replacement programme • Increased top to bottom cleaning, including stricter monitoring system • Improved hygiene training programme for staff, including updated infection prevention and control training in relation to cleaning standards • Stricter guidelines for cleaning of equipment • Repairs to identified areas e.g. plastering of walls. The CQC placed the Trust under close scrutiny and gave the Trust until 31 March to meet all the requirements of the hygiene code. On 18 February the CQC visited the Trust as part of the close scrutiny activity to gain assurance that we had taken the immediate action as outlined in the requirements. The Trust provided assurance that it had addressed the immediate action required and the CQC report following the visit stated “The trust had taken immediate action to clean the environment.” The CQC will undertake a further follow up inspection to gain assurance that we have fully implemented the requirements (which have a deadline of 31 March 2010) and recommendation. I have apologised to our patients, their relatives and visitors for not maintaining our high hygiene and cleanliness standards. We had been compliant with the hygiene standards since they were brought in, and are very disappointed that on this occasion we have let our patients and ourselves down. Nursing, clinical, housekeeping and estate staff have taken immediate actions to step up our cleaning programme. Improved training for staff is part of the new programme ensuring all hospital staff pay even greater attention to hygiene. Cleanliness is everyone’s responsibility and it is important we work as a team making sure this does not happen again. We have learnt from this and can assure the Board that the majority of the actions have already been carried out. We expect full implementation of the updated hygiene programme by the end of March 2010. 2. MRSA and Clostridium difficile infections The Trust continues to achieve a reduction in cases for Clostridium difficile and MRSA BSI (Blood Stream Infections) compared to last year. The decrease is a positive trend, which we look to continue. For MRSA BSI we have shown a real improvement over last year and have only six cases which are considered post 48 hrs (Trust acquired). As a comparison, during the 2008/09 financial year the Trust recorded 13 post 48 hrs cases. Chief Executive’s Report to the Board 1 March 2010 For CDI there have been fewer cases than this time last year and there has been a reduction in cases acquired whilst under the Trust’s care during November and December. The management of CDI continues to be a high priority for the IPCAS team and the Trust. The emphasis of timely isolation, barrier nursing practice and antibiotic stewardship remains high. Improvements are a result of: • Establishing a multi-professional Healthcare-Associated Infection (HCAI) Task Force since April 2008, which carries out closer surveillance of HCAIs and monitoring/audit of infection control practices at ward level • Changes to practices, e.g. increased chlorine cleaning in all clinical areas as standard practice. • Increased training and auditing including SLASH training for all Doctors on intake (Saving Lives Aseptic Skills for Healthcare) and Nursing staff on annual update. 3. Maternity achieves CNST Level 2 The Trust has received a clear vote of confidence that our maternity department is doing all that is required to deliver a safe service for the women and families in our care, after achieving Level 2 of the Clinical Negligence Scheme for Trusts (CNST) from the NHS Litigation Authority. The NHSLA works to improve risk management practices in the NHS. The Trust was already at level 2 - but the task this year was greater because the standards and assessment process has changed and become more stringent. Many other Trusts already at Level 2 on the old system are choosing to be assessed at Level 1 on the new system in the first instance. To achieve Level 2 is demanding and requires staff to have a good understanding of clinical risk issues and to be proactive in evaluating and developing the service. My thanks to all staff involved in achieving this excellent result. 4. Refurbishment of the Hospital Street Patients visiting East Surrey hospital will have an improved experience after the main ground floor corridor of East Surrey Hospital (known as the Hospital Street) is refurbished starting from 1 March. The six week project, costing over £600,000, will see a new floor being laid, lighting replaced, walls decorated and more seats and waste/recycling bins installed. The project will use colour schemes that have been shown to have a positive effect on health. The project includes the whole of the Hospital Street from the Friends’ shop at the West Entrance to Redwood. It does not include either the East or West entrance – these will form part of the capital programme for 2011/12. The project will be in five phases and will include some overnight work. 5. Service Improvements • The Surgical Assessment Unit will complete its refurbishment at the end of March. The unit will meet the latest same-sex guidelines for the privacy and dignity of patients. • We are investing £1.9m in two new MRI scanners for East Surrey Hospital. • A wide bore scanner (the first in Europe) will allow better scan results for bariatric patients. This will be operational in June. • An extremity MRI scanner (of which there are only 3 others in the country) will be operational in April. Chief Executive’s Report to the Board 2 March 2010 • We are also investing £400K in 5 new ultrasound scanners for Obs & Gynae. Three will be based at ESH and two based at Crawley Hospital for antenatal screening. • Two new Stroke Consultants, Dr Abousleiman and Dr Shah have recently joined SASH and both have vast experience and knowledge in stroke care. A thrombolysis service is now being provided at ESH from 8.00am to 8.00pm Monday to Friday. • 6. Organ Donor Study Day The Trust hosted the first Surrey-wide organ donation study day at East Surrey Hospital on 10 February 2010. The UK is one of the worst performing countries in Europe for organ donations with more than 10,000 people in the UK currently needing a transplant. The study day helped understanding of national changes and improvements, and how to implement them locally. 7. Adult Learners improve customer care East Surrey Hospital domestic and housekeeping staff have successfully completed a ‘Learning as you work’ course, which focused on improving customer care and achieving recognition through the Open College Network. This programme has significantly supported overall improvements to the patients’ experience. The group has been nominated for the Adult Learner Awards in Surrey. 8. PEAT Assessments Brook Ward and Limpsfield Clinic are leading the way in improving the patient experience after an assessment by the Patient Environment Action Team (PEAT) showed they achieved an average score of 98% for cleanliness and tidiness in weekly and monthly cleaning audits over the last year. PEAT assessments measure the quality of our food services, infection control, cleanliness and tidiness, and privacy and dignity. PEAT is supported by patient representatives who this year spent an entire day in February assessing wards and presented Brook and Limpsfield with a trophy each in recognition of their achievement. 9. Visits and meetings 29 January – The Chairman and myself met Horsham MP Francis Maude 11 February - Attended Horsham District Council Cabinet meeting to give presentation on Foundation Trust status. 22 February - Met West Sussex HOSC liaison councillors - Dr Howard Bloom and Dr David Skipp 9 March – Met the West Sussex HOSC Chair, Christine Field, and the Surrey HOSC Chair, David Munro 19 March - Meeting with Laura Moffatt, MP for Crawley 19 March – Meeting with Geoffrey Newman, prospective parliamentary candidate for the Liberal Democrats 23 March – Meeting the new Editor-in-Chief of the Surrey Mirror with the Chairman 25 March – Board to Board meeting with NHS West Sussex Chief Executive’s Report to the Board 3 March 2010 10. Communications and Media update Macmillan Lead Cancer Nurse Jane Penny and other specialist nurses hosted a visit for Horsham MP Francis Maude and the regional Macmillan Team in February. The Communications Team provided support and advice for the meeting. The visit was well- received by Mr Maude and he praised the team in his local newspaper. Following the publication of the CQC inspection report, the Trust issued a press release and set up interviews with radio stations and a local newspaper. We also organised a hospital tour for the newspaper with visits to the newly refurbished AMU and Tilgate Ward. There has been much positive coverage about a patient’s experience in ICU and Godstone Ward and her praise for the staff. The Trust also obtained positive coverage on a new scanner for A&E and about the Board’s decision to put on hold car parking charges for staff and to look at alternatives to reduce car use.
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