Agenda Item Number 5.2 Provider Update for Patient Safety and Quality of Care Report Board Meeting Thursday 4 September 2014 Submitted by: Chief Nurse – Lisa Allen Prepared by: Patient Safety & Quality Team and James Buschor Status: For monitoring Purpose This report gives an overview of the assurance for patient safety and quality of care at the main providers with whom we contract Basildon and Thurrock University Hospitals Foundation Trust (BTUH) Barking Havering and Redbridge Hospital Trust – Queens hospital North East London Foundation Trust (SWE Community Services) Southend University Hospital Foundation Trust South Essex Partnership Trust Spire Hartswood Nuffield Brentwood NHS 111 East of England Ambulance Trust Background This report continues to be developed to provide assurance about patient safety and quality at the providers from which the CCG commission care. Where possible benchmarking data is used, and this report will be developed further over time. Key issues BTUH BTUH was taken out of special measures after it received a ‘good’ rating from CQC on the 9th June. Services were described as effective, caring, responsive and well-led with seven out of eight areas rated as ‘good’ or ‘outstanding. The hospital is the first in the country to be rated as ‘outstanding’ for its maternity care. Barking Havering and Redbridge Hospital Trust BB CCG has received the first draft of BHRT’s improvement plan which will require further work due to new leadership arrangements. Barking, Havering & Redbridge CCGs have noted that there had been some improvement in performance on the emergency care target, but that it was still below target. North East London Foundation Trust (SWE Community Services) NELFT has undertaken a gap analysis of their compliance with the Francis report recommendations. There are still 3 areas which need to be addressed. Two residential homes were chosen to take part in the project ‘Prevention of falls in residential settings’: Cameron House in Basildon offers residential care to 44 residents and 1 employs 46 care home staff. Winifred Dell Care Centre in Brentwood Southend University Hospital Foundation Trust In response to the Risk Summit held in March 2014, the Trust have submitted an action plan which will be monitored through monthly Clinical Quality Review Group meetings, Executive Meetings and Quality Visits South Essex Partnership Trust (Mental Health) There are currently 8 active serious incidents, including 5 which have been declared since the previous report. CPR CCG has been working closely with the Trust to review all serious incidents and has agreed closure on 13 incidents since the previous meeting Spire Hartswood The CCG Quality Team will be carrying out a quality visit to Spire in July. Nuffield Brentwood The Nuffield Quarterly Quality meeting is due to take place on the 30th July 2014; the BBCCG Quality team have been invited to this meeting and will report back at the next meeting. The NHS 111 & OOH The CQC has inspected SEEDS out of hour’s doctors and found them to be compliant against four of the five standards they were assessed against. The required improvement under the ‘are the services safe’ standard pertained to Doctors having CRB or DAB checks. SEEDS have given assurance that all Doctors used are checked. The CCG is pro-actively supporting the service to ensure evidence is available for all 16 CQC Essential Quality standards East of England Ambulance Service Trust Following the risk summit there is to be a reorganisation of the consortium. There are to be three Accountable Officers one for each of the following Beds/Herts, Essex and Norfolk Suffolk & Cambridge Recommendation Members of the Committee/Board are invited to: Note the contents of the Provider update for Patient Safety and Quality of Care Report. Provider Update for Patient Safety and Quality of Care Report 2 Basildon and Thurrock University Hospital Trust CQC Update BTUH was taken out of special measures after it received a ‘good’ rating from CQC on the 6th June. Services were described as effective, caring, responsive and well-led with seven out of eight areas rated as ‘good’ or ‘outstanding. The hospital is the first in the country to be rated as ‘outstanding’ for its maternity care. In their summary, the CQC inspectors said: “We found very good care in most of the services we inspected. We saw some very good examples of care and treatment in maternity and children’s services. Patients who needed end of life care were supported by compassionate and caring staff. The service in A&E was improving and patients were mostly seen within the four-hour target. Professor Sir Mike Richards, Chief Inspector of hospitals at the CQC said…’ some improvements are however still needed, so the trust cannot be complacent. But, as the trust has moved forward and made improvements across its services, CQC has confidence in the trust’s leadership to continue to work to make further changes for the good of its patients.” The full report can be found at the following link; http://www.cqc.org.uk/location/RDDH0 Keogh – Mortality Review A final extended CQRG is to arranged, to agree between the CCG, Monitor, the Area Team and Trust what ‘business as usual’ will look like. As a minimum this will include: Monthly CQRG (including review of data) Monthly assurance visits Attendance at agreed internal meetings One to ones with both the DoN and MD Neither the Trust nor the CCG underestimate to work that remains to continue to improve and sustain improvements for PS&Q at the Trust. Mortality Mortality rolling average The crude mortality rolling average results demonstrate a continuing downward trend and improvement of the Trust’s mortality metrics. 3 HSMR The HSMR for the rolling 12 months period Feb 13 – Jan 14 is 90.88, which places the Trust in the significantly ‘lower than expected’ banding. There are no HSMR diagnosis groups attracting higher than expected deaths, evidence of improvement in the Trust’s performance. Nursing and medical staffing levels and skill mix Nursing NHS England, in association with the Care Quality Commission had published guidance aimed at ensuring all in-patients wards in hospitals had the right number and skill mix of staff to provide high quality, compassionate and safe care to patients. This followed the findings of the Mid - Staffordshire, Keogh and other high profile reviews, which highlighted that the number and competence of nursing staff on duty was a key determinant of the standards of care provided. In March 2013, NHS England published further guidance on the responsibility of NHS Trust Boards in ensuring not only that the minimum standards were met, but with monitoring and overseeing compliance with the standards. The Trust was fully compliant against six of the ten requirements and demonstrated partial compliance regarding the remaining four. Full compliance was required by no later than the end of June 2014. Unfortunately the publication of the Safer Staffing data in June showed incorrect (old) data for reporting of incidents and for CQC compliance. Fortunately this did not attract any adverse media interest. Medical Work towards 7 day working continues at the Trust Essex Quality Surveillance Group Bi-monthly meetings attended by the Chief Nurse and Chief Officer. Due to concerns around RTT – the Trust remains on Enhanced surveillance. Serious Incidents We are working very closely with the Trust to close down long running SI reports and action plans. This is now to be monitored through the CQRG and at fortnightly meetings with the Chief Nurse Number of SI’s for 2014/15 (April/May) Total; 30 (including 2 possible Never Events) Number under each category SI Category Quarter 1 (April/May) 2014/15 Documentation 4 Treatment / 14 procedure Clinical assessment 0 Information 0 governance Implementation of 2 care 4 Infection control 0 Maternity 3 Patient accident 6 Patient abuse 1 (alleged) Total 30 Incident Themes Patient Experience NHS Choices (Information as published at the end of June 2014) OVERALL RATINGS: Overall Rating Cleanliness Staff Co-operation Dignity & Involvement in Same-sex Respect decisions Accommod (based on (based on ation 199 rating) (based on 198 rating) (based on (based on 197 rating) 196 rating) 193 rating) (based on 149 rating) 4.5 stars 4.5 stars 4.5 stars 4.5 stars 4.5 stars 4.5 stars out of 5 out of 5 out of 5 out of 5 out of 5 out of 5 The overall ratings are the same as the previous three months. Extracts from the latest comments published on NHS choices website for Basildon Hospital Re vamp - excellent My 88year old mother was treated today with excellent care and staff were brilliant explaining everything. I was dreading Basildon hospital (my father died there ten years ago). I came back from Spain to oversee her treatment and have been very pleased with the treatment and respect and informative staff. Administration and reception may need attention...... but so far Haematology A & E and Orsett ward day unit deserve every star. My mother( a retired nhs nurse )gets treated with dignity and respect which is all one hopes for 5 when an elderly parent i just want her treated how she treated patients. I award you Five stars you deserve it. Visited in June 2014. Posted on 11 June 2014 Basildon University Hospital replied on 12 June 2014 We are very pleased that you mother's recent experience at Basildon and Thurrock Univeristy Hospitals NHS Foundation Trust was a positive one. Your kind words will be shared with staff in all the areas you have mentioned. Thank you for taking the time to let us know about your mother's experience. We wish her all the best for her future good health Gynaecology clinic - good I attended with my daughter in law, to support her as she had been quite upset at a previous visit.