Decision details

NHS Quality Accounts 2012/13

Decision status: Recommendations Approved

Is Key decision?: No

Is subject to call in?: No

Decisions:

NORTH LONDON HOSPICE

 

The Committee scrutinised the North London Hospice Quality Account 2012/13 and wishes to place on record the following comments:

 

·           The Committee noted the high quality of care provided by the Hospice and welcomed the patient focus.

·           The Committee supported the use of volunteers and the training that the Hospice provided for them. 

·           The Committee noted that a large proportion of the Hospices’ income was derived from fundraising activity and commended this. 

·           The Committee welcomed the participation of the Hospice on the End of Life Care Board and Frail Elderly Group

·           The Committee supported the introduction of a target of a 75 – 80% bed occupancy rate for 2013/14.

·           The Committee welcomed the decrease in the number of closed bed days from 156 in 2011/12 to 85 in 2012/13.

·           The Committee welcomed the Hospice beginning to work within a local five hospice consortium to benchmark performance.

·           With reference to Information Governance Assessment, the Committee noted that the Hospice had achieved an overall score of 60% and had been graded ‘not satisfactory’.  Hospice staff reported that this had been due to issues regarding connecting IT systems to the NHS Intranet which had very high security requirements.  Members were advised that was an action plan in place to ensure that the required score of 66% was achieved for 2013/14.  The Committee noted the response and supported the actions taken to improve performance.

·           The Committee noted that staff had been considering recommendations made in the Francis Report and how the Hospice would respond to these.  

·           The Committee highlighted the increase in pressure sores (an increase from one in 2011/12 to four in 2012/13) and noted that these were attributable to an increased number of patient days in the hospice and the medical conditions suffered by the patients which made regular movements painful.

 

 

ROYAL FREE LONDON NHS FOUNDATION TRUST

 

The Committee scrutinised the Royal Free London NHS Foundation Trust Quality Account 2012/13 and wishes to place on record the following comments:

 

·           The Committee welcomed that all targets, with the exception of C.difficile infection cases, had been met for 2012/13.  The Committee noted that the Infection Control Team had been undertaking detailed analysis of cases and steps were being taken to address this increase.

·           The Committee welcomed the move towards patient rather than clinician defined performance metrics.

·           The Committee noted that the hospital had been found to be non-compliant with one outcome relating to medicine management following a CQC inspection in October 2012 and that an action plan was being implemented to address this area of improvement.

·           The Committee noted work being undertaken by the Trust to ensure there was sufficient capacity for emergency operations. 

 

 

CENTRAL LONDON COMMUNITY HEALTHCARE NHS TRUST

 

The Committee scrutinised the Central London Community Healthcare NHS Trust Quality Account 2012/13 and wishes to place on record the following comments:

 

·           The Committee welcomed the continuing involvement of the Quality Stakeholder Group.

·           The Committee commended the award winning work of the Central London Community Healthcare NHS Trust staff.

·           The Committee supported work of the Trust to introduce technology to improve clinical record keeping and increase the amount of staff to patient time.

 

However, the Committee wished to express concern in relation to the following:-

 

·           The Committee commented that the Patient Survey Results indicated a lower performance for Barnet than in other boroughs and sought assurance that Barnet residents were not receiving a lower standard of service.

·           The ideal of having interdisciplinary meetings for individual patients’ treatment is splendid.  However, there is no mention in the Quality Account of how this will happen.

   

 

BARNET AND CHASE FARM HOSPITALS NHS TRUST

 

The Committee scrutinised the Barnet and Chase Farm Hospital NHS Trust Quality Account 2012/13 and wishes to place on record the following comments:-

 

·           The Committee welcomed the positive developments set out in the Quality Accounts and were encouraged by the Trust’s improved performance on Priority Three: Pressure Ulcers. 

·           The Committee were pleased to note the improvements that had been made in respect of Priority Five: Liverpool Care Pathway and the emphasis on dignity, respect and compassion. 

·           The Committee noted the Trust’s intention to improve record keeping.

·           The Committee congratulated the Trust in relation to their work on Priority One: Dementia Services.

 

However, the Committee wished to express concern in relation to the following:-

 

·           The Committee questioned why the Trust had not contributed to this year’s National Diabetes Audit and expressed concern that the data held on the Trust’s existing system was not adequate or specific to the audit.  The Committee were reassured to hear that the software required to contribute to this audit had been purchased and that the Trust intended to contribute to next year’s audit.

·           The Committee noted the number of large scale projects on-going at the Trust (including the response to the Francis Report, the business case for the acquisition of the Trust by the Royal Free London NHS Foundation Trust and delivering the objectives set out in the Quality Accounts) and expressed concern at the ability of the Trust to manage and prioritise these projects.   The Committee noted that the Trust were aware of the risks in balancing a number of projects and received assurance that they would monitor Key Performance Indicators closely. 

·           The Committee expressed concern at the Clinical Coding Error Rate and questioned what action would be taken to improve these figures. 

·           The Committee raised concern over the performance for MRSA instances in 2012/13 and noted that the target of four cases had been breached, with seven MRSA cases occurring within the period.  The committee noted that root cause analysis of the cases had shown that the cases had not been a result of cross-contamination. 

·           The Committee raised concerns that five “never” events had taken place during 2012/13, and sought assurance that appropriate action would be taken. 

·           The Committee expressed great concern that the target to see patients at Accident and Emergency within four hours had been breached in five months out of 12 during 2012/2013, especially in light of the changes due to be implemented in November 2013 as part of the Barnet, Enfield and Haringey Clinical Strategy.

 

 

BARNET, ENFIELD AND HARINGEY MENTAL HEALTH NHS TRUST

 

The Committee scrutinised the Barnet, Enfield and Haringey NHS Trust Quality Account 2012/13 and wishes to place on record the following comments:

 

·           The Committee welcomed that emergency readmissions to the Barnet, Enfield and Haringey Mental Health Trust were lower than the national average.

 

However, the Committee wished to express concern in relation to the following:-

 

·           The Committee noted that, following the attendance of a Committee Member at the Barnet Clinical Commissioning Group Board meeting, there was awareness that the patient “crisis line” was not fully operational.  The Committee expressed concern that the telephone line had not been working to the expected standard and highlighted the need for improvement. 

·           The Committee expressed concern that Members had received reports that the “GP Line” had not been answered when called. 

·           The Committee identified that comments submitted by the North Central London Sector JHOSC in relation to the 2011/12 Quality Accounts (which requested that more information on the absolute number of patients and the different types of treatment given be included within the Trust’s Quality Account to give those reading the report a clearer impression of the work of the Trust) had not been addressed.  The Committee requested that this information be added to the final version of this year’s Quality Accounts.

The Committee noted that it was proposed that the boroughs of Barnet, Enfield and Haringey meet collectively to consider the Barnet, Enfield and Haringey Mental Health Trust Quality Accounts 2012/13 and that the submission outlined above may be superseded by a joint submission from the three boroughs.  (Note: Members of Barnet, Enfield and Haringey Health Overview and Scrutiny Committees met on 28 May 2013 and agreed a revised submission).

 

RESOLVED that:-

 

1.             That the above mentioned comments by the Committee be noted by the North London Hospice and individual Trusts and incorporated into the final versions of their Quality Accounts for 2012/13.

 

2.             The Royal Free Hospital NHS Foundation Trust be requested to provide the Committee with details of changes to the National Patient Survey and the impact on measuring performance against key quality objectives. 

 

3.             NHS partners be requested to present a six month update to the Committee on actions taken to respond to the comments by the Committee when considering the Quality Accounts. 

 

4.             Barnet and Chase Farm Hospitals NHS Trust be requested to provide details to the Committee on actions taken to address performance issues in relation to the Clinical Coding Error Rate.

 

Report author: Andrew Charlwood

Publication date: 06/06/2013

Date of decision: 09/05/2013

Decided at meeting: 09/05/2013 - Health Overview and Scrutiny Committee

Accompanying Documents: