Issue - meetings

To consider a report of the Director of Transformation and Governance on issues brought to the attention of the Committee which impact upon the planning, provision and/or operation of health services within Hampshire, or the Hampshire population.

a)    Southern Health NHS Foundation Trust – Update on actions following CQC report

b)    Portsmouth Hospitals Trust – Update on actions following CQC report

c)    Solent NHS Trust – CQC Inspection Report

The Chairman took the items within Item 7 in a different order to the published agenda in order to accommodate availability of presenters:

b) Portsmouth Hospitals Trust – Update on actions following CQC report

The Medical Director from Portsmouth Hospitals Trust presented a report providing an update on action taken by the Trust in response to the areas the Care Quality Commission had identified as requiring improvement, following their inspection of the Trust’s services in 2018 (see report, Item 7b in the Minute Book).

Members heard that the Trust had been implementing a detailed quality recovery plan in response to the inspection findings. A re-inspection against a section 29A notice was expected, and three section 31 notices had been removed. The Trust view was that some improvements had been made, but in some areas there was still more to do.

In response to questions, Members heard:

·      It was disappointing that the caring rating had slipped from Outstanding in 2013 to Requires Improvement in 2018. The Trust was focused on promoting values and culture to improve this

·      CQC had recognised that for the Well Led category it would take time for the new leadership team in place to make an impact

·      The layout of the A&E area was a limitation and funding had been secured for an emergency care redevelopment project, however this would take a couple of years to reach fruition

·      Pressures were being experienced due to an unprecedented increase in demand. While the system had delivered improvements to delayed transfers of care over the past year, February 2019 had seen an 18% increase in attendances compared to February 2018

·      Some elective procedures had been suspended for a period in the past to help manage the emergency demand, however this had led to a backlog for some areas e.g. orthopaedics. The Trust had a recovery plan in place to deal with the backlog

RESOLVED

That the Committee:

a.    Note the update on action taken by the Trust in response to the 2018 CQC inspection findings.

b.    Request a further (paper only) progress update for the July 2019 meeting.

c.    Request PHT attends the November 2019 meeting to provide a further update and take questions.

a) Southern Health NHS Foundation Trust – Update on actions following CQC report

Representatives from Southern Health NHS Foundation Trust provided slides to give an update on action taken by the Trust in response to the areas the Care Quality Commission had identified as requiring improvement, following their inspection of the Trust’s services in 2018 (see slides, Item 7a in the Minute Book).

It was noted that the slides and the Trust’s Quality Improvement Plan would be circulated to Committee Members after the meeting. Members requested that the Trust provide a further update to a future meeting and provide a written paper in advance, so that Members have a chance to review the detail.

RESOLVED

That the Committee:

a. Note the update on action taken by the Trust in response to the 2018 CQC inspection  ...  view the full minutes text for item 127

To consider a report of the Director of Transformation and Governance on issues brought to the attention of the Committee which impact upon the planning, provision and/or operation of health services within Hampshire, or the Hampshire population.

a)    Hampshire Hospitals NHS Foundation Trust – Update on actions following CQC report

Hampshire Hospitals NHS Foundation Trust – Update on actions following Care Quality Commission report

The Select Committee received a report from Hampshire Hospitals NHS Foundation Trust, providing an update on actions being taken by the Trust in response to the Care Quality Commission report they received in September 2018 (see report, Item 7a in the Minute Book).

RESOLVED:

That the Health and Adult Social Care Select Committee:

a. Note the update on action taken by the Trust in response to the 2018 CQC inspection findings.

b. Request a further progress update for the May 2019 meeting.

To consider a report of the Director of Transformation and Governance on issues brought to the attention of the Committee which impact upon the planning, provision and/or operation of health services within Hampshire, or the Hampshire population.

• Southern Health NHS Foundation Trust: Care Quality Commission Comprehensive Inspection Report

• Hampshire Hospitals NHS Foundation Trust: Care Quality Commission Comprehensive Inspection Report 

Care Quality Commission (CQC) Inspection of services – Southern Health NHS Foundation Trust

Representatives from Southern Health NHS Foundation Trust presented a report on the Care Quality Commission comprehensive inspection of the Trust undertaken in June/July 2018 (see report, Item 7 in the Minute Book).

Members heard that the overall rating given to the Trust was Requires Improvement, the same as the previous inspection in 2014. However, the CQC had recognised that there had been significant improvements since the last inspection, with a number of areas being considered good or outstanding. 26 service areas had achieved an improved rating, 43 the same, and 6 had gone down.

An enforcement action was implemented in July regarding Bluebird House, and within three weeks the Trust had responded and it was lifted. The CQC report contained 20 must do actions and 74 should do actions. The Trust had come up with an action plan to respond to these areas, organised around seven themes; workforce; safeguarding; end of life care; records management; medicines management; privacy and dignity; supervision.

A Member commented on a report in the national press regarding a psychiatrist having been found to have worked in the UK for 20 years who didn’t have the relevant qualifications. Members were assured that the Trust was auditing their processes to ensure this would not happen.

RESOLVED:

That the Committee:

a. Note the findings of the most recent CQC inspection of Southern Health NHS Foundation Trust.

b. Note the approach of the Trust to respond to the findings and request provision of the improvement plan.

c. Request the Trust attend the HASC meeting in March to provide an update on progress made against the recommendations of the Care Quality Commission report.

d. Request the Trust be transparent about the findings of a review of procedures regarding checking staff qualifications.

Care Quality Commission (CQC) Inspection of services – Hampshire Hospitals NHS Foundation Trust

Representatives from Hampshire Hospitals NHS Foundation Trust presented a report on the comprehensive inspection of the Trust undertaken in June 2018. (see report, Item 7 in the Minute Book).

Members heard that the overall rating given to the Trust by CQC was Requires Improvement, which was a decrease from the previous rating of Good. A presentation was provided that summarised the actions CQC required of the Trust and the action the Trust was taking in response. Members asked questions for clarity and to explore particular areas.  

RESOLVED:

That the Committee:

a. Note the findings of the most recent CQC inspection of Hampshire Hospitals NHS Foundation Trust.

b. Note the approach of the Trust to respond to the findings and request provision of the improvement plan.

c. Request the Trust attend the HASC meeting in February to provide an update on progress made against the recommendations of the Care Quality Commission report.

To consider a report of the Director of Transformation and Governance on issues brought to the attention of the Committee which impact upon the planning, provision and/or operation of health services within Hampshire, or the Hampshire population.

·       Portsmouth Hospitals NHS Trust: Care Quality Commission Re-Inspection – Monitoring of Quality Improvement Plan

Councillor Tonia Craig left at this point in the meeting.

Portsmouth Hospitals NHS Trust; Care Quality Commission Re-Inspection – Monitoring of Quality Improvement Plan

The Chief Executive of Portsmouth Hospitals NHS Trust and his representatives attended alongside a representative from Hampshire CCG Partnership in order to speak to the Quality Improvement Plan and related issues (see report, Item 7 in the Minute Book).

Members heard that a number of papers had been sent to the Committee including progress against the quality improvement plan, which was a detailed overview of all the actions being undertaken by the Trust.  This overview provided an indication of those actions that are on track and those where delivery required further action.  This spreadsheet was the same document made available to the internal Trust review group considering progress made against recommendations.  Also included within the papers were the outcomes and Trust statement on the Care Quality Commission (CQC) investigation into radiology services.

In response to questions, Members heard:

·      That the Trust received an unannounced inspection of its urgent care services in February which focused on the Trust’s response to winter pressures.  The Trust had been one of a number of Trusts inspected due to its status as a ‘high risk’ system. 

·      The CQC’s urgent care inspection report highlighted some areas of positive progress but was also clear on areas for definite improvement.  All the recommendations from this report had been picked up through both the quality improvement plan and the wider system improvement plan.  The Chief Executive was confident that those recommendations requiring urgent action had been implemented, and that the comprehensive inspection that had been undertaken in April and May would see improvements.

·      It had been three years since the Trust had last been subject to a comprehensive CQC inspection; the reports published since had focused on areas of the Trust’s activity but had not provided overall ratings.  The inspections were considering all elements of the Trust’s business, with the exception of gynaecology.  The inspection elements had finished in the last week, with the most recent visit focusing on whether the Trust was a well-led organisation.  It was expected that an initial draft report would be available towards the end of June.

·      The CCG had been involved in the oversight process, with a significant role in ongoing quality committees, and the Director of Quality and her team actively involved in assisting the Trust.  Meetings and the sharing of information took place both weekly and monthly, in order to ensure that actions are being completed.   The CCG continued their view that improvement was being evidenced in the Trust, and the new Board were committed to leading the Trust through its improvement journey.

·      At the last meeting where Portsmouth Hospital Trust appeared before the Committee, the issue of the urgent care department and acute medical unit’s estate was raised and discussion was held on whether works could be undertaken to improve the flow and layout of this area of the hospital.  This estate issue remained difficult to  ...  view the full minutes text for item 64