Agenda item

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 Comprehensive Inspection Report

·       Southern Health NHS Foundation Trust: Care Quality Commission and Mazars recommendations – update on progress

Care Quality Commission (CQC) Inspection of services – Portsmouth Hospitals Trust

Dr John Knighton from the Portsmouth Hospitals Trust (PHT)  presented a report on the CQC inspection (see report, Item 7 in the Minute Book). It was acknowledged that the Trust had an overall rating of ‘Requires Improvement’ following the CQC Inspection.

Dr Knighton was pleased to confirm that some areas had seen significant improvement since the last inspection, including Critical Care, which  was one of few areas to be awarded ‘Outstanding’. Children’s Services and End of Life Care had also performed well.
 

Maternity Services and Accident and Emergency had both been focuses for the new leadership team, with programmes for change already being implemented before the inspection. Despite some areas still needing further attention, it was a positive step that there had been no surprises arising from the inspection and areas of need had already been identified and a Quality Management Plan established, which would focus on medicines management and provision of safeguarding primarily.

In response to questions, Members heard:

·      The matrix within the report confirmed overall scores, with 30 areas marked as ‘Good’ or above and 23 as ‘Requiring Improvement’ or ‘Inadequate’.

·      Whilst there were high standards of cleaning, the cleanliness as part of the inspection related to inconsistence with clinical cleaning, for example beds and bedside equipment and there was a risk standards could be jeopardised during busy periods.

·      There had been a large increase in the requests for X-rays and scans and a national shortage of radiographers, but more imaging capacity was being provided via a temporary scanner for over the winter period.

·      Part of the £2.8 million grant will go towards regenerating the A&E department at Queen Alexandra (QA) which was an old part of the building designed around the 1979 provisions and not updated during the 2009 work.

·      Last year the QA hospital had been the most successful with preventing the spread of the Norovirus, with no beds being lost due to good infection control.

·      A new role of ‘Director of Integrated Governance’ had been created, with a focus on openness and transparency and closer working with other colleagues and organisations.

·      A separate bereavement suite had not yet been established, but there was a suitable area reserved for such incidences.

·      Mental Health nurses were on the daily rota within the A&E department to assist with difficult behaviour, but it was acknowledged that such behaviour was not always a result of mental health problems.

·      It took 8-10 years to train radiographers and difficult to know what the requirement would be for them over than length of time. Due to great cost, there had been a caution to not over train and have more than was needed, but this was a difficult balance to get as the sudden increase in demand could not have been predicted.

·      There was a quiet space available for those who needed it, which could also be used by those with autism if required.

RESOLVED

The Committee:

1. Noted the findings within the recent CQC inspection of Portsmouth Hospitals Trust;

2. Noted the approach of the Trust to respond to the findings;

3. Agreed that that an update would come back to Committee on progress made against the recommendations within the CQC report in six months time.

Care Quality Commission (CQC) re-inspection of services – Southern Health NHS Foundation Trust, and update on response to Mazars report on ‘deaths of people with a learning disability or mental health problem in contact with Southern Health’

Dr Nick Broughton from Southern Health presented an update to the Committee regarding a re-inspection (Item 7b in the Minute Book).

It was confirmed to the Committee that the Trust had been fined £2 million in March 2018 due to past failures. As part of an overhaul, a new Board of Directors with the necessary expertise and experience was now in place to take forward the necessary transformation of the Trust. Good progress had already been made and the level of regulatory scrutiny had reduced due to adequate improvements.

A Service User Coordinator had been appointed with focus on better working with patients and carers. Quality improvement initiatives were now addressing recruitment and retention, as well as reducing pressure ulcers, improving access to therapies and reducing violence and aggression. There was also work being done to develop a new in-house low secure unit for young people.

A further inspection by CQC was done over the summer and a report with their findings was due in the autumn.

In response to questions, Members heard that:

·         Training on autism was limited unless for staff who were specialised in the area, but this was standard across the NHS

·         There was a lack of psychological treatment, but this was something that hoped to be expanded in the future.

·         There were organisational barriers (i.e. between CAMHS and Adult services), which could make some cases and work areas difficult

·         Recruitment and retention was one of the top priorities within Mental Health, as vacancies and the use of locums undermined the continuity of care for patients. Some medics hadn’t felt valued by the organisation and it was important that was a focus.

Councillor Stallard informed the Committee that Public Health at HCC undertake an annual audit of suicides in Hampshire, which could be made available to the Committee.

RESOLVED:

The Committee:

a)    Thanked Dr Broughton for the update, which was noted;

b)    Agreed that an update be brought to the November or January 2019 HASC meeting, following receipt of the latest CQC report

c)    Made no further recommendations