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.

• Southern Health NHS Foundation Trust: Care Quality Commission and Mazars reports – update

The Interim Chief Executive and representatives from Southern Health NHS Foundation Trust presented a report providing an update on the progress made against actions recommended by Mazars and the Care Quality Commission (CQC) (see report, Item 9 in the Minute Book).

An overview of the history to these issues was provided by the Interim Chief Executive for the benefit of the new HASC Members, with the reasons for the Mazars report and subsequent CQC inspections provided.  The Trust had been subject to a significant amount of public scrutiny since this time, including through regulators, commissioners, the media and the HASC, but feedback has shown that the Trust were improving and were in a much more positive position than the one reported at the time of the Mazars publication.  The Trust were continuing to implement a number of recommendations and actions from regulators, as well as those from internally commissioner reports, such as how Southern Health involve service user families in the investigation of the death of their loved ones. 

The Trust had received a further CQC inspection in March 2017, following up previous reviews of adult mental health services, and additionally reviewing physical health services which hadn't been inspected since 2014.  There was still a lot of progress to be made, but it was felt that the latest inspection by the CQC would highlight that the direction of travel was a positive one.  From the draft report, the Trust were satisfied that the issues likely to be recommended for action by the CQC were those reported by the Trust at the beginning of the inspection.  It was hoped that the main headlines from the report would be that the culture within the Trust is different, with a more visible senior leadership, greater staff engagement, and positive feedback from service users.  It was expected that the report would be published within the next few weeks.

The Trust continued to meet with commissioners monthly to scrutinise in detail actions outstanding, in conjunction with NHS Improvement.  A strong group of families also continued to work closely with the Trust to aid its journey of improvement, with feedback from these being embedded into the quality improvement programme.

A new Chair had been recruited to the Trust, who had a wealth of experience in mental health, and had previously been a Director of Nursing.  Currently recruitment was ongoing for a permanent Chief Executive, as well as a number of Non-Executive Directors, with positions likely to be offered in July.  Further recruitment would take place to secure a permanent Medical Director and Director of HR to complete the Board.

In response to questions, Members heard:

·         That the 95% target for all deaths receiving an initial review within 48 hours was one set by the Trust, and was more ambitious than those for other providers.  This related to anyone in contact with Southern Health prior to their death, expected or unexpected, and was approximately 50 per month. 

·         Of the three months in the previous six where this target was missed, the review had usually taken place within a day of the target, with the underlying cause tending to be resilience during bank holidays (as these still formed part of the 48-hour window).  The Trust tracked the timescales for all initial reviews, and were able to understand when these were missed, how much they were missed by and what the cause of the delay was.  Historically, these review targets would be regularly missed, and missed by a long period of time

·         The implementation of the strategic direction of the Trust would be monitored by the Steering Group set up for this purpose.  Commissioners had signed up to the principles contained within it, and the next stage was to turn the strategy into an implementation plan, for agreement by the Board.  The Trust would need to give thought to how service users and staff would be engaged in this work, as well as ensuring clinical leadership had a strong voice in the plans.

·         Plans were in place to continue to work with ‘outstanding’ mental health trusts across England, learning from their quality improvement methodology, and how they staff mental health services to respond to crisis, especially overnight.

·         Public engagement and education were important factors in the improvement of the Trust, building confidence in those accessing services and sharing messages about how best to access care when it is needed.  Patient feedback was assisting with this, and the Trust was using usual communication methods to try and get the journey of improvement into the public domain.  The HASC continuing to actively monitor implementation of the CQC and Mazars actions was a part of this.

The Chairman highlighted that specific issues or concerns relating to a Member’s constituency should be raised through the scrutiny officer or with the Trust in the first instance, in order to protect confidentiality.

The Chairman thanked the Trust for their attendance and welcomed the continued positive direction of improvement.  In discussion, a plea was made to the Trust by one Member that when referring to services aimed at people with Learning Disabilities and those with Autism, that they not always be referred to together, as those with Autism might not have a Learning Disability, and vice versa, which the Trust took on board.

RESOLVED

That Members:

a.     Note the update from the Trust.

b.     Request the outcomes of the most recent Care Quality Commission report on the Trust, once available.

c.      Request a further consideration of progress made against the recommendations of the Care Quality Commission and Mazars report at the November 2017 meeting. That this include detail on work ongoing with partners, both to improve processes and to share information between providers.