Issue - items at meetings - Update on Unscheduled Care/ Emergency Dept at BSUH

(copy attached).

35.1    Mr Matthew Kershaw (Chief Executive, Brighton and Sussex University Hospitals NHS Trust), Ms Sherree Fagge (Chief Nurse, Brighton and Sussex University Hospitals NHS Trust) and Dr Mark Smith (Chief Officer Accident & Emergency) introduced the report regarding the Care Quality Commission’s (CQC) inspection of Urgent and Emergency Services at the Royal Sussex County Hospital which took place in June 2015. The CQC’s report was published in October 2015. They noted that this was a brief summary, prior to the more detailed session scheduled for January 2016.

            The committee heard about the main areas for improvement for the hospital to focus on, and the improvements that had already been implemented, recognising that there was still some way to go to address all of the issues that had been identified.

35.2    Councillor Marsh noted that new members of staff had been recruited with the skill set being widened, and asked if that had helped address the issues raised by the Care Quality Commission. Mr Kershaw said that there had been changes to staff, such as the appointment of Dr Smith, and that had brought fresh ideas to the department. There was also a scheduled change in the non executive director make-up.

35.3    Councillor Moonan noted that there were patients who were fit to be discharged from hospital but were unable to go home as the support they would need in the community was not available. Mr Kershaw said that that was a problem, and there were currently 40-50 patients within the trust who would be better placed elsewhere. He said that the Local Authority, Community Trust and Third Sector needed to continue to work together to address the problem.  

35.4    Councillor O’Quinn noted the pilot project within the elderly care ward, where patients were discharged and then assessed at home for their further care needs, and asked if further information were available. Mr Kershaw said that more detailed information could be provided at the January meeting

35.5    Councillor O’Quinn referred to the Care Quality Commission report and noted that there was ‘a continued deterioration of performance’ with the Emergency Department. Mr Kershaw said the report concerned 2014, and since then changes had been made and the work that Dr Smith had undertaken had made a difference. Dr Smith said that there had been an improved level of  clinical engagement with staff, and that had made a difference. Nevertheless, it was accepted that not enough progress had been made to date and it was hoped that the new arrangements would improve service in a speedier manner.

35.6    Councillor Allen referred to the Summary of Findings in the CQC report, and asked why the Board had been complacent in addressing the recommendations. Mr Kershaw said he didn’t fully agree with the Summary, and whilst he accepted that actions undertaken hadn’t fully addressed the challenges he did not feel that the Board had been complacent.

35.7    Councillor Allen noted that there was pressure to reduce the number of agency staff and asked how the hospital would ensure that there continued to be an adequate level of employees. Ms Fagge said that a number of strategies were being used; recruiting from overseas, focus on recruiting local staff and working with the universities to commission student nurse places.  She has one senior member of staff solely dedicated to workforce issues. Dr Smith added that the Royal Sussex was a National Trauma Centre, with a good reputation, so it was an attractive place to work and that assisted in staff recruitment and retention.

            The Healthwatch representative said that patient feedback had largely been very positive but there was still a gap around communication with patients and an anxiety about the CQC ‘inadequate’ rating. Mr Kershaw thanked Healthwatch for the comments and said that they tried to provide staff with positive feedback in a variety of ways including the recent staff awards.

35.8    Councillor Peltzer Dunn asked if the Care Quality Commission result had been a surprise. Mr Kershaw said that it had not been, as many of the concerns raised were already being addressed. He said that whilst he didn’t agree with all of the findings, he accepted that overall it was correct.

35.9    The Chair thanked everyone and reminded committee members that any further questions could be raised at the special meeting in January.

35.10  RESOLVED: That the Committee noted the report.