West Herts Hospitals Board Meeting November 2011
Introduction :
- No ward/dept. visits due to other meetings – will resume before next Board meeting.
- Costs have been reduced from 101% to 94% of the national average.
- Procedures which the trust has developed for dealing with ‘never events’ are highly regarded and are in demand from other hospital trusts e.g. Allenbrooks.
- Confirmed that there are no ‘hidden waiters’ i.e. people who have missed the 18 week target and for whom there is reduced incentive to process urgently.
- Application for Foundation Trust status is on schedule.
Chief Executive Report.
Good performance on Infection Control, most A&E indicators and the 18 week treatment targets. Less satisfactory on the A&E time to treatment and the 2 week and 62 day cancer targets. The former is improving and should be on target by the year end. The 62 day cancer target only involves a few patients and so a low percentage can be misleading unless individual circumstances are taken into account which usually is not possible.
Finance.
Surplus to Oct of £1.7M against a forecast of £1.4M. There continues to be an issue over the cost of agency (not ‘bank’) doctors who cost the trust significantly more than if they were on the payroll. This is due (if I understand the situation correctly) to these people setting themselves up as a limited company for tax purposes with the agency. There is also an issue over some consultants who are being paid for more than 10 sessions per week where the extra sessions can be administration or research. Concern was also expressed that there is no consultant cover overnight but there was also recognition that many worked long into the evenings beyond their contracted hours.
Infection Control.
MRSA – 1 in Sept giving a total to date of 1 against a trajectory for the year of 4.
C. Diff. – None during Sept. and Oct. Total to date is 7 against a trajectory of 33.
MSSA – 2 in Sept. and 5 in Oct. But all were community acquired.
Nursing Quality Indicators.
Continuing good trends on issues such as ‘slips, trips and falls’, ‘commode cleanliness’, ‘hospital acquired pressure ulcers’. A new indicator of ‘normal births’ shows a decline from 61% in June to 51% in Sept. The target is 60% and this is being investigated.
Complaints.
A new initiative is for a non-executive director to carry out a detailed review of the complaints received in a given month. For August there were 67 (65 in 2010) from 80,000 patient/visitor events. 40 were available for reading. (A further 6 were actually commendations for excellent service !!). The review concluded that the replies were comprehensive with an excellent level of detail (up to 9 pages), with personal apologies from named individuals.
Mortality.
This is getting complex with a third index being introduced by DoH which measures things differently e.g. making no allowance for palliative care and including deaths within 30 days of discharge. On the Dr. Foster index the current score is 87 (100 is the benchmark – below is good !). On the new index the score is 106.
Pathology.
A national initiative (the Carter Review) has recommended that Pathology services are centralised into hubs serving several hospitals. Great concern was expressed that the quality of service (especially for the infection control teams) will be seriously prejudiced since samples will travel up to Bedford. There will be redundancies and there is a serious staff morale problem.
