Agenda item

Update on Current Issues

Minutes:

The Committee considered a report from the University Hospitals of Leicester NHS Trust (UHL) which provided an update on the proposed development of the Emergency Floor, UHL’s mortality rates, the forthcoming Care Quality Commission (CQC) hospital inspection programme and UHL’s financial position for 2013/14.  The Committee also received a presentation providing details of the proposed improvements to the Emergency Floor.  A copy of the report marked ‘Agenda Item 11’ and a copy of the slides forming the presentation is filed with these minutes.

 

The Chairman welcomed the following people to the meeting for this item:-

 

Dr Kevin Harris, Medical Director at UHL;

Andrew Seddon, Director of Finance and Business Services at UHL;

Nicky Topham, Project Director for Site Reconfiguration at UHL.

 

The Chairman also invited Dr Dave Briggs, Managing Director of East Leicestershire and Rutland CCG, to provide contextual details of the Better Care Together Programme which was aimed to make improvements across the local health and care system.  Dr Briggs explained that a single joint strategic five year plan for health and social care in Leicestershire, Leicester and Rutland would be co-produced for sign-off in April 2014.  This would be used to inform the individual operational plans of each organisation within the local health and care system.  Although the Better Care Together project had been in operation for some time, looking at such issues as the Emergency Floor, the speed of change had recently escalated and would need to be on a bigger scale than previously anticipated.

 

Written comments had been received from Healthwatch Leicestershire and a copy is filed with these minutes.  At the invitation of the Chairman, Geoff Smith OBE, Healthwatch representative, spoke in support of the new proposal for the Emergency Floor and requested that consideration be given to the Park and Ride schemes when considering access to the Leicester Royal Infirmary site.

 

Arising from discussion the following points were raised:-

 

Emergency Floor

 

(i)        While there is no longer a need under the new plan for the Emergency Floor to move outpatient services to the Leicester General Hospital, it remained the Trust’s long-term priority to move outpatient services away from the Leicester Royal Infirmary.  It was intended that the old A&E Department would be turned into an assessment area once the new one had been built.

 

(ii)       The NHS Trust Development Agency viewed the project as high priority.  Informal feedback on the scheme had been supportive.

 

(iii)      Concern was expressed that the new proposal would not improve access to the Leicester Royal Infirmary.  However, the Committee was assured that improved access for ambulances and car parking were included in the scheme.  A full site review of the car parking strategy would be carried out.

 

(iv)      It was noted that the Keogh Review had advocated a reduction in the number of Emergency Departments nationally.  It was felt that Leicester required a single Emergency Department in order to deliver the optimum outcomes for patients.  However, the current Emergency Department was too small and had been intended for treating 100,000 patients per year, not the 160,000 patients per year that were currently being treated there.  UHL was projecting an annual 3% growth in activity and it was intended that up to 200,000 patients could be treated in the new Emergency Department each year, thus making it sustainable for the future.  A new build would also mean a more flexible space.

 

(v)       Members suggested that Community Hospitals should be used more effectively, especially for patients requiring end of life care.  It was agreed that patients should not attend A&E if it was of little or no benefit to them.

 

Hospital Mortality Rates

 

(vi)      It was noted that there were very few hospitals with a similar configuration to UHL and it was therefore very difficult to benchmark levels of mortality against other Trusts.

 

CQC Wave 2 Acute Hospital Inspection Programme

 

(vii)     Concern was expressed that coding issues appeared to be a long term recurring theme for UHL.  The Committee expected that the CQC would seek reassurance in this area when they carried out the inspection.

 

Financial Position 2013/14

 

(viii)    The Committee was advised that, at the end of month 7, UHL was facing a financial deficit of £17.3m, or 3.8%.  However, it was on target to save just under £38m through its Cost Improvement Programme, just over £2m short of the total level of savings identified.  UHL was still in discussion with commissioners regarding its financial position at the end of the year.  Concern was expressed that achieving financial balance was a recurring problem for UHL.

 

(ix)      Concern was expressed that UHL had 500 vacant nursing posts.  It was noted that the number of vacancies had been substantially increased following an acuity review.  UHL was currently recruiting nurses in Portugal to fill the vacancies.  However, the Committee was of the view that UHL should seek to employ agency staff directly and, to that end, should be having discussions with local agency staff to understand why they preferred to be employed by an agency and how they could be encouraged to accept a permanent contract from UHL.

 

RESOLVED:

 

That the update on the proposed development of the Emergency Floor, UHL’s mortality rates, the forthcoming Care Quality Commission (CQC) hospital inspection programme and UHL’s financial position for 2013/14 be noted.

 

Supporting documents: