Agenda item

The Committee considered a report from the University Hospitals of Leicester NHS Trust (UHL) which provided an update on the following issues:-

·         Never Events 2009-2014;

·         Hospital-acquired pressure ulcers;

·         Nursing and medical staff and the use of agency staff;

·         Cancelled operations;

·         Emergency Department performance;

·         Financial position;

·         Care Quality Commission (CQC) inspection.

A copy of the report marked ‘Agenda Item 12’ is filed with these minutes.

 

The Chairman welcomed Richard Mitchell, Director of Operations and Rachel Overfield, Chief Nurse to the meeting for this item.

 

The Committee noted the comments of Healthwatch, a copy of which is filed with these minutes. 

 

Arising from discussion the following points were raised:-

 

Never Events

 

(i)      The recording of Never Events reflected an increasing recognition of human error.   A tool was used which enabled UHL to identify if an error was procedural, systemic or human error.  If it was the latter, a decision could also be taken to identify if it was a competency issue, intentional or caused by distraction.  Appropriate action could then be taken.

 

(ii)     The number of Never Events occurring at UHL was similar to, if not less than, other Trusts of a comparable size and complexity.  UHL had put checklists in place to prevent Never Events and compliance with their use had increased dramatically, although it was acknowledged that further improvements could be made.

 

Staffing Issues

 

(iii)    The Committee was pleased to note that UHL successfully recruited the majority of nurses who were trained in Leicestershire and that staff turnover and sickness levels were low.  UHL struggled to recruit nurses from other parts of the UK, hence the recent, successful, recruitment drive in Spain, Portugal and Ireland.  Overseas nurses were welcomed by UHL because of the challenge they bought to traditional systems and processes.

 

(iv)    It was likely to take a further 12 months before a sufficient number of nurses had been recruited by UHL.  In the meantime, agency and bank staff would continue to be employed to ensure that staffing was at a safe level.  UHL were considering ways to reduce the cost of agency staff.  It was noted that some nurses chose to be employed by agencies as it suited their lifestyle.

 

(v)     UHL offered an attractive recruitment packages to nurses, for example enabling them to gain experience in a research or education setting as well as in a clinical setting.  All NHS Trusts were recruiting nurses and it was felt that UHL’s package of support to staff would help with retention. 

 

(vi)    The safety of services was a priority which meant that existing staff might have to move wards to fill gaps.  However, where possible, UHL would seek to ensure that staff were not moved out of their speciality and would not have to move if they did not wish to.  Systems of support for existing staff were in place, such as being able to talk to the Chief Nurse and the Listening to Action staff engagement programme.

 

Financial Position

 

(vii)   There was an increasing level of confidence that the financial deficit would not increase before the end of the financial year.  UHL would be required to pay back the loan from the Trust Development Authority although the terms of repayment had not yet been agreed.  UHL would be required to break even within three years.

 

(viii)  UHL was identifying themes such as theatres and outpatients which would enable clinical teams to identify where savings could be made.  Leicester, Leicestershire and Rutland had been identified nationally as a ‘challenged’ health economy which meant that external consultants would work with key stakeholders to identify ways of making health services sustainable.

 

CQC Inspection

 

(ix)    It was noted that UHL had received the draft report from the CQC the previous day and had a week to comment on factual accuracy.  A quality summit would be held on 26^th March and it was expected that the report would be published on 27^th March.

 

RESOLVED:

 

(a)       That the Never Events that have taken place at UHL, the root causes and the organisational actions which have been implemented be noted;

 

(b)       That the actions being taken by UHL in the prevention and management of avoidable pressure ulcers be noted;

 

(c)       That the monitoring arrangements for the use of agency staff and the recruitment plans in place to reduce spend be noted;

 

(d)       That the current position with regard to cancelled operations be noted;

 

(e)       That the financial position of UHL be noted;

 

(f)        That the current status of the CQC inspection report be noted.