Agenda item

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

• paediatric congenital cardiac surgery;
• proposed relocation of inpatient vascular services;
• emergency care;
• nursing workforce;
• Care Quality Commission (CQC) inspection;
• Financial position 2014/15.

A copy of the report marked ‘Agenda item 11’ is filed with these minutes. 

 

The Chairman welcomed Kate Shields, Director of Strategy at University Hospitals of Leicester NHS Trust to the meeting for this item. 

 

Arising from discussion the following points were raised:-

 

(i)        Paediatric congenital cardiac services would be relocated to Leicester Royal Infirmary (LRI) from Glenfield Hospital as there was a requirement for all children’s services to be located on the same site.  While the Committee welcomed UHL’s commitment to the retention of the service in Leicestershire concern was raised over the suitability of access at the LRI and lack of parking facilities.  The Committee was advised that UHL would like to develop a children’s hospital at the LRI site which they hoped would resolve any access issues.  In addition a multi-storey car park was due to be completed by the end of 2015.  This would be funded from UHL’s capital allocation and managed by the Trust.

 

(ii)       There was no intention to move adult congenital heart disease services or the Extra Corporeal Membrane Oxygenation (ECMO) facility for adults from the Glenfield Hospital.  It was felt that the separation of children and adult services would provide an opportunity to make each service viable in its own right and reduce interdependencies.

 

(iii)      The Committee supported the proposal to relocate inpatient vascular services from the LRI to the Glenfield Hospital and recognised the need for this to happen at pace.  The Committee particularly welcomed the proposed provision of a new hybrid theatre.

 

(iv)      The Committee was concerned to note that in July 2014 there had been a nine percent rise in emergency hospital admissions compared with the same period in 2013.  The Committee were advised that UHL were aware of where the increased emergency admissions had come from as weekly breakdowns of consultant activity were received and data regarding referrals from GP practices was available.  However, the reasons for this increase had not yet been identified.  It was further noted that there had been a rise in emergency hospital admissions nationally and this was not therefore specific to Leicestershire.  Schemes were in place to reduce the level of emergency admissions and UHL was working with its commissioners to identify interventions for the following financial year.

 

(v)       The Committee raised concerns regarding the number of nurses employed by UHL.  The Committee was assured that, where there were shortages, as far as possible bank nurses were used rather than agency nurses.  This enabled a level of stability in the workforce.  The Committee was also advised that UHL was actively recruiting nurses and had undertaken significant work to attract nurses from abroad who were deemed to be both caring and technically competent.  UHL had developed a mentoring programme to retain these nurses and support them with issues such as accommodation.  Further work had been undertaken to recruit nurses locally with over 400 nurses recruited since April 2013.  The need for UHL to support patients to be involved in their own care was also organised.

 

(vi)      Concern was expressed regarding the number of action plans relating to the improvement of care at UHL and whether they were all interrelated.  The Committee was advised that all action plans relating to quality of care were overseen by the same Board and the structures in place enabled UHL to have control over the issues.

 

(vii)    The Committee was concerned to note UHL’s planned deficit of £40million for the 2014/15 financial year.  The Committee was advised that maintaining three hospital sites represented a significant financial challenge, however UHL’s financial plan would allow for the Trust to break even by 2019/20.  The Trust’s financial plan had been confirmed and challenged by the Trust Development Authority which was content with UHL’s long term financial plans.

 

RESOLVED:

 

(a)  That the future service priorities for vascular services as aligned to the blueprint of Health and Social Care in Leicestershire, Leicester and Rutland 2014-19 be noted;

 

(b)  That this Committee is of the view that the proposals to relocate inpatient vascular services from the Leicester Royal Infirmary to the Glenfield Hospital site are significant and as such constitute a ‘substantial variation’ which would normally need to be the subject of formal consultation;

 

(c)     That this Committee, having considered the outline of the proposals set out in (a) above is of the view that such changes would, if fully implemented as described, improve patient experiences and outcomes and, in view of this, agrees that it would not be in the interest of the people of Leicestershire for it to insist upon formal consultation as this would divert resources away from the project team charged with the delivery of these necessary changes, therefore waives its right to be formally consulted on the condition that the UHL Trust undertakes to:-

 

             i)        provide the Committee with a detailed project plan for the relocation of  services;

            ii)        provide regular updates on the progress of works and any variations to the plans; and

           iii)        to meet with the Committee or its representatives if there are any concerns  raised by members of the Committee about the implementation of the proposals;

           iv)        submit a copy of its engagement plan to the next meeting of the Committee for information.

 

(d)     That this Committee notes that the proposal to create a dedicated outpatient/daycase hub, incorporating vascular outpatient services, will be subject to public consultation as part of the future configuration of health services in Leicestershire;

 

(e)   That the updates on the following areas be noted:-

                     i)        paediatric congenital cardiac surgery;

                    ii)        emergency care;

                   iii)        nursing workforce;

                   iv)        care quality commission action plan;

                    v)        financial position.