Agenda item

The Committee considered a report of University Hospitals of Leicester NHS Trust (UHL) which presented the 3 Year Quality Strategy and Priorities 2019-2022. A copy of the report, marked ‘Agenda Item 6’, is filed with the minutes.

The Committee welcomed John Adler, Chief Executive, UHL and Colin Moorhouse, Head of Quality Improvement, UHL to the meeting for this item.

Arising from discussions the following points were noted:

(i)        UHL would be rigorously monitoring the success of the 3 Year Quality Strategy and using data in new ways to analyse trends and variations in performance. UHL acknowledged that culture changes needed to take place within the organisation, and the leadership styles of UHL staff needed to be developed, to ensure that improvements in quality were sustained. The Quality Improvement team would measure the progress of the culture changes. Whilst lessons could be learned from private industry regarding quality improvement, it would not be practical for UHL to use the same model for improvement. It was expected that coaching of staff from the technical team at UHL would have a small impact on performance, however the significant improvements would come from staff on the wards being empowered to make changes under their own initiative. Some UHL staff would become ‘Improvement Agents’ to help facilitate the work on cultural leadership. There were currently 175 Improvement Agents within UHL and this number was increasing. However, care needed to be taken that quality monitoring did not prevent staff from focusing on patient care. The Improvement Agent work was intended to be a very small proportion of the Improvement Agent’s duties and line managers would be liaised with to ensure that staff were able to carry out the Improvement Agent role.

(ii)       In response to a question as to how the Quality Improvement philosophy would be introduced to bank staff and agency workers it was explained that there was a cap in place for how many agency staff could be employed at UHL and therefore the numbers of agency staff used was relatively low. Many of the bank shifts were staffed by permanent employees of UHL who wanted extra work therefore they would already be familiar with the cultural improvements which were taking place.

(iii)      The UHL reconfiguration plans, including the proposed sale of the General Hospital, formed only a small part of the Quality Strategy and the rest of the Strategy would be implemented regardless of how quickly the reconfiguration plans progressed.  With regards to reconfiguration, UHL were waiting to submit a bid for Government funding however the next bidding round had been delayed and the Government spending review would not now take place until 2020. Comprehensive Spending Reviews usually took place in the autumn but it was not known exactly when the next one would be. Discussions were taking place with the planning department at Leicester City Council regarding earmarking the General Hospital site for housing. Staff residences at the General Hospital were being closed down and it was intended that this part of the site would be marketed for sale in 2020 however progress could not be made on the overall site until there were developments from central government. The marketing strategy for the site had not yet been determined and a decision had not yet been made whether the General Hospital land would be on open sale or whether partners would be identified to make use of the land. Consideration was being given to whether the land could be used for social housing or keyworker housing. UHL were committed to ensuring that local communities would be engaged with regarding the sale.

(iv)      UHL was still relying on paper records for patients and the E-Hospital plans centred around the target for UHL to became paperless within three years and an aim to improve the interface with patients. A contract had been signed with a company called Nervecentre to provide the computer software. This was being funded from UHL’s own resources though UHL would also welcome any government funding for this project.

(v)       Environmental concerns around pollution and becoming carbon neutral were addressed in UHL’s Sustainability Strategy though it was acknowledged by UHL that the work they were doing in this area needed to have a higher profile. Andy Williams, the new Chief Executive for Leicester City, West Leicestershire and East Leicestershire and Rutland CCGs had expressed a wish to make environmental and sustainability issues a priority for the Health and Social Care economy and UHL intended to work with the CCGs on this. UHL would give consideration to pollution issues at Leicester Royal Infirmary and whether measures could be taken to make the site more environmentally friendly.

RESOLVED:

(a)      That the 3 year Quality Strategy and Priorities 2019-2022 be noted;

(b)      That the approach of University Hospitals of Leicester NHS Trust towards quality improvement be welcomed;

(c)       That the lack of certainty regarding the future timetable for the hospital reconfiguration plans be noted with concern.