Agenda item

Resolved: to note the update.

3.1      Belinda Regan (Deputy Director of Governance, Lewisham and Greenwich NHS Trust) introduced the report; the following key points were noted:

• In February 2014, Lewisham and Greenwich NHS trust was inspected by the Care Quality Commission.
• The newly formed trust welcomed the inspection and the subsequent CQC report.
• An improvement plan had been developed to monitor progress against issues identified in the report.
• The plan was split into four themes: patient flow; workforce; safety and organisational learning.
• 140 actions were being monitored on an on-going basis and were due to be completed by 2015.
• There were some outstanding actions in the areas of patient flow. Some of the improvements identified required the redesign of patient pathways in order to ensure safe and timely discharge of all patients.
• Some of the improvements required the re-design of models of care, which in some instances, required the recruitment of specialist staff, which would be subject to its own timescales.
• Work was taking place on the development of the five year strategic plan
• Additional beds were being created from previously under-utilised space
• It was recognised that further work needed to take place to ensure that fit patients were able to move out of hospital quickly.

3.2      Lynn Saunders (Director of Strategy, Business Development and Planning) provided a verbal update about winter pressures; the following key points were noted:

• As reported, there had been significant increases in the demand for A&E services across the region and nationally.
• The Trust had seen 600 more A&E attendances in December 2014 – compared to December 2013.
• There had also been 200 more admissions that month.
• Meeting the four hour A&E target had been a challenge.
• The Trust was putting in places services and facilities to increase capacity.
• The Trust had been on alert for a number of weeks – this ensured that there was a robust set up of clinical and systems management to deal with problems as they arose.
• Crisis management teams met three times a day to review all of the Trust’s patients.
• Work was also taking place with adult social care services and the CCG to ensure that there was sufficient step-down capacity for patients who were ready to leave hospital.
• Some new capacity had been opened at QEH – which had already delivered 36 extra beds.
• The Trust had also received some winter funding to help relive pressures; this had been used to facilitate additional weekend working by clinical staff and patient transport.
• Additional measures were being tested to reduce pressure on frontline services.
• The NHS national support team had been invited to the Trust in November and December to review implementation of improvements and comment on winter resilience plans.
• Quality of care to patients was the foremost consideration in all discussions about changes.

3.3      Belinda Regan (Deputy Director of Governance) and Lynn Saunders (Director of Strategy, Business Development and Planning) responded to questions from the Committee; the following key points were noted:

• Future reports would include additional information about the successful work being undertaken at the Trust as well as highlighting the improvements required.
• The Trust worked well with its PFI (Private Finance Initiative) partners and the PFI was supportive of the Trust’s goals.
• The CQC inspection had highlighted a specific problem with waste management, which had been dealt with promptly.
• The report also underlined the importance of hand sanitising and of ‘bare below the elbow’ working.
• Observational audits were carried out in the Trust and managers at all levels were regularly challenged to ensure the Trust’s procedures were being followed.
• Regular challenge of internal audits took place as well as independent inspections of services to support the Trust’s improvement plans.
• The Trust was still working towards foundation status. The focus of work was on the development of the Trust’s five year strategy.

Resolved: to note the update.