Agenda item

Resolved: The committee noted the quality account.

Amanda Pithouse (Deputy Director of Nursing, SLaM) and colleagues introduced the report. The following key points were noted:

4.1 The South London and Maudsley NHS Foundation Trust (SLaM) draft Quality Account for 2016/17 sets out the Trust’s performance against the quality priorities and national priorities set last year, as well as setting out new priority areas for the coming year. It is part of SLaM’s five-year 2014-19 Quality Strategy, which comprises more than 100 quality-improvement projects.

4.2  The quality priorities for 2016/17 covered patient safety, clinical effectiveness and patient experience. The Trust set nine priorities, achieved four and has seen improvement in all areas except staffing. Given the staffing pressures, SLaM is currently working with local partners (Oxleas and St George’s NHS Foundation Trusts) to consider new workforce models.

4.3 Overall, the number of restraints in the Trust has decreased by 20%. The number of prone restraints, however, has increased by 9% – the Trust had aimed for a reduction of 20%. This could be the result of better reporting by staff.  The Trust is aiming for a 50% reduction in prone restraint in 2017/18.

4.4 Overall, 91% of patients received a full risk assessment – exceeding the target of 85%. This could be the result of an improved electronic system at the Trust. The Care Quality Commission (CQC) said in its recent report that it had also noticed improvements in this area.

4.5 The Trust achieved its target for people feeling involved in their care, with 90% of patients saying that they do. The Trust is however carrying out further work to speak to patients and understand what it means to them to be involved in their care.

4.6 The Trust partially achieved its target for physical healthcare screening of patients, with 93% of inpatient, 77% of early intervention services users and 68% of community service users assessed. The target for inpatient and early intervention was 90%, the target for community users was 50%.

4.7 43% of identified carers were offered a carers assessment and a carers care plan. The Trust did not achieve its target of 50%. In response to feedback from carers, the Trust has developed a new assessment tool which looks at more than just the financial aspects.

4.8 The Trust has set 12 priorities for 2017-18. This includes a new strand on staff experience, which includes priorities relating to staff wellbeing, stress and whether staff would recommend the Trust as a place to work.

4.9  The southeast London Sustainability and Transformation Plan (STP) should help the Trust improve further in some quality areas, for example, providing care closer to people’s homes.

4.10 The impact of Brexit on nursing staff is unclear at the moment. The Trust has significant challenges in this area already. This is why it is collaborating with local partners (Oxleas and St Georges NHS Foundation Trusts) to try to reduce Trusts competing for staff.

4.11 Providing care close to home is about providing more person-centred care in the community. It involves community teams looking at what a person needs and whether they can be treated intensively at home. It’s also about trying to shorten the length of stay when an admission to hospital has been necessary. It includes having crisis care plans in place and identifying triggers of poor health and intervening early on, at home or with a short stay in hospital.

4.12 One of the Trust’s new quality priorities is to reduce work-related stress. The Trust is looking to achieve this by better job planning and improving appraisal standards – making sure that people’s jobs are doable and that they feel valued. Support for line managers and staff will also be improved, enabling managers to better support staff and prevent stress-related illnesses developing.

4.13 The mortality rates among people with mental ill health are higher than average. People with mental ill health are more likely to be overweight, smoke and have poor access to services. Improved physical health screening can help with this. This is why the Trust is working with patients early on to make sure people register with a GP and get into the habit of having regular checks and seeking medical help.

4.14 SLaM’s IT systems were not affected by the recent NHS malware attacks.

4.15 SLaM, in partnership with Oxleas and South West London and St George’s, has developed new Assistant Practitioner roles to work in inpatient care areas. Assistant Practitioners will receive training at London Southbank University and work towards a Foundation degree via day release for 18 months. The new roles will be able to take some tasks away from registered nurses. It is anticipated that the delegation of appropriate tasks will release time for more therapeutic engagement time with patients.

4.16 The target to reduce the average length of stay from 45 days to 40 days and then to 30 days is not as drastic as it sounds. It is about focusing on those who tend to have very long stays (100s of days). It’s an ambitious but doable target. And by freeing up more beds the Trust can also relieve some pressure on community and primary care. 

Resolved: The committee noted the quality account.