Agenda item

11:10

Andrew Stevens, Director of Planning & Information, will discuss the findings of the recent Care Quality Commission (CQC) inspection. Mr Stevens will also discuss the Trust strategy, business plan and performance (JHO9).

Please find below the link to the CQC reports:

http://www.cqc.org.uk/provider/RTH

Andrew Stevens, Director of Planning & Information, Oxford University Hospitals NHS Trust (OUHT) attended the meeting to give an update on various topics of interest to the Committee (JHO9). These related to:

·         The Trust Strategy for 2014/15 to 2019/20

·         The Trust Business Plan for 2014/15 to 2015/16

·         The outcome of the recent CQC inspection

·         Trust performance against key national standards

·         Progress on the Trust’s Foundation Trust application

·         An update on the Cotswold Maternity Unit

·         An update on the Horton General Hospital

·         Other key developments

He introduced the report grouping topics under the headings of ‘Strategy and Priorities for Patients; Quality and Performance; Local Services for Local Patients; and Working with Others. He corrected the second sentence in paragraph 9.2, page 73 refers to state (correction in italics):

‘In order to help the local health and social care system manage the activity and financial pressures with which it is currently faced, the Trust has agreed contractual arrangements with OCCG that seek to manage risk across the system ‘in a much more equitable way’

A member of the Committee asked what action was being taken by the Trust with regard to meeting the admitted standard for orthopaedics and spinal surgery (5.11, page 68 refers). Mr Stevens responded that specialist orthopaedic surgery was a problem shared around the country due to sheer numbers coming through. The Trust was witnessing the centralisation of patients to specialist hospitals, of which the Trust was one, and it was therefore looking into the areas where patients were willing to consider other providers. Weekend operating was another option under consideration. With regard to spinal surgery, the Trust had taken action to restrict surgery to the catchment Oxfordshire and neighbouring counties. He commented on the need to conduct a national review of specialist commissioners with the aim of establishing referrals on a planned basis. A member asked why people would elect to go elsewhere for an orthopaedic operation when the resources offered at the Nuffield were of such high quality, Mr Stevens responded that it was a matter of giving patients a choice as they had a right to be treated within 18 weeks.

In response to a question concerning the problem in meeting the 31 day radiotherapy standard (5.14, page 68 refers), Mr Stevens assured the Committee of his confidence that the Trust would be again meeting the target very soon, adding their plans for a satellite service for local patients.

In response to questions, Mr Stevens reassured the Committee that the Trust were in the process of working up a business case on how equipment in theatres could be refreshed; and that there was no restriction on grounds of age for operations in Oxfordshire.

With regard to the length of time it can take for the issue of medicines on discharge, Mr Stevens explained that improvements had been made. Winter pressures monies had been used to make pharmacy staff available during out of hours and at weekends. From September prescriptions would be checked and automatically dispensed by a robot.

A member asked how the Trust planned to achieve the level of cost savings and still meet the required targets. Mr Stevens explained that each department had been sent a particular improvement target and a variety of trust-wide transformation projects were underway to drive down costs and support doctors in a much smarter way, for example, the implementation of electronic patient records and sending out advice, as appropriate, via email rather than admitting patients to hospital.

A member asked how theTrust was putting into place the thoughts and ideas which had been gleaned from the listening events that were part of the CQC process. Mr Stevens responded that the Trust had already started work on some of the key issues raised, for example, an internal peer review process had been devised and an environmental issue within the Accident & Emergency had been tackled. He added that the principle issue was on embedding good practice across the whole organisation, such as staff training in dementia and engagement with the public.

In response to questions regarding what measures were to be taken to improve an effective discharge process into GP care in a timely way. Mr Stevens commented that the Trust were still involved with discussions on the use of monies for the Better Care Fund and it was also working very closely with Oxford Health, GPs and Social Care on Delayed Transfers of Care and the development of a single,  integrated approach to community based support services. In addition, the Trust was looking at how an enhanced diagnostics, imaging and testing service could be provided outside of Accident & Emergency.

The Chairman thanked for his report and for his attendance and also congratulated the Trust on their ‘good’ CQC report.