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Agenda item

Quality Accounts

12:00

 

Healthcare providers have a statutory duty to send their Quality Accounts to the local Health Scrutiny Committee for comment. Representatives from Oxford University Hospitals NHS Foundation Trust (OUH) and the Oxford Health Foundation Trust (OH) will present an overview of progress against their 2016/17 quality priorities and the emerging quality priorities for 2017/18. The reports are attached at JHO9.

 

A letter outlining the quality principles for South Central Ambulance Service in 2017/18 is also attached at JHO9 for comment; however, no representatives will be present to answer questions.

 

In light of the timing of this Committee meeting, full quality account reports are not available at the time of the Agenda publication.

 

The full reports will be circulated separately to Committee members in the coming weeks and further feedback from the Committee will be collated and sent to providers as HOSC’s formal comment on the Quality Accounts.

Minutes:

The Chairman welcomed Dr Tony Berendt, Medical Director, Clinical Governance & Risk Team, Oxford University Hospitals NHS Foundation Trust (OUH) and Dr Clare Dollery, Deputy Medical Director. She also welcomed Richard McDonald, Head of Operations – Oxfordshire, South Central Ambulance Service NHS Foundation Trust (SCAS) and Simon Holbrook, Head of Compliance.

 

Oxford University Hospitals NHS Foundation Trust – Quality report

 

Dr Berendt and Dr Dollery were invited to come up to the table to respond to questions and concerns regarding the covering report provided (JHO9). These included:

·         In response to a question about the selection of quality targets, and how they were prioritised for external audit, Dr Dollery stated that they were prioritised by a Council of Governors from a number of proposals provided. The Council selected on how much importance it had to the hospital in terms of disease or aspect of care;

·         In response to a request for more information regarding patients requirement for drugs in dosset boxes, Dr Dollery stated that, within a 2 week period, 98% were being discharged within 24 hours;

·         Dr Dollery confirmed that RAG traffic light rating (red, orange, green) could be utilised, but it was felt that this was a little too impersonal;

·         In relation to the Delayed Transfers of Care (DTOC) issue, Dr Berendt stated that the targets were achieved in accordance with what the Trust set out to do. However, there had been a great deal of volatility since then. There were a multi-factional set of inputs which had driven the final figures for domiciliary/hospital bed care. Where there was a deterioration in the programme, this was linked to availability of domiciliary care;

·         The Trust was still in the process of recruiting of the 140 reablement workers;

·         In relation to a question about how the Trust managed reductions in incidents of medical harm, Dr Berendt responded that this was via investigation. The general approach was to understand that people were human, then to minimise the impact of error, then to change systems and finally to re-train people, if necessary. Moreover, they had a professional and legal duty of candour to explain what had gone wrong. The vast majority of incidents were without harm but people were asked to report all incidents, including near misses. Thus all could learn from the event and aim to get as close to zero as possible, or at least a reduction;

·         A member asked if there were opportunities to look at some of the wider issues such as staffing and recruitment; and was there a roll-over of issues from 1 year to the next, thus having the effect of threading through the blockages to achieve the targets. Dr Berendt responded that sometimes it took time to measure achievement of quality and improvement. If an issue, such as staffing, turned out to be a major impediment, then the Team would have to work out what action should be taken;

·         In response to a question about availability of bereavement training at the Horton Hospital, Dr Berendt confirmed that all staff had access to a computer to undertake e - learning and the problem had been that it had taken longer than originally thought to get the design together.

 

Dr Berendt undertook to report back to the Committee in writing when a quality target had been achieved or partially achieved, stating his assurance that the Board were cited on this aspect and nothing was overlooked.

 

Dr Berendt and Dr Dollery were thanked for their attendance.

 

South Central Ambulance Service -  Quality Report

 

Richard McDonald and Simon Holbrook attended for this item.

 

In response to a question about whether the Trust had been consulted as part of the Sustainability & Transformation Plan (STP) Plan, Simon Holbrook replied that the Trust was one of the health care providers who formed part of the STP. Currently the Trust was waiting to find out how it would be involved in the Plans. He added that the STP would have an impact on the Ambulance Service as any changes would translate into a reconfiguration of service.

 

Richard McDonald was asked if some journeys to the John Radcliffe Hospital (JR) were beyond inclusion in the performance indicators, due to matters such as heavy traffic, which were beyond control. Mr Mcdonald stated that all statistics were provided to the JR and published on the NHS England website, with a view to any of concern being a focus for improvement. A member asked why it was not a priority to work with the JR on travel times. Mr McDonald responded that the Service did sign up to safety pledges and was working in collaboration with other healthcare providers. It was not, however, currently a priority to address travel times.

 

The Committee thanked Mr McDonald and Mr Holbrook for attending and AGREED to request the Ambulance Trust to:

 

(a)  inform the Committee in writing where improvements had been significant; and

(b)  that priority should be given to the Trust should work with the JR to improve travel times from the Horton and Chipping Norton Hospitals to the JR.

 

In conclusion, the Committee AGREED that members’ comments on the Quality Accounts would be collated and sent to providers as this Committee’s formal comment on the Accounts.

Supporting documents: