Hertfordshire Health Scrutiny Committee

13 December 2018

Care Quality Commission

Progress Report

Our ratings

Results for our hospitals

Ratings for the Lister

Ratings for the New QEII

Ratings for Mount Vernon

Hertford and Community

Services unchanged

Actions taken by the CQC

Improvement notices issued for

• Surgery at the Lister

• Urgent Care at the New QEII

Requirement notices around

• Infection prevention and control

• Safe care and treatment

• Good governance staffing

• Fit and proper persons employed

Outstanding practice

• Emergency department alerts system

• Emergency department streaming system

• Band 6 nurses and early sepsis treatment

• RAID team

• Twins and multiple births association rating

• Research at MVCC

• Pharmacist chemotherapy service

New ‘Use of Resources’

report ~ Requires improvement

Work to do around

• Lorenzo

• Performance

• Consultancy

• Medical staff costs

• Collaboration

• Non-pay costs

• Staffing

• Financial delivery of plans

CQC – the issues

• Effective oversight and learning from incidents

• Surgery and QE2 Urgent and Emergency care

• Quality Governance

• Local management of risks

• Medicines management

• MVCC

Safe Effective Caring Responsive Well-led Overall

Surgery InadequateRequires

improvementGood Inadequate Inadequate Inadequate

New QEII

urgent careInadequate

Requires

improvementGood Good Inadequate Inadequate

CQC – the progress

• CQC working group with clear action plan reviewed monthly

• Reviewed and addressed Divisional Quality Governance arrangements

• Strengthened leadership at QE2 (nursing and clinical leads) and reviewed assessments in line with Lister practice, part of Daily site meetings

• New leadership in Surgery and implemented check list of key issues for ward rounds

• Progress tested via Internal/ external inspections

• MVCC – MSH patients relocated to ward area, positive visit by HealthWatch Hillingdon

• Quality Transformation Program

Our Quality Transformation

Programme

Quality Strategy 2019 - 2022

valuing the basics

• Where is the Trust in terms of quality?

• What are the key areas of focus for the coming year?

• Harm free care

• Infection prevention and

control

• Medicines safety and

management

Keeping our patients safe• Where is the Trust in terms of quality?

• What are the key areas of focus for the coming year?

• HSMR/SHMI – consistently reducing year

on year

• Deteriorating patient, sepsis

• Safer surgery collaborative

• Maternity and neonatal safety & Better

Births

• Discharge summaries and GP hotline

responsiveness

• Clinical Harm Process

Quality Governance & risk –

the progress

• Review TOR of Quality and Safety Committee

• Reviewed Quality Governance structure beneath

Q&S Committee - patient experience, clinical

effectiveness & patient safety

• Reviewed the structures for corporate and clinical

governance teams - significant investment

approved to deliver new structures

• New and refreshed Quality and Safety Dashboard

from ward to board

• Improved reporting culture

• Development of integral learning system and QI

framework

Patient experience

• More patients than ever would recommend our services

• Nationally recognised for the work we do to support Carers

• Improving picture in national patient experience, ED and maternity survey results

• Poor cancer patient experience survey

• Increase number of formal complaints

• Turnover in complaints team

• Integral to trust wide learning for continuous service improvement

Next steps

• Quality Assurance Visits – continue to test and challenge

• New Trust clinical strategy underpinned by culture work

to be approved by the Board in January

• Development of Quality and Safety Dashboard and IPR

• Development of a quality strategy – 2019-2022

• Continue to expand on development of safety culture

and staff engagement

• Thank You

•Questions