Agenda item

Members will receive an update on the two inspections undertaken by the CQC in March and October 2022.

Members considered a report that provided an update on the two inspections undertaken at York and Scarborough Teaching Hospital NHS Foundation Trust (the Trust) in March and October 2022 by the Care Quality Commission (CQC).

The Chief Executive and the Deputy Director of Quality Governance of the Trust provided an overview. They informed Members of the immediate safety actions that had been implemented to address the concerns raised from both inspections and the assurances that had been provided to the CQC, which included:

·        The implementation of a comprehensive action plan with delivery being overseen by a Quality and Regulatory Assurance Group.  

·        The implementation of a new electronic clinical record system Nucleus across all wards and the Emergency Department.  This would replace the paper record system and provide a greater oversight and assurance of the fundamental of care delivery.

·        Processes had been strengthened in relation to any closures of the maternity unit due to staffing pressures.

·        Checks and challenges had been implemented to address the environmental issues raised within the Emergency Department.

·        Two improvement plans in relation to Emergency Care at York Hospital and Maternity Services had been produced and shared with the CQC.

·        The Trust remained in the inspection phase pending the well-led review which was taking place between 22-24 November 2022.

During discussion and in answer to questions raised from Members, it was noted that:

·        The environmental issues flagged were also a consequence of the redevelopment of the Emergency Department.

·        The Trust regularly collaborated with City of York Council, North Yorkshire County Council and East Riding of Yorkshire Council.

·        The impacts of Covid and the intensive staffing pressures throughout the Trust had impacted the continuity of care.

·        Since 2019, over 400 international nurses had been recruited and a team was currently in Kerala, India to recruit 100 more nurses.

·        Positive steps were being taken to manage the delayed transfers of care, and the new Emergency Department should make significant improvements to services.

·        A Head of Patient Experience had been recruited to work with families and patients to monitor satisfaction levels.

·        Three Patient Safety Partners had been recruited to assess the governance processes.

Members noted the acute demand at the Trust had been consistently high for the past year, with staff shortages adding to the strain. They acknowledged that this increased pressure was unlikely to fall throughout the winter months and the Director of Public Health noted that the prevalence of all respiratory diseases was a significant concern this winter. She stated that the statistics showed thatnot enough residents across all ages were coming forward for their flu and/or Covid booster vaccinations. Encouraging more residents to take up the vaccines, including children aged 2 to 3 years and care workers would be focused on and officers agreed to provide Members with the latest statistics for York.

The complexities and pressures around delayed discharges were discussed and it was noted that collaboratively the Trust and City of York Council were working to ensure the right services were in place to reduce the number of patients staying in hospital unnecessarily.  

Resolved:

(i)           That the update and next steps be noted.

(ii)         That the positive findings highlighted during the CQC inspection be noted.

(iii)        That the areas assurance from the immediate safety actions implemented within the Trust following the identification of areas for improvement be noted.

(iv)        That an update be received at a future meeting.

Reason: To keep Members updated.

[An adjournment took place between 6:09pm and 6:14pm]