Agenda item

Liz Shutler (Director of Strategic Development & Capital Planning & Deputy Chief Executive, EKHUFT), Lesley White (Divisional Director, East Kent Hospitals University NHS Foundation Trust), Simon Perks (Accountable Officer, NHS Ashford & NHS Canterbury and Coastal CCGs) and Hazel Smith (Accountable Officer, NHS South Kent CCG and NHS Thanet CCG) were in attendance for this item.

(1)       The Chair welcomed the guests to the Committee.

(2)       Members enquired about the appointment of a permanent Chief Executive and Chair and the Trust’s Financial Recovery Plan. Ms Shutler explained that Susan Acott and Dr Peter Carter OBE had joined the Trust as interim Chief Executive and Chair of the Trust. It was anticipated that interviews for a permanent Chair would take place in January with interviews for a permanent Chief Executive taking place as early as February. Ms Shutler noted that the Trust had a deficit target of £19m by the end of the financial year. She reported that the Trust was making good progress and had already delivered on over £30m of cost improvement savings. She noted that given the size of the organisation, the Trust's deficit was relatively low in comparison to other Trusts across the system. In response to a comment about saving targets resulting in service cuts, Ms White explained that savings related to efficiencies. She gave an example of the savings made within the Urgent Care and Long Term Conditions division; due to the successful recruitment of permanent middle grade staff in A&E, the division had made significant savings against agency spend. Ms Shutler noted that it was not efficient for the Trust to provide services on all sites; it was important for specialist services and teams to be co-located together.

(3)       Members asked about the pay award and staff recruitment particularly consultant recruitment at Queen Elizabeth The Queen Mother (QEQM) Hospital. Ms White explained that the pay award was a national issue. She noted the Trust was looking at new roles, particularly for Band 4 nurses and more senior nursing roles, to enable staff as part of their career development to move into specialist roles. She reported that the Trust was working to recruit medical staff both in the UK and abroad. Vacancies were being advertised in the BMJ and the Trust was looking to attract staff by offering clinical specialisms; flexible working; shared posts in the community; and potential research posts with universities.  Ms Shutler noted that the Trust had advertised 74 consultant posts and recruited 55 staff including 22 staff that had joined since June; however the Trust continued to have gaps in medicine and geriatric roles. Ms White stated the Trust had recruited two new consultants to the QEQM Hospital since June; a Respiratory Consultant who had subsequently left and a Geriatrician. She reported that the Trust was continuing to actively recruit to posts across all three sites.

(4)       A number of comments were made about sickness absence, the flu vaccine and appraisals. Ms Shutler acknowledged that the sickness absence was above the Trust’s 4% target and committed to providing the Committee with a briefing about sickness absence. She stated that the Trust had worked hard to encourage and increase the number of staff choosing to have the flu vaccine; for every staff flu vaccination, the Trust was donating a flu vaccine to Africa. The Trust’s target was for 70% of staff to have the flu vaccine; 58% of staff had had the vaccine which was the highest percentage ever achieved by the Trust. Ms Shutler noted the importance of appraisals and the Trust was working to improve the staff appraisal rate; the national staffing survey had identified a high staff appraisal rate by the Trust.

(5)       A Member enquired about the declaration of a Code Black at the QEQM Hospital. She explained that a Code Black at QEQM Hospital had not been declared to external partners. Due to a high level of activity at both the William Harvey Hospital and QEQM Hospital, the Trust had internally declared Code Black the previous night and had implemented additional activities to support A&E and emergency medical admissions which had included increased consultant activity, ward rounds, nursing and management support. It was anticipated that the sites would be downgraded to Code Red by lunchtime. Ms Shutler noted that codes were reviewed and changed throughout the day depending on activity levels. She reported that the actions in the emergency care improvement plan were beginning to make a difference; in the last week the Trust compliance rate for the A&E 4 hour target had improved to 80% in comparison to 70% in September.

(6)       In response to a specific question about the establishment of a medical school, Ms Smith explained that there was a national process for creating new medical schools; a key element in the national criteria for the creation of a new medical school was being able to evidence a deficit in local GP workforce.   She stated that a bid for a medical school in Kent & Medway had been submitted and an announcement by Higher Education Funding Council for England (HEFCE) and Health Education England (HEE) was expected in March 2018; if the bid was successful, the medical school would open in the 2020/21 academic year.  The bid was supported by the University of Kent and Canterbury Christ Church University; in addition to every NHS organisation, local authority and Member of Parliament in Kent & Medway. She noted that the bid focused on primary care and psychiatry and had partnered with an existing medical school, Brighton University, to ensure General Medical Council agreement to the proposed curriculum. Ms Shutler added that the Trust, along with the other Kent & Medway acute trusts, were supportive of the bid and noted that the medical school would be for the whole of Kent and Medway.

(7)       The Chair invited Steve Inett, Chief Executive, Healthwatch Kent to comment. Mr Inett stated that he wanted to assure the Committee that Healthwatch undertook regular visits to the Trust’s sites to gather patient experience and shared these experiences with the Chief Nurse as part of its regular meetings with the Trust. Healthwatch had been invited to attend an oversight group which had overseen the move of junior doctors from the Kent & Canterbury Hospital site and had been involved in the drafting of letters and press releases to patients about those changes.

(8)       The Chair stated that whilst the early indications of improved A&E performance were welcome, it was important that the improvements were sustainable. She recommended that regular written updates on A&E performance should be provided to the Committee to enable them to monitor performance.

(9)       RESOLVED that:

(a)       the reports  be noted;

(b         East Kent Hospitals NHS University Foundation Trust be requested to provide an verbal update at the appropriate time;

(c)        the Committee receives regular written updates on A&E performance at the Trust.

Cllr Lyons, in accordance with his Other Significant Interest as a Governor of East Kent Hospitals University NHS Foundation Trust, withdrew from the meeting for this item and took no part in the discussion or decision.