Agenda item

A.  To receive a report containing performance figures on a suite of indicators based on the Kent Health and Wellbeing Strategy

B.  To receive an update on progress in producing a quality report that fulfils the requirements set out in the Francis report and an overview of quality issues in Kent

A – Assurance Framework

(1)       Malti Varshney (Consultant in Public Health) introduced the report which provided performance information on a suite of indicators based on the Kent Health and Wellbeing Strategy and additional stress indicators.  She drew the board’s attention, in particular, to indicators relating to bed occupancy rate by Trust and by speciality and the percentage of A&E discharges, admittances or transfers within 4 hours by Trust.  She said the figures relating to A&E discharges for December, which had become available since publication of the report, showed an improvement. 

(2)       During discussion about demand for services over the Christmas period, it was reported that West Kent had been extremely busy with 30% more admissions than on a normal Sunday but the system had been able to absorb this increase because of the commitment of all partners.  It was also said that it was important to validate the perception that increased acuity was driving the increase in admissions.

(3)       With considerable effort East Kent had been able to maintain its performance at 89.3% and had followed this up with a “perfect week” exercise which confirmed that it had been the commitment of all partners that enabled performance to be maintained. A further “perfect week” exercise was planned for March to understand the capacity required, workforce issues across all partners and whether there might be a need for “sub-acute” capacity. 

(4)       The Darent Valley Hospital was the only Trust to achieve the targets set for quarter 1 and quarter 2 and the Integrated Discharge team had played a significant role in avoiding the need to move into major incident mode and in enabling the Trust to recover quickly from increased demand, particularly the 40% increase in the admission of elderly patients compared with the same period last year.  Ms Davies also said that Secamb had seen an increase of 40-50% in activity levels above projected levels which had resulted in issues covering some shifts.  For the first time ever IC24 and Meddoc had difficulty covering shifts and had been let down by agencies.

(5)       Work to improve performance at Medway NHS Foundation Trust was continuing.  Activity had reduced over the last couple of weeks and consequently performance had improved.

(6)       Social care services had seen an increase in activity too and, although the general response had been good, there were issues relating to workforce, particularly in domiciliary care, which may be related to the increase in acuity and the need for double handed care packages.

(7)       Resolved that:

(a)       The report be noted;

(b)       A robust analysis of trends be undertaken to understand what was driving demand with a report to a future meeting of the HWB.

B – Update on Quality

(8)       Steve Inett (Chief Executive – Healthwatch Kent) gave a presentation on the progress made to produce a quality report that fulfilled the requirements set out in the Francis report.  A copy of the presentation is available on-line as Appendix D to these minutes.

(9)       Resolved that:

(a)       The Quality Report highlighting the complex systemic issues that have the most impact on providing high quality services in Kent be noted;

(b)       Healthwatch Kent contacts representatives from commissioners, providers and working groups to gather feedback on the main issues of concern;

(c)        Healthwatch Kent presents a further report analysing the issues and identifying key trends.