Agenda item

Louise Ashley, Chief Executive, Dartford and Gravesham NHS Trust and Helen Mencia, Deputy Director of Nursing and Quality, Dartford and Gravesham NHS Trust were in attendance for this item.

(1)      The Chair welcomed the guests to the Committee.  Ms Ashley informed the Committee that she was new to Kent and had started in the role of Chief Executive of the Trust over 4 weeks ago.  She said that the Trust had had a successful year, with a commitment to clinical quality. She provided an example of holistic care within the Trust. 

(2)      Ms Ashley referred to operational and clinical performance and that many standards were being achieved, emphasising the importance of these targets to patients.  She said that the 4-hour wait was averaging at 90%, but that the recently changed target of 95% had not been met.

(3)      Ms Ashley highlighted the Foundation Healthcare Group.  The Trust along with Guy’s and St Thomas’ NHS Foundation Trust were making the most of the partnership, with the alliance delivering good clinical outputs, developments for staff and improvements for patients in Kent.

(4)      Ms Mencia informed the Committee that in reference to infection prevention and control incidences, there was a very enthusiastic and effective Infection and Control Team supporting frontline staff through practice and training.

(5)      Ms Mencia highlighted to the Committee that the Trust was disappointed to receive the CQC overall rating of ‘requires improvement’.  She said that a lot of activity had been undertaken since the inspection and publication of the report, with a focus on quality, as well as working with CCGs and Healthwatch to support inspection and engagement visits.  Ms Mencia said that sharing good and bad practice at all levels was helping to enhance governance and provide support to staff. 

(6)      A Member highlighted some key workstreams including Private Finance Initiatives (PFI) coming to the end of contracts and penal issues for providers when the hospital is handed over at the end of the contract, emphasizing that the NHS should be receiving facilities that are as good as new; that revenue sharing of a reduction in corporation tax should be explored with key decision makers; and that the Trust should consider signing up to the Vanguard on Trusts paying business rates, should a leading group be established.  Ms Ashley endeavoured to follow up on the points raised.

(7)      Members enquired about the CQC overall rating, finances and performance.  Ms Ashley emphasised that in relation to the overall rating, discussions across the trust had taken the holistic view that people had just taken their eye off the ball but that she was encouraged by new personnel who were making a huge difference.   She continued that an interim meeting had taken place and the CQC were impressed with the developments.  Ms Ashley informed the Committee that in two years she aimed for the Trust to have a CQC overall rating of ‘outstanding’.

(8)      Ms Ashley said that there were daily tough decisions on patient safety experience versus money.  She highlighted that due to performance against A&E and financial targets not being met meant the loss of Provider Sustainability Fund funding, worsening an already large deficit.  She acknowledged that NHS Improvement had not placed the Trust in Special Measures as they awaited changes within the governance structure to be implemented. 

(9)      Members enquired about staffing, morale and ‘Freedom to Speak Up’ Guardians.   Ms Ashley informed the Committee that the vacancy rate was 12 to 13% but highlighted that there were two issues in relation to staffing – the vacancy rate and a staffing review.    The staffing review identified that in relation to nursing there had been understaffed wards in budget terms and as a result agency nurses were hired to maintain patient safety.  Ms Ashley said that work was now being undertaken to employ permanent staff.  Ms Ashley said that 250 European staff had been affected by the recent ‘settled status’ issue but that the Trust had agreed to fund these costs.  She said that the Trust is working with Health Education England to get the best for the area but that National and London issues were having an impact.  Ms Ashley emphasised that the ongoing problems with financial deficits meant that staff were warier to join but she was encouraged by a new doctor training scheme which would be innovative.

(10)   Ms Ashley said that ‘Freedom to Speak Up’ was incredibly important and the current Head of Midwifery was the ‘Freedom to Speak Up’ Guardian and had appointed eight others across the Trust.  She said there is a whole infrastructure in place to address bullying and harassment. 

(11)   RESOLVED that the report be noted, and Dartford and Gravesham NHS Trust be requested to provide an update at the appropriate time.