Agenda item

Tracey Fletcher, Chief Executive, Angela van der Lem, Chief Finance Officer, and Sarah Hayes, Chief Nursing and Midwifery Officer, from EKHUFT were in attendance for this item.

1.    Ms van der Lem introduced the report and provided a brief overview, including:

a.      At the end of 2023-24, the Trust had a deficit of £117,4m. For 2024-25, the Trust were working towards a deficit of £85,8m which it was expecting to meet.

b.      The Chief Nurse had conducted a review of safer staffing during 2024. The review led to the recruitment of permanent staff thus reducing reliance on temporary workers which was expensive.

c.      The Trust’s improvement plans for 2025/26 focussed on medical agency spending and length of stay in hospitals.

2.    In response to comments and questions it was said:

a.    The Trust were reliant on a number of temporary medical staff due to challenges in recruiting to some specific specialties. Ms van der Lem explained improvements would not come from just recruiting permanent staff to those posts, but understanding how to deliver services in the most productive way possible. Positive steps had been made, such as the increase from 3 to 10 substantive Emergency Department consultants since the start of the year.

b.    The Trust tended to use bank staff as opposed to agency staff. Reasons cited for working for an agency instead of being directly employed included pay and flexibility. Quality of service could be impacted as agency staff only carried out a few shifts but needed to be trained in Trust specific practice.

c.    With recruiting nurses to substantive posts, the largest proportion of vacancies were held in the Emergency Department and Acute Admissions. 80% of positions recruited to over winter had been filled. In addition, 90% of student nurses had chosen East Kent as their new employer. The overall turnover and vacancy rate at the Trust was low.

d.    Retention was important, and this was aided by the support package on offer.

e.    Length of stay for patients was prolonged by the shortage of social care support. Whilst the Trust played a role in reducing this, collaborative work across partners was required (and already happening). The readmittance rate was tracked by the Trust and it was relatively low. Cases were looked at to consider if lessons could be learnt.

f.     To assist in reducing length of stay, the Trust wanted to build a virtual hospital model, expanding from the current virtual wards in specific departments which had been successful. A Hospital at Home service was also in use.

g.    The Chair requested statistics on the number of hate crimes committed against hospital staff and narrative on whether this was having impact on retention. Ms Hayes said work was underway in this area, though incidence were low. They offered to bring this information back.

h.    The percentage of the Trust’s deficit in relation to the total budget was around 9%. Acknowledging she was new in post, Ms van der Lem agreed she would be looking at comparative data as well as relevant research on coastal areas.

i.      It was important to utilise more effectively Urgent Treatment Centres to reduce the demand in Emergency Departments. The Trust were looking at best practice models to inform improvements.

j.      Any overspend in acute trusts would impact the Kent and Medway Integrated Care System though not directly the primary care budget.

k.    The Trust had reduced their waiting lists, particularly for endoscopy. The national target was for patients to wait less than 6 weeks for a diagnostic test, but urgent referrals were targeted at 28 days.

l.      The report noted 2,300 patients were waiting 65 weeks or over for their treatment (including operations) to be completed. Ms Fletcher update the Committee that the figure had reduced to around 160. Dr Rickard from the Local Medical Committee commented that this had an impact on primary care as patients often contacted their GP for an update. Ms Fletcher recognised the reliance of primary and secondary care on each other.

m.  The constraints of the capital budget, reflected in the ageing estate and ongoing high maintenance costs, was discussed.

RESOLVED that the Committee considered and noted the report.