Agenda item

The Board received a report from Ms. Liz Craig, Director of Governance at North Cheshire NHS Trust, providing information about the Trust’s position at the end of 2006/07 in relation to the Health Care Commission Annual Health Check.

 

Attached to the report was the Annual Health Check Declaration 2006/07 including an overview of the self assessment process requested by the Health Care Commission and those standards to be included within this year’s assessment in order for the Health Care Commission to define its final rating for the Trust. The report focused on areas of partnership working across the health economy and those criteria identified as relevant to the Healthy Halton Policy and Performance Board so that the Board could comment on the Trust’s performance against the standards should it wish to do so.

 

Ms. Catherine Beardsall, Chief Executive of the Trust, attended the meeting to provide an overview of these standards and results together with Ms. Liz Craig - Director of Governance, Jane Downey - Head of Risk Management, and Anna Alexander - Deputy Director of Nursing

 

The Board considered the following issues:

 

·        the Trust was in a situation of financial turnaround to establish a system by which it could sustain services into the future - over the next 14 months, savings of £18m had to be achieved;

·        there was non-compliance with the MRSA and decontamination targets;

·        processes had been examined to maximise capacity as part of the financial recovery plan;

·        bad behaviour to staff was on a downward trend - the Trust had a pro-active security team and offered conflict resolution training to all front line staff;

·        the number waiting four hours or longer for beds had reduced, with only 20 patients waiting longer than the 4 hour period in February;

·        there had been publicity about consultants refusing to transfer to Halton. Ms Beardsall confirmed that consultants had been cautious about what work could be transferred; however, good progress had been made with 16% transferring successfully, demonstrating to those who were nervous that this could work. It was intended that the transfer be completed by June with 25% of activity taking place at Warrington and 75% at Halton: the number of beds at Warrington’s site would be reduced so the default had to be at Halton; and

·        the hours of opening would be the same.

 

In addition, the Board considered the non-compliance of the MRSA and decontamination targets in detail and noted the following:

 

Decontamination

 

·        the hospital did not comply with regulations coming into force this year with respect to decontamination as the hospital did not have a wall between clean and dirty instruments – this was not unusual and, had the licence not been up for renewal, the Trust would have met the standard until arrangements were in place to comply with the new regulations;

·        the licence was time limited and up for renewal intermittently – this was outside the Trust’s control;

·        following a national initiative, the Trust had been working with a Consortium to provide a new building off-site at Trafford Park – once this was ready, full compliance could be declared;

·        this had been a lengthy process due to the necessary steps that had had to be taken including setting up the Consortium, the tendering procedure and carrying out the building work.

 

MRSA

 

·        information was provided in respect of MRSA and how it was carried and contracted;

·        the Trust advised that it was working hard to reduce the figures in this respect but had been unsuccessful so far with 33 incidents to date this year;

·        9 of the 33 cases had been community acquired, which meant that the patients had come into hospital with MRSA – unfortunately, this still counted against the target;

·        all the action plan objectives had been achieved apart from one, which was to screen patients before they came into hospital - it was intended that elective surgery be targeted for this as it was a high-risk group: thought was also being given to checking those people who had vascular surgery;

·        screening was costly and the Trust was liaising with its colleagues in the PCTs to try and arrange for the Trust to do the screening side with the GPs carrying out the necessary treatment; however, this would not stop all of the cases and, even those hospitals that screened all patients still had incidents of MRSA;

·        a ‘root cause analysis’ was being carried out on every patient who contracted MRSA to see if the reason why they had contracted it could be pinpointed;

·        visitor guidelines were also in place;

·        a Patient Environmental Action Team Inspection had been carried out regarding cleanliness, which had classified Halton as ‘excellent’ and Warrington as ‘very good’;

·        the cleaners were the hospital’s own staff;

·        the same regimes were operated in both Warrington and Halton and all staff were trained by the same infection control team;

·        the Trust would be working closely with the Health and Safety Executive over the next twelve months in accordance with the Action Plan.

 

The Chairman thanked Ms. Beardsall and her colleagues for attending the meeting and invited them to return in the near future.

 

RESOLVED: That the contents of the report be noted.