EXECUTIVE SUMMARY. The purpose of this paper is to present the Chief Executive s Report for May 2014.

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1 Report to Trust Board Date Tuesday 27 May 2014 Agenda Number 1.7 Agenda Item Chief Executive s Report May 2014 Sponsor Dr Alison Diamond, Chief Executive Prepared by Juliet Cross, Trust Secretary Presented by Dr Alison Diamond, Chief Executive 1 Purpose and Key Issues EXECUTIVE SUMMARY The purpose of this paper is to present the Chief Executive s Report for May Supporting Information The report is attached. 3 Controls and Assurances The Chief Executive s Report highlights risks and opportunities to the business of the Trust and provides an update of local and national issues that may have an impact on the organisation. 4 Legal Implications The legal implications have been considered and none have been identified. 5 Equality and Diversity Implications The Trust aims to design and implement services, policies and measures that meet the diverse needs of our service, population and workforce, ensuring that none are placed at a disadvantage over others. No adverse or positive impacts have been identified from the Board s actions. 6 Patient, Public and Staff Involvement The Trust ensures that patients, the public and staff are involved in the decision-making process when appropriate. 7 Cost Implications There are no cost implications. 8 Potential Risk to the Organisation No risks identified. Trust Secretariat Page 1 of 6

2 9 Board Prompts Have members of the Board had an opportunity to raise questions or concerns with the Chief Executive? 10 Recommendations The Board is asked to RECEIVE the Chief Executive s Report. 11 References Tiverton & District Hospital inspection report January 2014, Care Quality Commission (March 2014) Hospital_INS _Responsive_-_Follow_Up_ pdf Tiverton & District Hospital inspection report 9 April 2014, Care Quality Commission (May 2014) Hospital_INS _Responsive_-_Follow_Up_ pdf Securing a health service fit for the future. NHS England (February 2014) 12 Strategic Objectives The Trust s Strategic Objectives were reviewed by the Board in February X Highest quality Flexible and multi-skilled workforce Sustainable services Efficient and effective Integrated health and social care X Local provider of choice 13 Principal Risks The Principal Risks have been identified through the Trust s risk management processes. They are updated as and when required. X Financial planning & management Clinical records management X Strategic & business planning X Leadership & management Workforce numbers Unsafe behaviour Workforce skills X External demands Procedural management X Partnership arrangements Equipment & facilities arrangements Communication Trust Secretariat Page 2 of 6

3 Chief Executive s Report May Care Quality Commission Inspection at Tiverton & District Hospital The Care Quality Commission made unannounced inspection at Tiverton & District Hospital on 30 and 31 January Following the inspection, the Care Quality Commission issued a Warning Notice on the inpatient services at the hospital as the Trust was found to be non-compliant with Regulation 18 Consent to care and treatment. This was based on a review of patient healthcare records and the failure to properly record end of life planning on the Treatment Escalation Plan form. The Treatment Escalation Plan form is completed by the patient s GP in a community hospital, or in an acute hospital by a doctor. For patients, their relatives and carers, the form shows how clinicians are working together to support and care for patients as they near the end of their life. The form moves with the patient along their pathway of care. An action plan was implemented to ensure compliance by the end of March The Care Quality Commission subsequently made an unannounced inspection on 9 April The final report has been received from the Care Quality Commission and it confirms the Trust is now meeting the standard. The final report has been published on the Care Quality Commission s website. 2. Care Quality Commission Chief Inspector to visit the Trust We have received notice that the Chief Inspector of Hospitals will be visiting the Trust between 1 st 4 th July This is a new style of inspection by the Care Quality Commission which involves using much bigger inspection teams led by the new Chief Inspector of Hospitals, Professor Sir Mike Richards, and includes a senior NHS clinician, professional and clinical staff, experts by experience, patients and carers. Whilst every Care Quality Commission inspection is daunting, we are looking forward to it as part of our journey to Foundation Trust. This inspection is the last milestone before our Foundation Trust application gets to the NHS Trust Development Authority and ultimately Monitor. This is a highly transparent process and we can expect the inspectors to have a very detailed understanding of our services before they arrive. This Inspection is an excellent opportunity for the Trust to open their doors to these teams and show the Care Quality Commission the care and treatment we provide to our patients as well as the high quality service we offer to the population of Devon. The team will inspect some core services, including: Accident and Emergency Medical Pathways including the Frail Elderly Surgery Critical Care Maternity Paediatrics/Children End of Life Care Outpatients As well as these core services, they will complete background research to identify any other areas that they feel should be inspected. We expect the Chief Inspector of Trust Secretariat Page 3 of 6

4 Hospitals to also visit community hospitals and the integrated health and social care teams. The Chief Inspector of Hospitals will also hold a series of public engagement events where those that have experienced our care are asked to provide feedback in a public arena. 3. Financially Challenged Health Economy In February 2014, eleven financially challenged health economies were identified, which included Devon. The eleven areas were chosen on the basis that they will most benefit from external support in the first few weeks of the new financial year. Monitor, NHS England and the NHS Trust Development Authority have agreed to fund a series of projects to help groups of commissioners and providers work together to develop integrated five-year plans that effectively address the particular local challenges they face. In Devon, PricewaterhouseCoopers has been appointed to act as a critical friend, seeking to bring together all partners in the Devon health economy and testing whether the organisations are undertaking their long term strategic planning in the most effective way. A programme of work was implemented in April 2014 which will last around 12 weeks. The Devon health economy has to submit plans by 30 June to state the service reconfigurations that are required to resolve the major local challenges. The plans will include: A sustainable set of high quality services for patients in each health economy; A financially sustainable future for both commissioners and providers; Recommended future service configurations; and How Devon is going to implement the proposals. The Trust is committed to working with our partners and neighbouring NHS organisations to secure future services in Devon. 4. Smartcare Electronic Health Record The Trust is in a procurement process with Yeovil District Hospital NHS Foundation Trust and Gloucestershire Hospitals NHS Trust for an Electronic Health Record. We re calling this project Smartcare because it will bring us real benefits to the way we deliver care. It will provide us with modern information systems for our teams of clinicians and support staff which in turn will benefit patient safety and care. Over 200 clinicians from the three organisations were involved in the procurement process and we now have a preferred supplier. The preferred supplier was identified following an evaluation process based on strict criteria which were weighted to allocate 70% to quality and usability of system and the remaining 30% to financial cost. The choice of supplier has been approved by the Health and Social Care Information Centre central procurement team and will be announced once all suppliers have been notified of the final decision. The next steps are for the Trust to submit a final business case to the UK Government Treasury to secure funding for the first four years of Smartcare. We expect this to be approved in late summer Trust Secretariat Page 4 of 6

5 5. Northern, Eastern & Western Devon Clinical Commissioning Community Services Strategy The Northern, Eastern & Western Devon Clinical Commissioning Group (NEW Devon CCG), the commissioners of healthcare services in Devon, published a strategy for Devon community services on Thursday 15 May. They plan to get views on this strategy over an eight week period, ending on 30 June The proposals in the strategy indicate a shift away from inpatient beds to more care being delivered in the community, with the wider community (e.g. GPs, voluntary groups) having a key role in future service delivery, and new arrangements for urgent care services. There is an acknowledgement that different arrangements may be needed in rural and urban areas. NEW Devon CCG asks for comments on: The vision for community services; The rationale for a change in community inpatient services; The redesign of urgent care services; and The proposed organisational form of the organisations responsible for providing these services. Following the Transforming Community Services initiative when we took on a range of community services, including community hospitals and Health & Social Care Teams, from the Eastern Devon area, we have always been clear that we wish to earn the right to continue providing these services on the basis of the quality of care we have all achieved and because we see the learning being shared across and between acute and community teams in terms of patient safety, testing service models, innovation and being able to describe and deliver joined up care. We are very keen to respond to the strategy s proposals and will form our operational and strategic response from the views of our front-line and clinical professionals. Staff have also been encouraged to respond as individuals. 6. Listening into Action Programme There is widespread recognition across the NHS of the absolute need to engage and empower all staff, particularly medics, clinicians and other health professionals, around the delivery of better outcomes for patients, for staff and for organisations. The Trust has signed up to be a National Pioneer on Staff Engagement and Empowerment through the widespread adoption of the Listening into Action Programme. The Programme is a proven structured approach for engaging with frontline staff and those who support them, so that they can influence, shape and provide the best possible services for our patients and service users. There will be an initial intensive 12 month journey in parallel with other NHS Trusts to provide a starting point from which to embed Listening into Action as the way we do things around here. The opportunity to participate in the Programme alongside other NHS Trusts will enable a high level of cross-learning and sharing of ideas. We are looking to nominate a Listening into Action Lead, who will be a senior individual, ideally with a clinical background. They will report to and work very closely with myself and will: Trust Secretariat Page 5 of 6

6 Commit to a new way of working in the Trust which brings staff on the journey in managing fundamental service change; Engage key staff in what really matters; Mobilise and empower staff to drive change; and Embed the Listening into Action approach. This is an exciting opportunity to fundamentally shift the way we work and lead, putting staff at the centre of change. Trust Secretariat Page 6 of 6