Presentation to the Care Quality Commission. Dr. Lucy Moore, CEO 15 September 2015

Transcription

1 Presentation to the Care Quality Commission Dr. Lucy Moore, CEO 15 September 2015

2 Our Improvement Journey- Key Messages We have Board, Executive and Divisional leadership teams now in place with serious leadership capability and talent to deliver. We understand that there is a depth and breadth to our challenges and we are delivering improvements with increasing pace and grip. The Trust is a very different organisation now; there is still however a significant culture shift required. 2

3 Our Improvement Journey- Context Prolonged scrutiny (2 ½ years) Keogh - February 2013 Cancer concerns - August 2013 NHS England - February 2014 CQC inspection May 2014 CQC Unannounced Visit - November 2014 CQC Unannounced Visit July 2015 Increasing range and depth of concerns raised Calibration Consistency Compliance Culture Leadership change began in Autumn 2013, however key changes in clinical leadership and critical mass of new leadership team not in post until May

4 Our Improvement Journey - a Strategic Approach 1. Bringing robust governance structures to life 2. Leadership development Key to our success 3. Our partnership with patients at the heart of everything we do 4. Empowering staff to deliver We continue to strive to develop open and honest relationships with partners and have welcomed external advice 4

5 Our Improvement Journey- a Strategic Approach 1. Bringing robust governance structures to life 2. Leadership development Agreed vision, corporate objectives, Board Assurance Framework and risk appetite Embedding performance framework Deloitte follow up review demonstrating improvements to risk management Risk registers, risk management & escalation developing with more work to do at service/ward level clear mechanisms to escalate 2 and 3 at the top increasingly valued Substantive team of executives 5 Divisional Directors 5 Associate Directors of Operations and 5 Associate Directors of Nursing Corporate Restructure New Chair Increasing strength of deputies Experienced Company Secretary Strengthened day-to-day leadership at Essex County Hospital Safety Improvement Team helping to open eyes and increase confidence in leadership and our ability to get things done 5

6 Our Improvement Journey- a Strategic Approach 3. Our partnership with patients at the heart of everything we do 4. Empowering staff to deliver Closer working with HealthWatch Increasing grip on managing complaints owned by divisions but recognise there is significant further work to do to improve our responsiveness Clear plan for increasing PALs capacity and relocating to the front of the hospital Agreed patient and carer strategy Vibrant service specific patient and carer user groups Significant increase in clinical staffing Staff involvement group Targeted development support to clinical teams Executive adopt-a-ward programme At Our Best - Its Up To Us, development programme involving 1300 staff At Our Best- pledge to speak up Freedom to speak up guardian agreed Good and improving relationship with staff side Evidence staff are more able to speak up Recent staff and patient surveys indicate improvement 6

7 Our Improvement Journey- Current Position Women s Services Children s services Strong and visible leadership team Fantastic new birthing facilities Embedding of risk & learning from incidents Very positive Friends & Family Test ratings Well regarded for medical training Aspiring to be outstanding Good access- RTT compliance Proactive management of Stanway Ward risks Strong team providing hospital and community paediatrics High regard for medical training Positive friends and family outcomes Good access to services Recognised risk due to national shortage of qualified children s nurses & high vacancy levels Children s Board focussed on action to improve compliance for children cared for outside of the paediatric speciality Dedicated Children s Emergency Department 7

8 Our Improvement Journey- Current Position Surgery Medicine New leadership team in place Rapid improvement in cancer services Vascular service continues to expand & grow Increased day surgery capacity in place Improved confidence in safety & quality on Brightlingsea and Mersea wards Surgically led roll out of Human Factors training Ongoing focus on recruitment Leadership team embedding and has set some standards for others to follow Sustainable Dermatology solution in situ Focussed support for endoscopy to improve quality and safety Strengthened Birch ward leadership team and increased senior support On-going recruitment focus for clinical & nursing posts Dedicated effort to improve medical training in elderly medicine Very positive feedback from Recent NHS England Cancer Visit regarding visible improvements to pathways and access 8

9 Our Improvement Journey- Current Position Critical Care Increase to 13 bed capacity Outreach team 24/7 with in reach to EAU Managing risk regarding staffing Implementation of care view High Observation bay developed in EAU A&E Including EAU New medical, nursing and operations leadership team Significant progress with recruitment and fill rates but more to do. Consultant rota is now fully staffed (9 posts) New ambulatory pathways, CDU, MDU, EFU, SAU, ENP streaming & Rapid Assessment and Treatment now embedded Confident regarding January 2015 section 31 compliance We recognise that we need t make improvemnets on Patient Flow and we have a number of initiaves and are pleased with plans to intergate the discharge team and high expectations of our chnages to the site team 9

10 Our Improvement Journey- Current Position End of Life Care Good visibility at Board level Strong palliative care team with 7 day service Strong clinical lead Clear leadership on governance from Cancer and clinical support division 7 day on site specialist assessments Recognize there are still gaps to embed across the whole hospital Outpatients and diagnostics New and modern facility being developed to host relocated Essex County Services Increasing visibility of improved performance Transition to partial booking to mitigate high levels of cancelled appointments Capacity and demand modelling completed to improve access and right size services 10

11 Our Improvement Journey- our Enablers Increasing operational grip New improvement plan- partners aligned to increase immediate focus Workforce recruitment and retention plan implemented revitalised nurse bank Delivery of financial recovery programme Embedding the clinical portal Triangulation of SIs, Incidents and complaints to improve safety and quality of care Consolidation of the corporate nursing infrastructure to deliver greater impact Our Agreed Immediate Improvement Plan Priorities Workforce Freedom to Speak Up Clinical Documentation Mortality Safeguarding Patient experience Deteriorating Patient Medicines Management Clinical Leadership Ward to Board Governance 11

12 Our Improvement Journey- our Enablers Bringing our strategies to life, implementation of our agreed strategies for Workforce Organisational Development Quality Essex County Hospital re-provision Increased digitalisation Picture Development of our clinical services strategy Delivery of integration programme with delivery partners Key player with partners in the Essex Success Regime 12

13 Our Improvement Journey- The Future Expectation of increasing pace of continuous improvement. Our staff have responded to the call to action with renewed energy and commitment leading indicators in right direction performance framework driving delivery We are proud of our recent improvements but recognise that we are some way from where we need to be, and need to focus on culture and behaviours, particularly at service level to bring about change The new leadership team are here for the long term and are determined to sustain long term improvement for our patients and their families We will continue to increase our understanding and ability to use risk management and clinical governance to bring about change. Your visit will provide a clear assessment of our position and help us to improve our ability to listen and act We have used this visit as a catalyst for change and to bring about a step change in pace 13

14 Key Messages to Conclude We have Board, Executive and Divisional leadership teams now in place with serious leadership capability and talent to deliver New pictures We understand that there is a depth and breadth to our challenges and we are delivering improvements with increasing pace and grip The Trust is a very different organisation now however there is still a significant culture shift required. We are all committed to make our shared vision a reality- to be the most caring hospital provider 14