Members to receive a verbal update on general activities regarding University Hospitals Leicester (UHL).
Minutes:
Richard Mitchell, Chief Executive Officer at university Hospitals Leicester (UHL) was introduced to the Committee as the Chief Executive in post since October 2021.
Richard Mitchell provided a verbal update around 5 themes which included the following points:
Covid
There were currently 210 patients in UHL across 10 wards, of these 85% were presenting with Covid as a secondary diagnosis. As for staff, 10% were currently off with Covid too.
Waiting Lists
Acknowledged that waiting times had deteriorated and had been worsened during the Covid situation. Some progress had been made over last 6 months to reduce the waiting times for Elective Care although given length time of closures there were still very high volumes and Leicester was amongst worse in country and they were looking to address that.
Emergency care performance had been very challenged at Leicester; Covid was still making it more difficult, and the hospital was focusing on discharge pathways to improve the situation.
In relation to cancer care patients were waiting longer than pre-covid, however waiting times were overall within the safety marker but the hospital was keen to get back to where they were and to improve.
Senior Staffing
There had been a number of changes since October 2021 with Richard Mitchell taking up the CEO role following John Adler’s retirement. Three executive director vacancies had also been recruited to and 4 non-executive directors had joined. The Board chaired by John McDonald were looking to fill other senior appointments over next 3 months.
UHL Finances
The annual accounts for the financial year 2019-202 were still not signed off, although they had now been presented to the audit board and were due to be taken to the public board next week. The annual accounts for financial year 2020-2021 were also due to be taken to the public board next week and the hospital hoped to be exiting the Recovery Support Programme (RSP) around October 2022.
UHL Reconfiguration
As part of national strategy UHL was lucky to be one of eight pathway trusts on the reconfiguration programme. Members were reminded that there were four pillars to the programme, a dedicated Children’s Hospital; restructuring of the Intensive Care Units from three to two due to be completed in May 2022; reconfiguration of Maternity services to two units; and finally the separation of elective/emergency care, this was awaiting final confirmation around receipt of £37m to help facilitate that.
Members discussed the update which included the following points:
There were concerns that the concentration of services around Glenfield Hospital was problematic for residents in south Leicestershire and it was accepted that access to Glenfield could be difficult, but UHL wanted to work with people to address those issues e.g., through development of a travel plan.
It was commented that despite the reconfiguration plans and the large amount of monies involved that was not addressing the waiting list issues mentioned or the waits for other services e.g., musculoskeletal conditions and assurance was sought that was being addressed. In response it was advised that in January UHL had been able to reopen orthopaedics; 9% of the waiting lists were related to musculoskeletal conditions, in comparison to pre covid there would have been less than 10% of patients who were waiting more than 12 months to be seen, unfortunately since covid and the length of time that certain services were restricted UHL were now a long way from getting patients waiting under 2 years. In terms of numbers on waiting lists, those were growing and continued to do so with a forecast they would grow nationally to 12+ million so waiting lists at UHL were also likely to go up but importantly for those who were waiting a long time the length of time spent waiting was now reducing.
In relation to cancer care patients, it was recognised that long waits could have detrimental impact on patients and assurance was given that the 14 day and 62 day referral/treatment rates had improved, patients were being clinically prioritised and cancer markers used and it was affirmed that Leicester, Leicestershire and Rutland were not an outlier in terms of its cancer care.
There was dissatisfaction that the hydro facility at the General Hospital had remained closed since covid and those using it to maintain conditions had nowhere to go during that time and no effort made to repair or restore that facility
Members expressed their disappointment that a range of subjects had been covered on a verbal report preventing them the opportunity of fully scrutinising points about topics, particularly as they hadn’t been updated on progress with things like the reconfiguration programme for some months.
Members noted it was reported that a lot of staff were off with covid, and more details of that impact were sought as well as steps being taken to ensure staff wellbeing. Members were informed UHL staff were an important priority and there was a variable range of services in place to support them, among the basics it was crucial that staff had ability to take breaks, were supported to eat well, provided with lockers and had working equipment. However, people were tired and there was trauma arising from the effects of the pandemic as well as the ongoing transmission of the virus.
Discussion progressed onto the reconfiguration programme. Members were told that the reconfiguration programme had been approved and conversations had taken place today with the government around the business case. Leicester UHL was now 1 of 8 organisations waiting to move to the next stage.
Members asked for clarity that the £450m had been approved by the Treasury and queried any current estimated shortfall or changes to the reconfiguration proposals. It was advised in terms of estimated shortfall there had been conversation with government around increased construction cost, and they were looking at ways forward to secure the money for that.
Members were not satisfied that the £450m had been formally approved by the Treasury and were uncertain as to the hospitals final reconfiguration plans or whether there would be changes to those due to increasing costs. There followed a strong discussion in which Members raised concerns they had not been advised previously about such approval and they were not assured by what was being said at this meeting.
Richard Mitchell clarified and reiterated that:
· the reconfiguration programme still had 4 pillars, namely the 3 into 2 intensive care; reducing maternity departments from 2 to 1; a stand-alone children’s hospital and separation of elective/emergency care.
· the Treasury had committed to £450m as stated.
· UHL had not received confirmation that capital was extended beyond £450m but the wider context was that construction costs, resources and supplies etc had gone up.
· there was an ongoing discussion with government for additional funds to meet the uplift costs.
The Chair drew further discussion on the reconfiguration to a close and requested more detailed information about the status of the reconfiguration bid be provided to the Chair/Vice Chair and Rutland representative outside this meeting.
AGREED:
1. That Health Partners provide detailed information on current status of reconfiguration bid to the Chair, Vice Chair and Rutland representative as soon as possible.
2. That a briefing be convened as soon as possible for Chair, Vice Chair and Rutland representative with Andy Williams, Richard Mitchell, and Angela Hillery to ascertain position and progress with reconfiguration.
3. That future updates to the committee be by written report and to include any data in a written digest.
4. That the Committee at a future meeting have opportunity to scrutinise the £46m misstatement of accounts and to explore what the systemic failures were, and any measures put in place to avoid that happening again.