Agenda item

To receive a presentation from Kate Shields, Director of Strategy, University Hospitals of Leicester NHS Trust (UHL) on the Trust’s strategic priorities and current challenges.

Kate Shields, Director of Strategy, University Hospitals of Leicester NHS Trust (UHL) gave a presentation on the Trust’s strategic priorities and current challenges.  A copy of the presentation had been previously circulated with the agenda for the meeting.

During the presentation the following comments were noted in relation to the Trust’s plans for the future and the challenges being faced in the current economic climate:-

a)         UHL was the last large acute NHS Trust operating from 3 sites which needed to be addressed as part of the Trusts’ 5 Year Operational Plan, the vision for which was set out in the presentation.

b)         The Trust was a local, regional and national provider of health care services and a third of the Trust’s income came from providing tertiary specialist services.  The Trust was working hard to ensure that hospitals referring patients to the LRI were fully supported so that the Trust could concentrate on providing the specialist tertiary services.

c)         The Trust had made positive changes in a short time to change ‘behavioural issues’ in both staff and patients to drive forward the changes required. The Trust’s beliefs and values fully underpinned the work to support behavioural change.

d)         The Trust’s Quality Commitment was refreshed each year.  Currently the strategic aims were to reduce preventable mortality, to reduce the risk of        error and adverse incidents and to improve patients’ and their carers’ experience of care.

e)         The Life Study funding had recently been withdrawn.

f)          The Estates Reconfiguration Plan would look to reduce inefficiencies of the use of sites over the next 5 years.  The Trust were committing £320m of investment over the next 5 years to provide the Emergency Floor and reconfigure the estate to allow vascular services to move from the LRI to the Glenfield site, and to provide a better co-ordinated approach to general surgery to reduce the number of planned operations being cancelled due to emergency operations.  Also, the Children’s Hospital must be established at the LRI site by 2020 if the Trust was to retain children’s congenital heart surgery.

g)         The Trust had received £10m capital funding for the Emergency Floor this year which was to be welcomed.  However there were increasing pressures on the capital funding nationally as it had been cut by 25% to fund revenue deficits in the NHS.

h)        The Trust’s current budget deficit was reducing and the Trust was confident that it would reduce in future years in accordance with the Trust’s financial plan.  The Trust still spent too much on agency and locum staff and efforts were being directed to making ‘bank nursing’ more attractive to staff in order to reduce the reliance on more expensive agency staff. The Electric Patient Record, when fully introduced, could be the biggest change to improving efficiencies within the hospital; as it would allow the full patient history to be available from primary care records and would enable faster decision making, better care and avoid duplication of recording patients’ details.

Following questions from Members the responses below were noted:-

a)         Work was progressing with improving integrated care. Better Care Together was helping to improve integration.  Glenfield Hospital was working with GPs and Public Health Consultants to see how better access could be provided to the Clinical Decisions Unit.  This was similar to the work at the LRI for single streamlining into UHL.

b)         The Better Care Programme was also providing an opportunity to improve the long term conditions of patients and the Trust were looking to see how respiratory and cardiology consultants could provide treatment to patients in community hospital and neighbourhood hub settings.  Although there had been considerable discussions in relation to working together, further work was still needed to achieve full integration or working practices.

c)         Dealing with the frail and elderly remained one of the major challenges.  Space could still be used better at the LRI site and if more beds were provided they would face more pressure from the frail and elderly than surgical cases.

d)         It was not always necessary to increase facilities to manage larger demands.  Medical staff were keen to change service delivery and moving to 23 hour hospital stays was an effective way of increasing patients numbers for a number of minor surgical interventions using the same number of beds.

e)         Using the Intermediate Care System beds provided by LPT to the maximum effect would be crucial to future service delivery, particularly under Better Care Together.

f)          Although the results of staff satisfaction and patients recommending others to use the hospitals was disappointing, particularly at the LRI site, a great deal of work was being undertaken by the recently appointed Director of Human Resources to change staff perceptions and promote positive achievements such as the moving the cardio-vascular service to Glenfield, building the new emergency floor and creating the children’s hospital.

g)         The Trust was the 9^th largest teaching hospital in the country but struggled to retain students after qualification. Students were being actively involved in shaping future services and business cases for making change.  The Trust recognised that part of the solution was having an offer for students that involved LLR and not just UHL.

h)        UHL were working to deliver eye casualty services in a more dynamic modern hospital setting, as it was currently considered to be outdated in its current form.

i)          UHL were having discussions with NHS England in relation to orthodontic services, which had been poorly commissioned and funded nationally for many years.  The Trust had the largest number of ophthalmic outpatients in the country but not the largest local population.

j)          The 25% reduction in the national capital programme was of concern but it was considered that the Trust would still receive support for reducing the number of sites from 3 to 2 and the Trust had regularly briefed the Minister on current issues and priorities.  However, if capital funding was prioritised, the Women’s Hospital and the Ambulatory Care Hub would be delayed as there were other projects with greater priority involving higher clinical safety issues.

The Chair thanked Director of Strategy for her presentation.  He felt that both the UHL and LPT had clarity in their planning with specific deliverables and milestones and for delivery.  He was less confident that this was currently in place for the BCT planning; the delivery of which was crucial to all those in the local health and social care economy.

Finally the Chair wished the Director of Strategy best future wishes in her new employment.