Agenda item

To receive the University Hospitals of Leicester NHS Trust’s draft Quality Accounts for 2015/16.  The Commission are invited to review the Quality Account and provide feedback by Tuesday 10th May which will be included in the final draft of the Quality Account presented to the Trust Board in June.

The University Hospitals of Leicester NHS Trust’s submitted a draft Quality Accounts for 2015/16.  Sharon Hotson, Director of Clinical Quality and Julie Smith, Chief Nurse attended the meeting to present the draft Quality Accounts and invited the Commission to review the Quality Accounts and provide feedback by Tuesday 10th May which would be included in the final draft of the Quality Accounts to be presented to the Trust Board in June. 

The Quality Accounts were produced annually to a prescribed format and they were subject to a statutory requirement to be shared with a number of stakeholders including the Commission.

The successes for 2015/16 included:-

a)   Achieving the three Quality Commitment priorities from the 2014/15 Quality Accounts:-

·         Reducing preventable mortality and having a Hospital Level Mortality Indicator ? 100.

·         Reducing the risk of error and adverse incidents by 5%.

·         Improve patients’ and their carers’ experience of care achieving a Friends and Family Score of 97%.  

b)  Having only 1 case of MRSA in the last 14 months.

Particular challenges during the year remained the emergency pathway and in particular meeting the 4 hour emergency care access standard.  Although internal and external reporting was showing an improving picture in relation to compliance with SEPSIS 6 Care Bundle there was still more challenges to achieve all three performance indicators for SEPSIS.

Following questions from Members, it was noted that:-

a)         The nationally defined pathway for the early identification of SEPSIS had been implemented within the clinical teams.  Additional training had been put in place for identifying SEPSIS and meeting the national standards.  The process involved identifying patients with SEPSIS and carrying out 6 interventions within 60 minutes of arrival at hospital.  Each case was reviewed the following day to assess whether the process had been followed and whether the patient had suffered if the 60 minute target was exceeded.  The Trust was working closely with EMAS to determine if they could be involved in the process and help to improve performance.

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b)         The hospital was in the middle of the table of NHS Trusts for the performance in relation to the 4 hour emergency care access standard. UHL performance was 87.8% against the national target of 95%.  The number of patients attending the emergency department was still increasing and approximately 750-850 patients were attending daily.  The opening of the new emergency floor would have a significant impact upon performance but other factors such as bed capacity, discharges and patient flows through the hospital could still be limiting factors.  There were ongoing discussions with GPs to reduce the number of patents attending emergency department where their condition could be safely treated through other healthcare services.  Patients were ‘triaged’ on arrival at the emergency department to ensure that those patients requiring urgent treatment were seen first. Patients waiting for treatment were monitored regularly and their priority would change should their condition deteriorate.

c)         The CRAB system was an alternative system to one that was already in use and following a pilot trial it had been decided not to proceed with implementing CRAB and to retain the existing system.

d)         The Acute Kidney Injury (AKI) performance target had not been met as the national advice had changed during the year. The 90% threshold was not achieved and the AKI would continue within the Commissioning and Innovation payment framework (CQUIN) for 2016/17.

Members made the following observations on the draft Quality Accounts:-

a)         The rigid format of the Quality Accounts template can be unhelpful at times as it statements can appear more alarming that they are in reality to non-medical persons.  Parts of the Accounts could be less dense with less narrative.

b)         More could be made of what the Trust did with feedback received through complaints to improve services.

c)         There should be a more detailed explanation of CRAB to add clarity as to why it was not being continued.

AGREED:

            That the Chair submit the Commission’s comments to the Trust together with any additional comments from Members submitted to the Chair after the meeting.