Councillors and committees
Update from Kingston Hospital NHS Foundation Trust and progress with the CQC Inspection recommendations
Ann Radmore, Chief Executive will present an update from the hospital
Kingston Hospital submitted a report to the Panel to update on the following areas: performance, fire safety, car parking, progress against the areas identified by the Care Quality Commission – the 7 “must do” (of which 6 have been addressed) and 42 “should do” items (39 now addressed/being progressed). The remaining “must do” item concerning system improvements to monitoring equipment maintenance and safety checks is being progressed and an automated tracking system will be in place in mid-December.
The three outstanding “should do” items require significant capital investment which has not been identified so far and the CQC is aware of this:
· Consider how the environment and facilities in the ITU/CCU could be improved.
· Review maternity service bed capacity in order to address the increasing activity
· Review the environment of the chapel and multi-faith facilities
Ann Radmore, Chief Executive attended the meeting, gave a presentation and answered a number of questions.
The Trust has continued to perform well on cancer targets and the referral to treatment target (RTT) and has been exceeding the national targets for each. It is achieving well on digital development and is the 4th hospital in England to achieve HIMSS level 6. The Hospital also performed well on the Family and Friends Test – 95% of people would recommend the hospital to others.
Ann Radmore stated that performance in A&E in October was 92.6% seen within 4 hours, just below the national target of 95%. She explained that the Trust does achieve the 95% standard about twice a week. The capacity in the emergency department’s Major and Resuscitation area is being increased to create a further 7 spaces and the new urgent treatment centre (UTC) opened on 27 November.
The “Red Bag” Scheme piloted in Sutton has now been introduced in nursing homes in Kingston and Richmond enabling patients admitted to hospital to take their red bag with them. This contains important information on a resident’s health and a number of essential belongings which also aid discharge.
Ann Radmore confirmed that progress has been made on the provision of seven day services and extended consultant physician care is available on wards across the week with two consultants at weekends. This is aiding the ability to make discharges at the weekend.
Implementation of the fire safety plan is progressing especially with regards to increasing compartmentalisation within the hospital buildings. Significant investment will be needed to undertake these works, however two wards in Esher Wing have been completed. It is expected that the changes will be completed in the next 18 months. Mock evacuations /training exercises had taken place jointly with the London Fire Service. During discussion it was suggested that there was a need for more Fire notices directing people where to go.
Car parking at the hospital is being reviewed to explore whether it would be possible to increase the amount of onsite parking but currently several spaces have been temporarily lost due to the UTC and A&E extension works but 12 spaces will be lost permanently due to the larger UTC footprint. CP Plus will be operating the hospital car parking from 22 January 2018.
Other achievements include:
· Clinical research has been driven forward and the Trust is now seen as having made the greatest improvement in England. The Trust will report in April and May on its quality goals achievements.
· The Trust has more than 600 volunteers working in every part of the hospital who make a great contribution.
· The Trust is at the forefront of adopting digital technology and seeing the benefits in way care is provided to patients.
· Radiology department is being developed and new CT and MRI scanning will be on site next year.
A question was asked about the additional funds which were being made available for hospitals as announced in the recent budget and what was happening locally. Ann Radmore stated that capital money has been allocated to the four regions but as yet there are no descriptions about how this should be allocated and for what purpose. Longer-term investment has also been announced and this may be allocated via CCGs
£350m has been allocated for winter and bids have been invited. The Delivery Board for Kingston, Richmond and East Elmbridge has identified three areas for funding and is awaiting a response:
· community team for rapid response at weekend
· physician and GP in A&E to reduce admissions
· additional staffing at weekends to increase the number of discharges at weekends including discharge co-ordinator, occupational therapist and social worker
Several questions were asked about Parking at the hospital especially concerning reports of disabled parking in Galsworthy Road on double yellow lines leading to potentially dangerous situations. Ann Radmore replied that there were 32 disabled spaces on site and these were not used to capacity. She added that a new provider will be taking over in January and the hospital want a system which is more appropriate for elderly people. Members requested that the hospital investigates the under use of disabled spaces and reasons for those choosing to park in Galsworthy Road. It was suggested that leaflets could be placed on car windscreens to find out the reasons for parking in the street and other views and Ann Radmore agreed to undertake this. It was confirmed that the Trust did provide parking concessions for relatives of people who were in intensive care.
In response to a question from the gallery Ann Radmore explained that security do check periodically that cars parked in disabled bays do have blue badges.
In response to the suggestion that the Hospital’s respiratory lung function test equipment is very dated, Ann Radmore explained that the capital programme is considered by the Board annually. Clinical directors are invited to identify needs and bring forward business plans but there are never sufficient funds to meet all requests. She agreed to ask about where this equipment was placed in the list of priorities.
In response to a question about delayed transfers of care (DTOC) Ann Radmore explained that a lot of effort has been invested in last 18 months by both health and social care partners in Kingston, Richmond and Surrey to ensure swifter placements. There are occasions where there are no delayed discharges for social care reasons and at other times there can be 1-3 delays.
In response to a question from the Chair, concerning the CQC’s identification in the June 2016 report of A&E leadership as being problematic, Ann Radmore explained that at the time of the inspection in January 2016 the clinical director was very new into post. Several changes have been made since that time including around clinical and nursing management. Leadership is now more rigorous and this is resulting in an improvement in performance and management of the department.
In response to a question about Maternity services and whether any expectant mums are ever turn away Ann Radmore stated that 5,500 babies are delivered at the hospital annually and none have been turned away so far. Recent maternity service developments at West Middlesex have reduced the pressure in that area. She added that today expectations are different and the hospital wants to be able to provide services in a more discrete way. For example currently the Post-natal Ward is not close to the maternity unit.
The changes to paperless systems were welcomed and a question was asked about next steps. Ann Radmore referred to the national programme which was aiming to be paperless by 2021. She added that there were some challenges about technology particularly where wards were not designed for this and there were log in complexities when step away. However the Trust was making very good progress.
Mr Robb in the gallery asked whether there was good IT compatibility with other systems and Ann Radmore replied that technology is more cloud based and this has helped with compatibility and there is better integration with hospitals, social care, mental health and GPs. However it is important to exercise care with patient information.
1. the information provided is noted;
2. The Trust undertakes an investigation into disabled parking and the apparent increasing trend for disabled people to park in Galsworthy Road rather than the hospital car park.