Agenda item

The Chair confirmed that she had agreed the Panel should consider an urgent item on the Care Quality Commission (CQC) Inspection Report on Wexham Park Hospital which had been published on 8^th January 2014 (after the agenda had been issued) following an unannounced inspection.

The Panel considered the Inspection Report and received a presentation from Philippa Slinger, Chief Executive of Heatherwood & Wexham Park Hospitals NHS Trust about the progress being made by the Trust in implementing the Action Plan to address the CQC warning notices.  The latest Inspection Report related to a further unannounced CQC inspection in October 2013 which was a follow up to the first inspection in May 2013.  A further new style CQC inspection was scheduled for February 2014.

The Panel noted the latest CQC findings which had stated that whilst the Trust had made ‘significant improvements in some areas’ the hospital was failing to meet the required standards in a number of significant respects and that a revised Action Plan had been produced to address the concerns raised.  The key points made in the presentation are summarised as follows:

• The inspection report recognised that improvements had been made, notably that capacity issues had been addressed; A&E had 40% more capacity and services had been improved; a Surge Escalation Policy was in place; and there were 56 additional beds since May with a net gain in the number of doctors and nurses.
• Implementation of the Action Plans put in place in response to the first inspection in May 2013 were ongoing and the Trust had been clear in stating that some actions would take longer to implement.
• Whilst improvements had been recognised in a number of wards, issues remained in wards 4, 7 and 8 in particular and a further Action Plan had been sent to Monitor is response to concerns about the involvement and welfare of service users; cleanliness and infection control; safety and suitability of both premises and equipment; staffing; quality monitoring; records; and governance.
• It was not envisaged that the potential merger with Frimley Park Hospital had been effected by the latest inspection report.

Members made a number of comments and asked a wide range of questions during the ensuing discussion including whether the Trust had sufficient financial resources to bring about the require improvement in services.  Philippa Slinger responded that sufficient resources were available; that the Trust had fully spent its £17.5m capital programme during the past year which had brought about major improvements, particularly in A&E with further investment due in upgraded the wards; and that the Trust’s deficit had reduced from £13.8m to £6.9m.  The Trust was approximately two years into a five year building programme of major improvements to premises and equipment.  A number of new temporary support staff had joined the Trust, particularly to add project management capacity and to ensure existing clinical staff could focus on service delivery during winter.

The Panel also raised a number of issues in relation to impact of staff morale and the ways in which the problems of culture and practice identified during both inspections were being addressed.  Members were informed that whilst a wide range of measures were in place to address these issues including training, communication and changes to working practices, it was recognised that cultural change was difficult to implement and took time.  In terms of staff morale, Philippa Slinger recognised that the period of inspection and change had left some staff feeling ‘under siege’ with insufficient time to evaluate whether the changes implemented had brought about improved services for patients.

The Chair thanked Philippa Slinger for her progress report to the Panel and highlighted that a further update was scheduled for the meeting on 24^th March.

Resolved –  That the CQC Inspection Report be noted, and that the Panel consider further progress against the Action Plan at the meeting on 24^th March 2014.