Agenda item

Sir Andrew Morris, Chief Executive of Frimley Health NHS Foundation Trust made a presentation on the findings of the recent Care Quality Commission inspection into Wexham Park Hospital and the wider developments to further improve services and facilities at the hospital.

(Councillor Shah joined the meeting)

Wexham Park Hospital has been rated as ‘inadequate’ upon acquisition by Frimley and it had been agreed that the CQC would conduct a further inspection after 12 months to assess progress.  The re-inspection took place in October 2015 and the hospital received an overall rating ‘good’ and ‘outstanding’ for urgent and emergency services and critical care.  The Chief Inspector of Hospitals had commended staff on the ‘transformation’ achieved and it was recognised that the improvement since the acquisition had been very substantial.  Sir Andrew explained the approach taken in making such rapid improvement which included strong leadership at all levels, values and behaviours, engaging staff and a shared view of what ‘good looked like’.

Despite the improvements, the hospital still faced many challenges such as sustaining and continuing to improve services and reducing the vacancy rate in view of the difficulties in recruiting staff.  The hospital had a deficit of £30m at the point of the acquisition and whilst there had been £18m of support from the Department of Health to support the transition, the Trust continued to face a significant challenge in addressing the deficit as part of the three year programme to achieve financial balance.  The Panel were also briefed on the future development plans at Wexham Park that included a £49m investment in a new emergency department, £10m investment in maternity facilities, additional car parking spaces a major programme to address a backlog of repairs.  The Trust also had plans for a £72m redevelopment of the Heatherwood site to provide new and enhanced facilities.  Part of the site would be sold to help fund the plans.

The Panel congratulated Sir Andrew, his management team and staff on the substantive improvements that had been delivered since the acquisition that were reflected in the CQC inspection findings and welcomed the future investment plans.  Members asked a number of questions which are summarised as follows:

·  CQC inspection – several Members asked how the action plan arising from the inspection report would be taken forward and the plan to move from an overall rating of ‘good’ to ‘outstanding’.  Sir Andrew provided assurance that all of the areas for improvement identified by the CQC would be addressed and it was highlighted that there had been considerable improvement in areas identified previously such as patient discharge by working closely with social care partners.  A new plan had been put in place for pharmacy support for the emergency department.  The Trust were committed to continuing to improve through a strong and proactive approach to performance management and the development a new clinical strategy.

·  Clinical strategy – Members were briefed on the new Clinical Strategy across Wexham Park, Heatherwood and Frimley Park.  For Wexham Park this included the provision of a paediatric high dependency unit, extension of the heart attack service, onsite radiotherapy and new ophthalmology provision.  The Trust were seeking to secure additional elective activity at Wexham Park and this was important in moving towards financial balance.

·  Staff morale – previous inspections had identified a weakness in the levels of staff morale and Sir Andrew was asked how it was being measured and improved.  It was responded that staff engagement had been a key part of the improvement plan upon the acquisition and there was stronger leadership and accountability on each ward which helped with morale.

·  Recruitment – the Panel had previously been informed of the actions being taken to address staff shortages for example the recruitment of nurses from the Philippines.  150 trained nurses had been interviewed but the new requirement for an English exam had delayed the process as there was only one examination centre.  Recruitment and retention remained a key priority for the Trust.

·  4 hour waiting time target – a Member asked whether a shortage of doctors was resulting in longer waiting times for patients in A&E.  Sir Andrew stated that there was not a shortage of doctors and nurses in the department and that 95% of people were seen at A&E within the national 4 hour target during the previous month which was considered to be strong performance.  He explained that the primary reason for longer waiting times was the significant variations in demand.

·  Car parking at Wexham Park Hospital – Members highlighted that parking remained a major issue and asked when the additional parking would be available.  Planning issues had delayed the project but work had started on the provision of 500 additional spaces.  However, the new emergency department would take up around 200 existing spaces and these would need to be provided elsewhere on the site.

·  Future investment plans – A Member asked whether a covenant on the Heatherwood site may impact on the redevelopment plans, to which Sir Andrew responded that all such issues would be addressed through the planning process and the Trust were confident that the plans would be delivered.

At the conclusion of the discussion, the Panel welcomed the progress that was being made in improving services at Wexham Park and congratulated Sir Andrew and staff at the hospital.

Resolved –

(a)  That the finding of the CQC inspection report into Wexham Park Hospital and wider update be noted.

(b)  That the significant progress that had been made in improving services at the hospital be welcomed and that a further update be provided to the Panel at a later date.