(Note: the Chair has agreed that this item be included on the agenda in accordance with Section 100B (4)(b) so that the Committee can consider the matter prior to the next scheduled meeting)
The Chief Executive of Stockport NHS Foundation Trust will attend the meeting to report on current issues and developments at the Trust that may be of interest to the Scrutiny Committee.
Officer contact: Jonathan Vali, 0161 474 3201, jonathan.vali@stockport.gov.uk
Minutes:
Ann Barnes (Chief Executive) and Andrew Burn (Director of Financial Improvement) from Stockport NHS Foundation Trust attended the meeting to report on the Trust’s involvement in the Financial Improvement Programme, being led by NHS Improvement.
The Trust had been invited us to take part in the programme which was aimed at those Trusts with sustainable financial challenges, and provided focussed support to identified challenges and implement measures to improve sustainability of the Trust. The Professional Services company KPMG has been assigned to the Trust to provide additional capacity and insight.
The Trust had completed the first phase of the programme during which an analysis was completed and recommendations developed, and this had been reported to the Board. Phase 2 had now begun with the implementation of the findings.
The challenge for the Trust was that each year it was required by NHS England to make savings, but this meant the Trust was then making a loss. It was hoped that through this Programme to make additional savings of approximately £16m to ensure the financial sustainability of the Trust.
Some of the key areas that the Programme Team were looking at included:-
· length of stay
· theatres
· estate
· delayed discharge (reduce delays to reduce cost and to improve patient experience)
· spending thresholds
· addressing absenteeism
· reduced reliance on agency staff and better co-ordination of their use
· reviewing budgeting process.
It was emphasised that these measures would not be to the detriment of operational activity at this hospital and that although being delivered quickly, proposals were quality assessed to ensure clinical considerations taken into account.
Councillors asked questions and made comments, including:-
· What was the impact of the Programme on the Trust’s Five Year Strategy? In response it was stated that Strategy and its objectives remained in places, in particular the committmint to Stockprot Together and an integrated health and social care organisation, as well as a focus on cancer care and older people. The ‘complexion’ of the Trust was likely to change in the future, given the changes under consideration but the form of the organisation would follow from decisions about its function.
· What steps were being taken to improve existing capacity within the Tryst’s management team to address the problems being encountered? In response it was stated that one of the reasons for the Trust getting involved with the programme was because KPMG would provide development capacity to enable the Trust’s staff to improve management practices.
· Further information was requested in relation to work to improve delayed discharges. In response it was stated that KPMG were working closely with the Trust’s senior managers to address this area of work, and this included addressing activity on each ward; bringing activity forward in the day to ensure prevent conflict with other activity; working with Council staff to ensure practice and activity was effective. Early efforts had resulted in an increase in discharges and a positive trend in activity. Work was also underway to accelerating ‘front door’ activity to deflected inappropriate attendances and to ensure improved monitoring of patients to improve appropriate hand-off. Further comments were then made about the need for early conversations between hospital and social care staff, and the variability in practice between wards. The issues were acknowledged and assurances were given that these issues were being addressed through this work.
· Had the ability to recruit of staff improved since the decision on Healthier Together, reducing the reliance on Bank and Agency staff? In response it was stated processes had now changed so that Bank staff were now arrange through a central office to provide greater co-ordination. Bank staff were, for the most part Trust staff so were desirable to use. The Trust was actively working to reduce the use of agency staff, and there were also national targets to do so.
· What was being done to reduce/ discourage people from attending? In response it was stated that this was the central aim of the Stockport Together programme, for which detailed Business Cases were currently being prepared, and which sort to ensure interventions took places as early as possible. The new ‘consultant connect’ initiative allowed GPs to contact consultant/specialist directly for input early with patients in the surgery. Feedback from clinicians had been very positive and early indications were that this had been successful at deflecting significant numbers of referrals.
· What was being done to address the lack of suitable facilities to discharge into? In response it was acknowledged that there was a shortage of accommodation, but this was a commercial challenge. There had been a number of properties close creating capacity problem for whole locl economy, reflective of the regional and national challenge. Partners were exploring options, including the NHS and Council providing some form of accommodation. There was a separate challenge around families and choices of accommodation. It was acknowledged that professionals needed to have those difficult conversations about the need to discharge those who are medically fit because the hospital was neither the best nor safest place for many of these people to be.
RESOLVED – (1) That Ann Barnes and Andrew Burn be thanked for their attendance and presentation.
(2) That the Scrutiny Committee would welcome further feedback from Stockport NHS Foundation Trust in relation to its Financial Improvement Programme as it progresses.