Agenda item

[To consider the results of the recent Care Quality Commission inspection into the Royal Wolverhampton NHS Trust]

                                                                                                            [David Loughton]

The Chief Executive of the Royal Wolverhampton NHS Trust (RWT), David Loughton CBE presented the Care Quality Commission (CQC) Quality Report on the outcome of the inspection, conducted between 2 to 5 June 2015 into the New Cross Hospital and Cannock Chase Hospital (the latter being included as some services from the dissolved Mid Staffordshire NHS Trust having being taken over by the RWT). He advised that the RWT had lodged formally 294 challenges to the report of which 205 had been accepted immediately by the CQC. He advised the Board that the RWT Board was disappointed with the overall rating of “Requires Improvement” and that a formal appeal had now been lodged.

The Chief Executive of the RWT reported that the stance of the Trust Board was supported by the Trust Development Agency. The Trust was also in the process of recruiting 75 trained nurses, a skill mix review was to be conducted at the next Trust Board meeting when the requirements for a further 200 qualified nurses would be considered. He outlined the procedures and opportunities which had been explored for the recruitment of additional qualified nurses including the problems encountered with the recruited nurses obtaining the requisite numbers from the Nursing and Midwifery Council (NMC). He also referred to the potential difficulties to be encountered in retaining qualified nursing staff from abroad if minimum income levels were to be imposed by Central Government on employees so recruited after a period of seven years.

The Strategic Director – People commented that Wolverhampton should be in a position to be self- sufficient in nurses. Professor Linda Lang advised that if that was allowed with entry limits on training places not being limited the problem would not arise. The Chief Executive of the RWT outlined steps which could be taken to reduce expenditure on temporary or locum staff and reminded the Board that in 2005 he had taken steps to cease recruitment of Agency staff in order to ensure that the Trust had overall control of infection prevention.

The Chief Executive of the RWT reported that an Action Plan with some 400 actions had been developed in response to the CQC report albeit that implementation had been held in abeyance pending the outcome of the appeal against the findings. He reported that the Head of Radiation Protection from the University Hospital of Birmingham NHS Trust had been seconded to assist with the issues identified in respect of that particular area. He advised that he still had a number of concerns in relation to infection control within the Hospital given that capacity issues limited the steps which could be taken to address the issues involved..

Alan Coe commented that there were over 50 references in the CQC report in relation to Adult Safeguarding. The Chief Executive of the RWT advised that protocols and procedures with regard to Children’s Safeguarding were well established but less so in respect of Adults. He opined that there appeared to be more of a concern in raising adult safeguarding issues. The Service Director, Public Health and Wellbeing commented that in terms of the safety domain the area was well led but that staffing levels were an issue. The Chief Executive of the RWT acknowledged the point made and accepted that some areas were better than others. He questioned why the incidences of C. Difficile were different between New Cross Hospital and Cannock Chase Hospital when the same Management Teams were responsible. He drew to the attention of the Board that the opening times of the Minor Injuries Unit had been questioned in the CQC report but that this was outside of the control of the RWT as the opening times were determined by the Commissioners.

The Chair, Cllr Sandra Samuels, referred to the 75 vacancies mentioned earlier and asked how these positions were being covered prior to appointments being made. The Chief Executive of the RWT assured the Board that “Bank” staff were used and that every shift was sufficiently covered albeit that a difficulty was encountered in respect of night shift cover. He reminded the Board of the increase in admission rates and that nurses with particular specialities were being transferred across other specialisms to ensure adequate cover which could lead to a lowering of morale.

Resolved:

That the report be received and noted.