Agenda item

[To consider, The Royal Wolverhampton NHS Trust – Quality Account 2020-2021]. 

The Deputy Chief Nurse from the Royal Wolverhampton NHS Trust presented the Quality Account 2020-2021 for the Trust.  A copy of the slides are attached to the signed minutes.  She thanked the Chair for her statement she had provided on behalf of the Panel, which had been included in the Quality Accounts.  Three priorities were addressed in the Quality Accounts, Workforce, Safe Care and Patient Experience.

The Vice-Chair referred to the performance of the Trust against national operational standards.  In the report, of the 23 columns, 5 were in the green (meeting target indicator) and 18 were in the red (not meeting target indicator).  He completely understood the challenges of Covid.  The one area that particularly stood out was the two weeks wait for breast symptomatic patients indicator.  The performance in 2020/21 was 51.14%, the target for the year was 93%.  He asked what measures the Trust were taking to improve performance in this area.   He thanked New Cross Hospital for their services. 

The Deputy Chief Nurse responded that performance in the two weeks wait for breast symptomatic patients was now much improved.  They had been working collaboratively with other hospitals in the Black Country and West Birmingham CCG area. 

Panel Members thanked the representatives from the Trust for the report, which it was clear a great deal effort had been put into.

A Panel Member referred to the Trust’s partnership with the private company Babylon and asked for comment on what they saw as the private sector becoming more involved with the National Health Service.  They asked how the Trust could address fundamental issues of inequality such as the digital divide and people from poorer backgrounds more likely to have health problems and live shorter lives.  They had a particular interest in how Female Genital Mutilation (FGM) was reported by hospitals because medics were often the first to become aware of the occurrence.  They asked about the overall process in managing FGM including where it was seen within the Trust, how it was reported and who was informed.  They commented that end of life care in the community was more complicated than within a hospital setting.  They believed there was often a disconnect between the care a person received in the community and what their primary care doctor or trust staff felt was appropriate.

The Chair requested that the question regarding Babylon be deferred to a special Health Scrutiny Panel meeting on Primary Care planned for December.  The Deputy Chief Nurse commented that inequalities was a huge challenge for the Trust.  They had tried to improve their understanding of the situation by an analysis of data, such as looking at geographical locations of patients where inequalities were more prevalent.  The Trust were looking at inequalities based on deprivation and ethnicity.  They were analysing urgent and routine healthcare pathways.  They were also looking at other inequalities such as learning disabilities and how they performed against the standard. They were analysing key planned pathways, particularly focussing on hip arthritis, Chronic Obstructive Pulmonary Disease (COPD), heart failure and cataracts.  They had been addressing waiting times by ethnic group in addition to social economic status.  A key area for which they would be publishing a dashboard was in maternity, to identify health inequalities in this area.  The Trust were actively pushing the inequalities work forward.

The Head of Patient Experience and Public Involvement added that the Trust were working with Wolverhampton Voluntary Council on a project scoping the issue of social isolation.  It recognised that technology was not for everyone.  They were hoping to be successful in receiving some national funding for the project.  They were also working with the University of Wolverhampton on coproduction and codesign.  A series of workshops had taken place with particular patient groups.  Clinical staff and patient representatives had attended each of the workshops.  The Trust had been conducting some research on complaints related to end of life care and the findings of this work would be published in the forthcoming months. 

The Deputy Chief Nurse remarked that the Trust had partnered with Compton Care to have a post where someone supported people from ethnic communities in order to access end of life care resources.  Most of the FGM cases were picked up in maternity services by midwives.  There was a process for reporting them.  It was monitored every month through the safeguarding operational group within the Trust.  There was an end of life steering group at the Trust which looked to share best practice across all services.  The Community nursing teams worked hard, where they were not involved in some cases it was when domiciliary care agencies were providing some end of life care.  There was now a Wolverhampton place-based group, which involved the hospice, RWT, the CCG, Healthwatch and the voluntary sector.  This group looked to address what could be done better in terms of the care people received.             

Panel Members thanked the Trust for the report received on the Quality Accounts 2020-2021.