[Jeremy Vanes, Chairman, The Royal Wolverhampton Hospital NHS Trust,to present draft Quality Account 2016/17 report for comment]

Jeremy Vanes, Chair of the Royal Wolverhampton NHS Trust (RWT) presented the draft Quality Account for 2016/17 and highlighted the key points.

He stated that the format for the document had been established over six years ago, and was comparable year on year.  It was assured and audited in the usual way, with stakeholders given the opportunity to comment.  He referred to the three key priorities for improvement; safe nurse staffing levels, safer care and patient experience.  He invited the Panel to comment and provide a statement to be included in the document when published on 26 June 2017.

The Panel considered the issue of safe nursing staffing levels and in response to questions regarding staffing shortfalls and training available for career progression, Jeremy Vanes confirmed that there continued to be a shortfall in experienced registered nurses, with recruitment abroad to find the necessary skills and experience.  In some cases more health care assistants (HCA) were employed to compensate for that shortfall.  There was also an extensive training programme for HCAs to allow career progression, including flexibility and re-designing job roles and innovation.  There were also numerous local and national initiatives to both attract and retain staff.

In answer to a question regarding exit interviews, Jeremy Vanes stated that the feedback generally followed national trends.  It was also acknowledged that Wolverhampton could not offer as much as some larger organisations.  If the Panel thought that it would be helpful, it would be possible to ask Human Resources to provide a breakdown of the reasons for leaving.

The Panel considered the issue of safer care and in response to questions regarding what type of confidential breaches occurred and how serious incidents were graded, Jeremy Vanes confirmed that in the majority of cases it was paper documentation and it often involved younger members of staff who were not so aware of dealing with paper documentation.  The increase in number could be because several GP surgeries had been added.  At present he did not have a breakdown of how incidents were graded; however, that information could be provided at a future Panel meeting.

In respect of numbers and themes of Never Events, Jeremy Vanes and Ros Jervis, the Service Director for Health and Wellbeing confirmed that although those were extremely serious events, the outcomes for patients was usually not serious.  Nevertheless, given the serious nature, every effort was made to ensure that those events were kept to a minimum.

The Panel considered the issue of patient experience, including the complaints procedure, how those complaints were investigated plus outcomes.

In answer to a question regarding the number of days given to process a complaint, Jeremy Vanes confirmed that the timescale had been increased from 25 to 30 days as previously the 25-day timescale had been breached by one or two days.   

Jeremy Vanes referred to the Summary Hospital-Level Mortality Indicator (SHMI) and in particular the steps taken regarding coding for palliative care.  Work was still required on the reasons for data and coding choices and it was hoped that national protocols would be available by the end of the municipal year and it would be an appropriate time for scrutiny.

Dr Isabel Gillis confirmed that Healthwatch would be commenting independently on the report and would circulate those comments to the Panel.

The Chair confirmed that a statement would be drafted and circulated to members of the Panel and agreed by the Chair and then forwarded to the Trust.

The Panel thanked Jeremy Vanes for his report and contributions to the discussion.

Resolved:

1. That the report be noted.
2. That the Chair forward a statement in response to the document.
3. That the comments from Healthwatch be circulated to the Panel when available.
4. That a breakdown of reasons why staff were leaving would be circulated to the Panel when available.
5. That a breakdown of how serious incidents were graded and near misses be circulated to the Panel when available.
6. That the possibility of scrutinising the Summary Hospital-Level Mortality Indicator (SHMI) and in particular the steps taken regarding coding for palliative care at the end of the municipal year be considered at a future meeting.