Agenda item

Presentation by Avril Lowery, Director of Quality Governance and Dr Chris Lanigan, Head of Planning and Business Development

Representatives from Tees, Esk and Wear Valley NHS Foundation Trust (TEWV) presented the Quality Account 2020-21 which provided an update on performance against their quarterly priorities for 2020-21, and sought to engage with the Committee in respect of their emerging priorities for 2021- 22.

 

The Committee welcomed the opportunity to consider and comment on the quality of services at the Trust and the key features of the 2020-21 Quality Account. The Committee had met previously with the Trust representatives to consider the Trust’s quality priorities and overall performance.

 

·         The committee was concerned at the high number of incidents of physical intervention / restraints, as Tees had the highest number of incidents per 1000 occupied bed days (OBD’s) with 43.64 against the Trust target of 19.25. Previously the committee was advised that the high rates of restraints in Teesside were as a result of the eating disorder service being provided in the area and the use of nasogastric feeding. However, the service is no longer delivered on Teesside and the rates remain high.

 

·         The committee was advised that Learning Disability services still have high levels of physical intervention / restraints although a number of initiatives were in place to address this issue. These include the introduction of Positive Behaviour Support (PBS) Leads and investment in staff training and qualifications.

 

·         The committee was very keen to see significant change in this area and looks forward to seeing the RAG rating for this metric change from red to amber and then green.

 

·         The committee was also concerned that staff were not always giving dignity and respect to patients. The end of 2020/21 position was 84.59% against the Trust target of 94.00%. All localities underperformed in 2020/21, although Teesside were closest to the target with 88.62%. The committee acknowledged that progress had been made but was keen to see further improvement in this area.

 

·         It was acknowledged that the launch of the ‘Big Conversation’ and the Trust’s ‘Journey to Change’ highlighted TEWV’s commitment to improving the patient experience and was a very welcome and positive development. Through this work TEWV had purposefully engaged with patients, carers, staff and partners and sharpened its attention and focus on areas for improvement. The committee was also pleased to see the inclusion of ‘Compassionate Care’ as a quality account priority for 2020/21 and looked forward to seeing improvements in respect of this metric. 

 

The Quality Account Priorities for 2020-21 were identified as below.  Two of the three were continuing priorities from the previous year.

 

·         Making Care Plans more Personal

·         Safe Care

·         Compassionate Care (new for 2020-21)

 

The priorities were supported by the Committee. Members welcomed the updates on progress made to date and made the following observations and comments:

 

Progress:-

 

·         The Trust’s open and honest response to concerns raised by the CQC was appreciated. The Trust had listened and taken on board people’s views in response to the CQC’s findings.

·         The notion of the ‘Big Conversation’, its extensiveness and involvement of a wide variety of stakeholders was very much welcomed and viewed as a key initiative.

·         The need to embed and extend the provision of ‘Compassionate Care’ at every level and across the system was acknowledged. 

·         The Oxehealth Digital Care Assistant initiative undertaken to help prevent people in in-patient settings trying to commit suicide had been a very positive step.

·         The introduction of the IT system Dialog offered reassurance around the future delivery of personalised care planning. 

·         The ‘Journey to Change’ would take time and it would not happen overnight but the notion of the journey and the areas identified for improvement were fully supported. 

·         The simplicity of the priorities for 2021/22 were acknowledged. The priorities were easy to remember and understand.

 

Concerns:-

 

·         The huge geographical footprint covered by TEWV and the differences in the socio-economic make-up of the areas served.

·         Recruitment and retention of staff at TEWV remained an issue and was impacted upon by both the national and regional shortages of mental health professionals. There were also concerns in respect of the availability of local training provision.

·         The CQC had raised concerns about care planning and risk management practices and it remained an area for improvement for TEWV.

·         The huge challenges presented by the COVID-19 pandemic and how these would be met in addition to those already faced by the Trust remained a concern.

·         The potential for there to be a huge increase in demand for children’s mental health service provision would also pose a real challenge in 2021/22.

·         The trauma and bereavement which people had experienced as a result of COVID-19 had generated a need for additional proactive work and increased investment in this area.

 

On a more general point the Committee felt there would be benefit in producing an easy read version of the Quality Account document, as this would allow it to be shared more widely and easily. The Committee thanked the Trust for its continued and pro-active engagement with the Committee and looked forward to continuing to receive updates on progress against the priorities during the year ahead.

 

AGREED that the Tees, Esk and Wear Valley NHS Foundation Trust Quality Account 2020-21 be noted and the Committee’s comments submitted as part of TEWV’s consultation on the Quality Account.