Agenda item

Ian Bennett (Deputy Director of Quality and Safety for South Tees Hospitals NHS Foundation Trust) will be in attendance to lead the presentation of the Quality Accounts document 2021-2022.

A number of representatives from South Tees Hospitals NHS Foundation Trust were in attendance to provide the panel with an overview of the Trust’s Quality Accounts document for 2021/2022.

A presentation was given and Members were advised it was hard to overstate the impact Covid-19 had had on acute hospital services. At its peak 1 in 15 staff members were out of action because of Covid and since the start of the pandemic South Tees Hospitals NHS Foundation Trust had cared for over 7000 Covid-19 patients. This in turn had resulted in a real emphasis being placed on clinical recovery for all of the planned work that had not been taking place at the height of the pandemic.

In respect of the level of investment in the digital strategy it was advised that over £8million had been invested resulting in the removal of over 5 million paper records, which would hopefully enable staff to spend additional time with patients.

Reference was made to the work undertaken by the Trust to strengthen its approach to nutrition and hydration and it was advised that snacks and drinks were now available to patients 24 hours a day. In terms of the transfer of care hub, which had been creased with local authorities the Trust was really proud of the work undertaken with Redcar & Cleveland Borough Council, North Yorkshire County Council and Middlesbrough Borough Council.

In respect of the Trust’s current position it was advised that it had recently seen an increase in the number of Covid-19 cases. The main impact had been on people over the age of 75, who had weakened immune systems. It was therefore imperative that the booster programme was widely available, as any increased in community infection rates led to increase in the number of hospital admissions.

Coming out of the height of the Covid-19 pandemic the Trust had revisited visitor arrangements and from 12 July 2022 visiting times had returned to normal – 2pm to 4.30pm and 6pm-8pm on a daily basis. Precautions were, however, still in place and visitors were still wearing masks in high risk areas.

It was emphasised that the staff remain the Trust’s biggest asset and from very early on in the pandemic experienced clinicians took charge. The hospital sites were divided into Covid and non-Covid pathways and the Trust had some of the lowest Covid hospital infection rates in the country. Over the last year 130,000 inpatients had been cared for, 62,000 had been undertaken – with 43,000 of those having been planned operations, which was just as important as urgent care. In the last 2 years 10,000 babies had been delivered and the Community Teams had delivered 2.3million home visits. The Doctors, Nurses and Midwife Teams were fantastic, as were the Estates Teams in ensuring all of the facilities were well managed.

The point was made that it was fantastic that the Trust had been named as one of the top two most improved Trusts in the country for the second year in a row, in the NHS Staff Survey, Staff had commented that they had every confidence in recommending our hospitals and it was hoped that the Trust could build on this momentum.

The Trust had invested significantly in a patient safety culture and the reporting of incidents had increased. However, despite the increased reporting the number of serious incidents had decreased. A very positive message about patient safety was being driven Trust wide.

With regard to the quality priorities it was noted that these focused on three domains, namely – Safety, Clinical Effectiveness and Patient Experience. In terms of safety the Trust was on an improvement journey in relation to all aspects of quality and there was a real focus on further reducing pressure damage and Clostridium Difficile infection rates, as well as delivering evidence based care through audit. In relation to patient experience it was advised that the area of focus for 2022/23 would be a patient’s experience of discharge.

Finally reference was made to the Cancer Institute’s patient experience survey undertaken in 2021 for James Cook hospital, the results of which had only recently been published. It was highlighted that the scores achieved by the Trust had been fantastic and there had been five areas (as highlighted in the presentation) in which the Trust had scored particularly highly. It was noted that everyone was really pleased with the results, as patient feedback was extremely important.

Members of the panel were afforded the opportunity to ask questions about the Quality Accounts 2021/22 document and the presentation. The following points were raised:-

A Member of the panel congratulated the Trust on keeping standards up over the last three years and ensuring many elected surgery appointments had been kept. However, the Accident and Emergency department had recently seen seven and a half hour waits, with patients in corridors and the department becoming a bottleneck. It was queried what action was being taken to resolve this problem. It was acknowledged that there were significant pressures in the Accident and Emergency department including delays with ambulance handovers. This issue was high on the Trust’s radar and an enormous amount of work was being undertaken. Efforts were being made to streamline processes through agreements between the Accident and Emergency department and other key clinical partners. In addition some fantastic work was being undertaken through the transfer of care hub to ensure beds were available to help get people out of hospital as quickly as possible. Reference was also made to the role of Urgent Treatment Centres in freeing up time and capacity. The whole system was working together to improve care pathways.

In relation to the work undertaken by staff at the Trust in relation to Covid-19 a Member of the panel advised that Middlesbrough’s population could not thank staff enough for the work undertaken.

Reference was made to the current situation with regards to symptomatic breast screening and whether this service had continued to be delivered throughout Covid-19 from North Tees Hospital. In response it was advised that although this had been the case patients referred to North Tees were receiving good outcomes and the service delivered a ‘one stop shop’ in terms of diagnosis. Work would be continued to ensure that all Middlesbrough patients were able to access the service.

AGREED that the South Tees Hospitals NHS Foundation Trust 2020/2021 Quality Account document be noted by the panel.