Care Quality Commission Progress Report Hertfordshire Health Scrutiny Committee 13 December 2018
Our ratings
Results for our hospitals
Ratings for the Lister
Ratings for the New QEII
Ratings for Mount Vernon
Hertford and Community Services unchanged
Actions taken by the CQC Improvement notices issued for • Surgery at the Lister • Urgent Care at the New QEII Requirement notices around • Infection prevention and control • Safe care and treatment • Good governance staffing • Fit and proper persons employed
Outstanding practice • Emergency department alerts system • Emergency department streaming system • Band 6 nurses and early sepsis treatment • RAID team • Twins and multiple births association rating • Research at MVCC • Pharmacist chemotherapy service
New ‘Use of Resources’ report ~ Requires improvement Work to do around • Lorenzo • Performance • Consultancy • Medical staff costs • Collaboration • Non-pay costs • Staffing • Financial delivery of plans
CQC – the issues • Effective oversight and learning from incidents • Surgery and QE2 Urgent and Emergency care • Quality Governance • Local management of risks • Medicines management • MVCC Safe Effective Caring Responsive Well-led Overall Requires Surgery Inadequate Good Inadequate Inadequate Inadequate improvement New QEII Requires Inadequate Good Good Inadequate Inadequate urgent care improvement
CQC – the progress • CQC working group with clear action plan reviewed monthly • Reviewed and addressed Divisional Quality Governance arrangements • Strengthened leadership at QE2 (nursing and clinical leads) and reviewed assessments in line with Lister practice, part of Daily site meetings • New leadership in Surgery and implemented check list of key issues for ward rounds • Progress tested via Internal/ external inspections • MVCC – MSH patients relocated to ward area, positive visit by HealthWatch Hillingdon • Quality Transformation Program
Our Quality Transformation Programme Quality Strategy 2019 - 2022
valuing the basics • Where is the Trust in terms of quality? • What are the key areas of focus for the coming year? • Harm free care • Infection prevention and control • Medicines safety and management
Keeping our patients safe • Where is the Trust in terms of quality? • What are the key areas of focus for the coming year? • HSMR/SHMI – consistently reducing year on year Deteriorating patient, sepsis • • Safer surgery collaborative • Maternity and neonatal safety & Better Births Discharge summaries and GP hotline • responsiveness • Clinical Harm Process
Quality Governance & risk – the progress • Review TOR of Quality and Safety Committee • Reviewed Quality Governance structure beneath Q&S Committee - patient experience, clinical effectiveness & patient safety • Reviewed the structures for corporate and clinical governance teams - significant investment approved to deliver new structures • New and refreshed Quality and Safety Dashboard from ward to board • Improved reporting culture • Development of integral learning system and QI framework
Patient experience • More patients than ever would recommend our services • Nationally recognised for the work we do to support Carers • Improving picture in national patient experience, ED and maternity survey results • Poor cancer patient experience survey • Increase number of formal complaints • Turnover in complaints team • Integral to trust wide learning for continuous service improvement
Next steps • Quality Assurance Visits – continue to test and challenge • New Trust clinical strategy underpinned by culture work to be approved by the Board in January • Development of Quality and Safety Dashboard and IPR • Development of a quality strategy – 2019-2022 • Continue to expand on development of safety culture and staff engagement
• Thank You • Questions
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