Agenda item

(To receive a report from Caroline Walker, Deputy Chief Executive, North West Anglia NHS Foundation Trust, which provides an update to the Committee on key areas of development at the North East Anglia NHS Foundation Trust since its formation on 1 April 2017)

The Chairman welcomed Caroline Walker, Deputy Chief Executive for the North West Anglia NHS Foundation Trust to the meeting.  The Committee received an update on key areas of development at the North West Anglia NHS Foundation Trust since its formation on 1 April 2017, which oversees the running of Stamford and Rutland Hospital, Peterborough City Hospital (PCH) and Hinchingbrooke Hospital in Huntingdon.

The Committee was advised of the following during the update:

·         It was hoped that members were reassured with the developments taking place that Stamford and Rutland Hospital was still key part of the Trust's offer.

·         A base for the Trust had been created which reconfirmed its commitment to that site so that services were where patients needed them.  It would also be a base for the South Lincolnshire Neighbourhood Team as there was space for everyone to work from Stamford, re-affirming the commitment to treat patients locally.

·         Members were advised that the merger had taken place in April 2017 and there was a 5 – 10 year plan to deliver all the benefits.

·         Staff were working to deliver benefits and one of the main benefits was about maintaining clinical services across all sites.  This was the main focus of a lot of the work, and there had been no deterioration in performance of any of the services as a result of the merger.

·         Some clinical benefits had been delivered already, but some would take longer to deliver.

·         It was reported that the hospital were working together and so some of the services could be integrated.  It was noted that some of the clinical teams had been integrated so that clinicians were moving between sites instead of patients.

·         Members were also advised that workforce remained one of the biggest issues and the Trust was trying to recruit internationally as well as within this country.

·         It was reported that the planned first year savings would be achieved, mainly from efficiencies to the back office function.  There was a commitment to make no savings from clinical services.

The Committee was provided with the opportunity to ask questions of the officers present in relation to the information contained in the report and some of the points raised during discussion included the following:

·         In relation to the minor injuries unit, it was queried how well it had performed, and members were advised that it did treat every patient within four hours 100% of the time.

·         In terms of workforce, it was reported that the Trust was approximately 150 nurses short of where it wanted to be (around 2,000 nurses in all) so there was about a 10-15% vacancy rate.  The Committee was reassured that shortfall was being covered through agency staff, bank staff and overtime.  However, this came at a premium in terms of cost.  It was also noted that there were 56 consultant posts vacant.  It was noted that this was not a general shortage, as some areas were fully established, but there were some types of doctors who were difficult to recruit.

·         It was commented that it was refreshing to have a positive statement coming through and there were a lot of people in the Grantham area who would opt to go to Stamford or Peterborough hospital for treatment.

·         It was noted that referrals had gone up by 10% for the south of the county.

·         Members were supportive of the inclusion of local people and users of the services as community representatives in the governance structures.

·         In terms of finance, it was noted that when the sites merged there was £11million of debt, and it was expected that the Trust would make £9million of savings.  Members were advised that every Trust had to deliver savings, and it was hoped that the £9million would be saved through changes to back office functions.

·         It was noted that the total revenue budget for the whole Trust was £418 million, and a £42million deficit was expected for the year.  However, members were informed that Peterborough was reducing its deficit every year, and this was one of the commitments from the Board.  The aim was for the deficit to be at £32million for the following year.  The costs associated with covering the vacancies were having a major effect on the budget.

·         In terms of the staffing issues and the reliance on Locums, it was noted that the vacancies were not being filled due to a lack of skills, but that doctors found it more beneficial to work as locums.

·         It was queried whether there was a lot of opposition to the merger, and it was acknowledged that there was some, but this was due to a misunderstanding that the Stamford site might close. 

·         In relation to the 62 day referral for cancer care targets which was falling marginally short of the standard, members were advised that the initial referral was always within two weeks, and it was after this that the 62 days commenced, but patients would then need to have all relevant tests, screenings and start treatment for recovery.  In the vast majority of cases this target was able to be met.

·         It was queried whether Thames Ambulance Service delivered any patients to the Trust's sites and it was confirmed that it did provide non-emergency patient transport for Lincolnshire patients and that some problems had been experienced.

·         It was queried what effect the repayment of the PFI had had on budgets.  Members were advised that of the £20 million deficit Peterborough had, £15million of that was due to PFI.  It was noted that there were another 26 years left and then Peterborough City Hospital would be owned by the NHS.  It was acknowledged that there were risks and benefits to PFI. 

·         In relation to PFI, it was confirmed that work was underway to ensure that the cost of this was recognised in the way the Trust was funded, and it was acknowledged that some subsidy had been received.

·         It was queried how the issue of it being more attractive to nursing staff to work for an agency rather than the NHS directly could be tackled.  It was noted that work was underway to try and address this with a three year pay award and recruiting into training.

·         It was commented that for doctors, being a locum was not always the best option as there could be significant insurance costs, as well as agency fees.

The Vice-Chairman proposed that the Deputy Chief Executive of the North West Anglia NHS Foundation Trust be thanked for her presentation and that she come back to a future meeting to keep the Committee informed of progress.

RESOLVED

            That the Committee receive a further update on developments at the North West Anglia NHS Foundation Trust at a future meeting.