The East Kent Hospital University NHS Foundation Trust Annual Members’ Meeting took place on 1 October 2015. There were around 130 in attendance, made up of Trust members, members of the public, members of the Council of Governors and Board of Directors, representatives from partner organisations and members of the Trust’s staff. A copy of the attendance register is held by the Trust Secretary.
Trust Directors presented an overview of the Trust’s business in the 2014/15, with an opportunity for questions from the public answered by an expert panel. Prior to the meeting, there was an opportunity to view a number of Trust exhibitions from various departments within the organisation.
A copy of the 2014/15 Annual Report and Financial Statements was made available at the meeting.
Notes of the meeting:
Chair’s welcome and notes of the previous meeting
Nikki Cole, introduced herself as Chair of EKHUFT and went through the order of proceedings for the event as outlined on the agenda.
Nikki was also sorry to report the sudden death of the Trust’s Lead Governor, Brian Glew.
Members of the public endorsed the notes of the previous Annual Members meeting as an accurate record of proceedings.
A review of the previous year
Chris Bown, Interim Chief Executive, provided a presentation outlining the Trust’s key headlines for 2014/15, achievements in the first six months of 2015/16 and the current position, specifically work ongoing to improve services for patients.
Financial Performance Overview including presentation of Annual Report and Accounts
Nick Gerrard, Director of Finance and Performance, provided a presentation outlining the Trust’s financial position during 2014/15. He also outlined the work of the East Kent Hospitals Charity during 2012/13.
A copy of the presentation and annual report and accounts can be accessed through the Trust’s website.
Excellence in Trauma Care
Dr Matt Jones, Trauma Director, and Fernando Candal Carballido, Lead Nurse for Trauma, provided a presentation on the developments of Trauma care in East Kent. The Trauma network for East Kent went live in 2013.
The latest analysis from the Trauma Audit and Research Network showed both the QEQM in Margate and WHH in Ashford providing the best survival rates in the country. This was further evidenced through TARN and national peer reviews.
Report from the Council of Governors
John Sewell, elected Governor, spoke on the work of the Council of Governors. He reminded those present of Governors’ legal and statutory requirements and responsibilities to members of the Trust and members of the public.
During 2014/15, the Council of Governors had successfully recruited new Non-Executive Directors and the new Trust Chair. This work has continued into 2015/16
A number of sub-committees of the Council were in place to take forward key pieces of work on behalf of the Council. John referred specifically to the work of the Strategic Committee in receiving updates and assurance around the Trust’s clinical strategy.
John’s report concluded with a tribute to Brian Glew, recognising his commitment to the Trust and to the Council of Governors.
Panel discussion
A panel convened, consisting of the following members of the Trust:
- Nikki Cole, Chair
- Chris Bown, Interim Chief Executive
- Nick Gerrard, Director of Finance and Performance
- Paul Stevens, Medical Director
- Richard Earland, Non Executive Director
- Matt Jones, Trauma Director
- David Hargroves, Chair of the Improvement Board
- John Sewell, Governor
The following questions were asked by members of the Trust and /members of the public. The responses were noted.
The Spencer Wing was purchased by the Trust in April 2008. In light of the forecast deficit for 2015/16, would the Trust consider selling this unit?
Chris Bown responded it was not the right time commercially to sell the private patient services. The Trust was currently reviewing its private patient strategy to maximise investment into NHS services.
Nick Gerrard added the current income from the Spencer Wing equated to less than 1% of the Trust’s overall income. There were a number of private patient providers across the geography of East Kent and this would need to be considered as the private patient strategy was developed.
When the Kings Hospital helipad is fully functional, would the Trust be designating QEQM as a trauma unit?
Matt Jones referred to the geographical challenges within east Kent, specifically the distance from Thanet to London. In developing trauma services, every effort had been made to ensure residents were not disadvantaged. The data presented at today’s meeting evidenced that care was being provided to the highest standards.
Work was ongoing with the helicopter emergency medical service (HEMS) and the South East Coast Ambulance service (SECAMB) to establish standard operating procedures for managing patients at QEQM.
Current facilities at QEQM equal that of WHH and staff on both sites receive the same training opportunities.
Why is the Trust still cancelling appointments by telephone 24 hours prior to procedures?
Paul Stevens responded he would be pleased to look into specific details. Cancelling clinics with 24 hours’ notice is not something any consultant or clinician would want for their patients.
As a general principle last minute cancellation of appointments should not be occurring unless completely unavoidable.
How is the search for a substantive Chief Executive progressing?
Nikki Cole was pleased to report the Trust had gone out to advert for a substantive Chief Executive and it was anticipated interviews would be completed by the end of October 2015.
A reference was made to the regional health authority structure 17 years ago where it was quoted at the time East Kent could not sustain three hospital sites. A further reference was made to current Trust documentation which states there were no plans in the short term for service reconfiguration but going forward the Trust would need to make difficult decisions to secure long term clinical and financial sustainability. A request was made for the Trust to share draft options as soon as possible to end uncertainty.
Chris Bown responded the Board of Directors was becoming increasingly aware that maintaining three acute rotas on three sites was clinical unsustainable. Hospital clinicians were working with GP colleagues to look at options but were not yet at a stage to share these as part of a consultation process. He added that the majority of challenges faced by Trusts across the country are exactly the same as the challenges we face. It was important to secure safe and effective healthcare for the population of East Kent.
The CQC report published in 2014 reported caring as ‘good’ but raised significant issues around leadership. It was important that the Trust’s future plans had direct links to the reasons why the Trust was placed in special measures. A specific reference was made to gaps in rotas identified by the CQC as ‘unsafe’. Reassurance was requested around the safety of surgery in east Kent.
Chris Bown reminded members of the public of the reasons for the Trust’s regulatory rating which was a consequence of the CQC report published in 2014. The report highlighted a range of cultural and quality issues. Since the report had been published, the majority of the Board had been refreshed.
Paul Stevens reported he was a clinical adviser to the CQC and reminded members of the public of the way in which the CQC rate hospitals within the domains of Safe, Caring, Responsive, Effective and Well Led.
Paul went on to report that although the Trust’s mortality rating was 20% better than the rest of the country the Trust understands that this simply means we have fewer avoidable deaths than other hospitals and that we should continue to seek to improve all aspects of patient safety.
Paul made a specific reference to a National Emergency Laparoscopy Audit which demonstrated an improving picture. The report concluded Queen Elizabeth the Queen Mother Hospital to have excellent mortality outcomes, one of the best in the country. The William Harvey Hospital reported better than average outcomes, again an improving picture.
However, the Trust was not complacent and work continues to improve quality improvement processes and reduce unavoidable deaths.
David Hargroves added, as Clinical Chair of the Trust’s Improvement Board, that the Trust’s improvement programme incorporated all recommendations from the CQC, including actions to resolve the disconnect between management and clinical staff. A number of programmes were in place which had started to evidence improvement.
The 111 service should be properly informed of services available to the public so they can be appropriately directed to reduce the burden on acute sites.
Paul Stevens referred to the vision of NHS England for three different centres to direct patients to: Urgent Care Centres which are led by primary care; Emergency Centre Hospital providing acute medical and surgical services; and Emergency Centre Hospital with specialist services. With this in mind, integration was important.
Simon Perks, CCG Accountable Officer, informed members of public of the work ongoing to develop services within primary care with the aim of avoiding admission to hospital. He agreed it was important to direct patients to the most appropriate service first time. It was anticipated more locally focussed services would be in place by April 2016.
Is the new planned CT (PET) scanner in addition to the current CT scanners in place within the Trust?
Chris Bown confirmed this to be the case.
The panel was asked if the Trust was satisfied with the management of information systems. Properly managed systems, and availability of site based data, would support day to day management decisions.
Chris Bown agreed that individual hospital data was important, rather than aggregated data. The Trust was continuously developing its information systems.
Nikki Cole, Chair, thanked all members of the public, staff and representatives from key stakeholder organisations for attending the meeting.
October 2015
