Tom Taylor Chief Executive

31st July 2008

TRUST BOARD

Appointments

• Cynthia Bower, appointed Chief Executive of the Care Quality Commission (Healthcare Commission + Commission for Social Care Inspection and the Mental health Act Commission)

• Peter Shanahan appointed Acting Chief Executive of WM SHA

• Wilf McSherry appointed Professor of Dignity and Patient Care-joint appointment with the University of Stafford

• Paul Tully appointed Director of Commissioning and Strategy Shropshire County Primary Care Trust

• Valerie Beint Appointed Director of Community Services for the new Unitary Authority

Darzi Review

• Interim Report Received by PCT Boards

• Presentations made to Councils and Joint Overview and Scrutiny Committee by 4 CEOs

• Joint Senior Responsible Officers Appointed (JC & SC)

• Monthly meetings with WMSHA commenced

• First Stage Proposals to be finalised by October

Key FT Milestones

• IBP re-submission to SHA/DH 29th August• LTFM submission to SHA/DH 30th September• HDD begins 1st October• HDD to report 30th October• Submission to DH Applications Committee November• SoS approval by 30th November• Monitor 1st January 2009• Governor Elections January 2009• Authorisation approved by 31st March 2009

Workflow

• WM SHA Review of Ambulance Turnaround Times

– John MacDonald/ Trish Curran to Lead

– Meeting with 10 Acute Trusts (including SaTH)

– Meeting with 3 PCTs (2 Birmingham 1 Stafford)

• Over 30 minute waits – ambulance drivers system

April 07 May 08

RSH 24.1% 11.0%

PRH 28.6% 11.5%

Worst 46.5% 38.6%

Workflow

• 98% A&E target achieved for 11 consecutive weeks but needs to be 98.5% to build “headroom” for winter

• All three cancer targets achieved but application of two week urgent referrals and complication of diagnostic decisions to be reviewed

• Outpatient referrals

– data issues being resolved

– new referrals above plan

– definition of consultant to consultant referrals?

Workflow

• Theatre Utilisation - high percentage of patient DNAs/ cancellations = lost time/ operating slots

• 18 week RTT – some challenged specialties

– December national target will be achieved

– September SHA milestone could cause serious financial problems due to additional out of hours clinics and operating sessions

– Short term measures i.e. waiting list initiatives not sustainable in the longer term

External Inspections - HCAI

• DoH monitoring team very positive praise for all staff – back to SHA/ PCT monitoring

• MRSA 2 cases April – June - Target 6 – last year 13

– 2007 70% hospital 30% pre 48hr

– 2008 70% pre 48 hr 30% hospital

– Only 1 elective case June 2007 – June 2008

• CDiff 38 cases April to June – Target 57 – last year 80

• CDiff infection control policy updated and issued

• Review of death certificates including CDiff undertaken

• Infection Control Development Plan 93% compliant

0

5

10

15

20

25

30

35

40

Apr-07 May-07 Jun-07 Jul-07 Aug-07 Sep-07 Oct-07 Nov-07 Dec-07 Jan-08 Feb-08 Mar-08 Apr-08 May-08

MRSA Bacteraemia

Cdiff

Linear (MRSABacteraemia)Linear (Cdiff)

Central line insertion audits

Hand hygiene audit

Clinell wipes introduced

Wards responsible for RCA on bacteraemia

Introduced Tristel for daily/terminal cleaning

Peripheral line audits

Cdiff HII audit

24 hour testing for cdiff

New beds & commodes

Antibiotic pharmacist 2 afternoons a week RSH

Productive ward programme

Launch of Yr3 CleanYourHands

Daily review of cdiff patients at RSH by wd22C doctor

Introduced Tristel cleaning toilets & bathrooms.

Weekly Consultant Microbiologist treatment review of cdiff patients RSH & PRH.

Antibiotic pharmacist PRH

RSH MRSA screening e/a’s

Cohort ward opened RSH

Daily CSM meeting with IC team

MRSA Cdiff care pathways introduced

Chloraprep introduced

Introduction of data packs from REW.

CVC ongoing care

MRSA and C Diff Related Activity

External Inspections

National Patient Safety Agency

• Environment (cleanliness) Excellent Excellent

• Food Quality Excellent Excellent

• Privacy & Dignity Excellent Excellent

Second year running all 6 Excellents

Healthcare Commission Hygiene Code

• 2 Green 1 Amber

• See Matron’s Report

RSH PRH

External Inspections

OFSTED Joint Area Review Shropshire Childrens Services

• Partnership between Social Care, Education and Health Services praised

• Some training issues which are being addressed

PRH Catering awarded Platinum Level for Healthy Eating by T&W Council

• Food hygiene compliance and management

• Smoke free dining

• Breastfeeding provision

• Promotion and provision of healthy eating options for patients and staff

External Inspections

Midwifery Local Supervising Authority Report

“Most pro-active and collaborative team of supervisors in the sector”

“Supervisory team is made up of strong individuals whom are regarded to be innovative and dynamic leaders”

“Within the team it is also clear that there is a spectrum of expertise and values that are strongly held”

“Everyone was most welcoming and friendly and the catering was excellent at both sites”

External Inspections

“Supervision is alive and positively thriving, with supervisors and midwives taking a proactive role in planning, provision and delivery of maternity services. They are to be congratulated!”

• Highly Commended for promoting the Normality of Childbirth by All Party Parliamentary Group on Maternity

Other Issues

• Severn Hospice officially opened by Princess Alexander – MB in attendance

• Chris Beacock (Divisional Director and Consultant Urologist) completed sponsored bike ride in Sicily – raised over £3,000

• NHS 60th Birthday Bike Ride and other events

Other Issues

• Severn Hospice officially opened by Princess Alexander – MB in attendance

• Chris Beacock (Divisional Director and Consultant Urologist) completed sponsored bike ride in Sicily – raised over £3,000

• NHS 60th Birthday Bike Ride and other events

• Productive Ward rollout continues – Brian Bennett letter

• Medical Staff Productivity Review commenced – Ernst and Young

• Cost Improvement Programme Review commenced - KPMG