Stephen Ward, University Hospitals Trust, will give a presentation on the Getting Into Shape and Next Stage Review.
Tim Rideout, briefly explained the next steps in relation to the Next Stage Review. This included the following:
It was also stated that healthcare services were approaching a period of political and financial uncertainty, therefore it was essential that any proposals be resilient and robust.
Malcolm Lowe-Lauri also reported on the progress towards Getting Into Shape. Specifically, consistently low infection rates, improvements to financial governance, the implementation of a new senior staffing structure, and new Committee based governance arrangements were outlined. The results of the Auditors Local Evaluation were also referred to, including the key areas of criticism and how these would be addressed. The organisational priorities for 2009/2010 were also mentioned, where it was stated that there was to be an emphasis on patient experience and valuing and supporting staff.
Members of the Committee raised concerns in relation to the reduction in research monies provided by Government and questioned what action had been taken to account for this reduction in funding. It was explained that the Department of Health were responsible for the allocation of research based funding, that the funding previously provided for research was being phased out under the Best Research Best Health Strategy, that a strategy was in place for replacing lost funding by way of improving the research and development profile of University Hospitals Leicester, and that the funding gap stood at £2m.
Malcolm expanded further on the Nest Stage Review, and in particular on the next steps. It was stated the ‘Darzi’ principle of local where possible, central where necessary was applied when considering any proposed changes to service provision, and that it was important to balance choice and critical mass. Members were also informed of the UHL Central and UHL Local models of service provision. In relation to UHL Local, the intention to develop non-specialist care more locally was outlined. In relation to UHL Central, in some cases UHL were not equipped to provide all aspects of care, particularly in relation to Spinal or Head injuries, and therefore a more strategic outlook was required which involved working in partnership with neighbouring providers in the short term and also developing a plan for longer term provision at UHL sites.
Members of the Committee raised questions in relation to patient transport and in particular transport to other hospitals outside of Leicestershire and the possible risk to life. Members were informed that the aim of the patient transfer service was to stabilise patients during the journey, but that the demise of the patient during the journey could not be eliminated, although reducing journey time as much as possible reduced the risk to patients.
A Member of the Committee also raised concerns about an instance where a patient had to be transferred to a Nottingham hospital to receive cancer treatment. It was stated that this presented accessibility issues, and questions were raised about what steps had been taken since to address this. In response, it was stated that in order for cancer services to be delivered competently the national guidance suggested that children’s cancer treatment services needed to treat at least 80 cases per year. It was confirmed that Leicester hospitals treated approximately 30 cases per year, and Nottingham hospitals treated approximately 60 cases per year, which presented a risk to both hospital trusts that the licence to offer children’s cancer services would be lost. Consideration was being given to bringing the institutions together as a virtual organisation to meet guideline requirements but in the short term some complex cases would be referred for treatment in Nottingham. All patients referred for treatment were consulted with in advance.
A Member of the Committee raised the issue of mixed sex wards and the position of the provision in Leicester. In response it was confirmed that in 2008/2009 the Trust would not have met the required target in two or three wards. This had been resolved in most non-acute areas. The trust was required to extend this to acute areas, which presented additional challenges.
A Member of the Committee raised the issue of outsourcing services within University Hospitals Leicester. In response it was confirmed that consideration was being given to outsourcing sterile services as internal services failed to meet minimum European standards. The Department of Health had provided guidance on the National Procurement Process for outsourcing to external organisations, which included comparing private bidders against a public sector comparator, that is making sure that the external provider could provide the service to a better standard than that achieved through internal provision.
A Member of the Committee raised the issue of Consultants working patterns, and specifically questioned whether the working patterns included weekends. The matter of medical negligence and litigation costs was also raised. In response it was confirmed that Consultants work also included weekends, that it was not clear that medical negligence litigation costs were increasing, and that insurance premiums to cover such claims were rising.
that the presentation be noted.