SOMERSET PARTNERSHIP NHS FOUNDATION TRUST

MINUTES OF THE PARTNERSHIP TRUST CONFIDENTIAL BOARD OF DIRECTORS’ MEETING HELD ON 26 SEPTEMBER 2017

AT FROME COMMUNITY HOSPITAL, MOXON SUITE, ENOS WAY, FROME, BA11 2FH

PRESENTStephen LadymanChairman

Liz SimmonsNon-Executive Director

David AllenNon-Executive Director

Barbara Clift Non-Executive Director

Phil Dolan Non-Executive Director

Jan Hull Non-Executive Director

Barbara GregoryNon-Executive Director

Dr Nick Broughton Chief Executive

Phil Brice Director of Strategy and Corporate Affairs

Sue Balcombe Director of Nursing and Patient Safety

Andy Heron Chief Operating Officer

Pippa MogerDirector of Finance and Business Development

IN ATTENDANCE

Lee Cornell Associate Director - Strategic Planning and Performance.

Karen ProsserAssociate Director Commercial and Business Development

Dr Lucy KnightInterim Deputy Medical Director/

Peter Lewis Chief Executive Taunton and Somerset NHS Foundation Trust Tracy Evans Project Service Director Community Services

Dawn Dawson Deputy Director of Nursing and Patient Safety

Lucy BubbDeloitte

Rupinder SinghDeloitte

RiaZandvlietSecretary to the Trust

19. / PROPOSALS IN RELATION TO COMMUNITY HOSPITALS
It was agreed to bring this item forward on the agenda.
The Director of Nursing and Patient Safety and the Project Service Director Community Servicespresented the report which set out the recruitment, patient safety and operational challenges experienced by the Trust’s community hospitals and proposals to temporarily consolidate the existing 222 beds on a reduced number of sites.
The Deputy Director of Nursing advised that a review had been undertaken and as part of this review a range of factors that impacted on the provision of inpatient care provided by the Trust had been taken into account. These factors included staffing; local factors –performance against clinical care indicators and environment - and the wider system impact. The report set out the findings of this review and recommendations to temporarily close inpatient activity at Chard, Shepton Mallet and Dene Barton community hospitals. It was stressed there will not be an overall reduction in beds as beds will be consolidated in other community hospitals.
The Board discussed the report and commented/noted that:
  • the findings of the review had been shared immediately prior to the Board meeting with the Somerset Clinical Commissioning Group (CCG) who had recognised that the current position was unsustainable and that urgent actions were required especially in view of the upcoming winter pressures and a possible impact of last minute temporary bed closures on the overall Somerset health system. The CCG supported the actions to be taken by the Trust and had expressed their support for the issues and proposals to be taken at the recent Health Overview and Scrutiny Committee meeting;
  • Shepton Mallet community hospital – the Trust was a sub contractor within a joint venture arrangement with Care UK and a temporary closure of the inpatient beds would have to be agreed with the CCG and Care UK, and this would require a contract variation. It was noted that Care UK were aware of the staffing and patient safety issues and they had been kept up to date with the latest developments. Care UK had been supportive of the Trust’s actions but had requested a letter from the Trust to enable them to further discuss this with the CCG;
  • the CCG will be developing a clinical commissioning strategy and it was queried whether the CCG would accept any proposals for temporary closures until the strategy had been developed and a consultation document produced. The Deputy Director of Nursing advised that the current staffing and patient safety position required immediate actions;
  • the STP work streams had looked at viable solutions and options and a new model of care was being developed by the Out of Hospital Care Group. It was noted that the Chard Development Group had also looked at possible solutions and options as it was recognised that a bespoke model may need to be developed for the Chard area;
  • an impact assessment of the proposed temporary closures will need to be undertaken;
  • the 222 inpatient beds were contracted but the contract did not state where the beds had to be provided. Bed numbers needed to be balanced to support patient flows from all of the acute hospitals and the proposed changes enabled escalation beds to be provided in either Williton or Wincanton community hospital. It was noted that the temporary closure at Dene Barton was specifically to enable an additional six stroke beds to be provided at Williton Community Hospital;
  • the proposed changes will result in 30 staff having to be redeployed to other community hospitals or community services and individual discussions had taken place with each affected member of staff. Staff morale in some community hospitals, but particularly South Petherton Community Hospital was low as a result of the considerable pressures and if no action was taken more staff could decide to resign or retire;
  • the STP had not made a decision in relation to the longer term future for community hospitals but staff were keen to see a vision for community hospitals going forward;
  • Leagues of Friends had been informed of the concerns over staffing issues by the Chief Executive and of the fact that difficult decisions had to be made soon;
  • it was stressed that community hospitals will not be closing but that the inpatient activity will temporary close;
  • the aim will be to reopen the temporary closed beds as soon as possible.
Barbara Clift proposed, Sue Balcombe seconded and the Board approved the recommendations set out in section 10. The Board stressed that there was no correlation between the immediate actions to be taken and a longer term community hospital strategy.
The Director of Strategy and Corporate Affairs advised that a meeting had been arranged with the CCG to formally present the Board’s recommendation. The recommendations will also be presented to the Health Overview and Scrutiny Committee’s meeting to be held on 11 October 2017. Communication of the Board’s decision will be key, especially in relation to managing communications with staff, and communication with primary care services and with local communities.