AGENDA ITEM NO: 2012/13/11

UNIVERSITY HOSPITALS OF MORECAMBE BAY NHS FOUNDATION TRUST

COUNCIL OF GOVERNORS MEETING

Date of meeting: / 20 July 2012
Title / Subject: / Issues raised by Governors
Status /
  • Public

Purpose: /
  • To provide responses to issues raised in advance of the meeting

Report of: / Sir David Henshaw
Chair
Prepared by: / Rachael Whitaker
FT Membership Services Officer
Contact for queries: / Rachael Whitaker

Action required / recommendation: / The Council of Governors are asked to:
  1. Note the contents of thr paper.
  2. Raise any issues for discussion.

Supporting Information

Background papers/ supporting agenda items
(if applicabe):
Previously considered by
(if applicable):
Link to UHMB’s objectives (select those objectives this paper supports): / Continuously improve the patient experience - becoming the provider of choice for excellence with safe and effective patient care / Yes
Support and develop all staff to take responsibility for what they do and help them to do their best - getting staff truly engaged in how the trust works / Yes
Encourage staff to be innovative when delivering and planning high quality and sustainable services - achieving long term financial sustainability / Yes
Work with our partners to provide an integrated health service that meets the needs of the local population – providing local access, including to specialist services wherever that is feasible / Yes
Positively contribute to the well-being of the local community / Yes
Link to UHMB’s business plan:
Link to UHMB’s Assurance Framework:
Link to a Care Quality Commission standard(s):
Identification of any statutory / regulatory implications for UHMB:
Public and patient engagement:
Equality Impact Assessed
(if applicable):

Maria Radice

Patients who are being discharged often have to wait hours for their medication/Dressings to take home with them. How is this issue being addressed?

The absence of day rooms on many wards also make waiting around a further problem.

There are a number of actions taking place to address the issue of delays in discharge, these include:

  • Lorenzo facilitating an electronic discharge summary which is accessible immediately in pharmacy on completion by the medical staff.
  • Each ward has a pharmacist to verify the discharge summary and dispense patients own medication on the ward.
  • Only medication not readily available then needs to be dispensed from pharmacy.
  • There are discharge lounges on both Medical Unit One and Medical Unit Two to facilitate a more efficient discharge and earlier availability of beds. The discharge lounges are staffed by nurses who support patients and liaise with pharmacy to ensure timely provision of medications
  • ‘Bed before 10’ has been implemented on Royal Lancaster Infirmary site to ensure a more streamlined approach to discharge and to improve the patient experience by reducing the length of time they need to wait prior to going home.
  • Dressings for any wounds are supplied by the ward, for a period of 7 days, and follow up referrals to district nurses are completed by nursing staff. Provision of dressings is based on the wound care plan, tissue viability nurse advice where appropriate. Patients may not be sent home with the same dressings as prior to admission and may require less dressing changes resulting in fewer supplies being sent.
  • There are day rooms on the majority of medical wards and patients/relatives/carers may utilise these as needed however, we do recognise that often these are not conducive environments for patients and are working with the King’s Fund to Enhance the Healing Environment and plans are in place to create new premises for six wards which are purpose built with patient comfort at the forefront of care.

John Kaye

Lost and/or incomplete Medical notes and Outpatients Clinics communication complaints

The specific issue raised has been passed through to the Customer Care department and Mr Kaye will be kept updated regarding a response.

As a more general update on medical records, The Trust has approved the new storage arrangements as an interim measure to meet capacity requirements prior to the implementation of an Electronic Document Management System (EDMS) next year. EDMS is a complex project requiring a significant amount of planning and it is envisaged that a system will be deployed in 2013. The plan is for all new records to be stored electronically whilst an on demand service will operate for historic documents where a scan of the patient record is created whenever a request is made.

We are currently working with all the divisions in improving how we provide the patient record and asking them to follow the correct tracking and tracing procedures and also to, wherever possible, give the minimum 7 working days’ notice when requesting any records (emergencies excepted of course).

On the Lancaster site the Trust has invested £169k in new facilities that will provide a further 385 linear metres of racked storage that will house an additional 75,000 records.

The extra capacity will enable the transfer of historic records from both FGH and WGH to the new unit, as well as existing records already on site at Lancaster. The new secure storage facility at Lancaster will create greater capacity at FGH and WGH for the most recent patient case notes.

This is a shorter term measure whilst we continue to progress plans for a comprehensive electronic document management system for future management of patient case notes.

John Kaye

Both myself and two member patient complainants have asked for a patient confidentiality waiver “form”, or whatever document satisfies the need, by way of which any member of staff may openly discuss the details of a specific patient’s complaint. Eric Morton confirmed to myself that there is such a document or form that would be made available but at the time of writing, this has this not yet been delivered to any of the requestors. Why is this so?

We are aware of one particular case, where a patient has requested the form stated above and we can confirm that patient has received and acknowledged receipt of this form. Please find a template of this consent form attached.

John Hunter

I have had a concern about the Chaplaincy division of our work. When I was elected a public governor I felt that to be honest in today’s secular age I ought to stand and make it clear that I was a clergyman. To my surprise I came not only top of the poll but three figures before my next competitor. However, some of my constituents had told me that they were voting for me because they wanted to protect the work of the chaplains, for when they were in hospital.

Previously, I had had a bad experience at Lancaster (before the appointment of the present chaplain), then last year when in FGH I asked to go to a service on Sunday and I found that neither the staff nor patients knew that there was no chaplain at Furness General; (much to the embarrassment of the matron). Thus despite the bland assurances in the patient’s handbook it was impossible to get a service in the FGH’s excellent chapel on a Sunday. The Chair has assured me that he is looking into this.

Please find attached a paper which was presented to the Trust Board, providing an update on spiritual care.

Shahnaz Asghar

I first just want to say thank you to Sir David for all his hard work in a time of difficult circumstances.

During the term of my 3 years as a governor, I have never seen the amount of stress the staff are suffering, forcing themselves to smile and help through everything. I believe they are uncomfortable and that they are afraid - they might lose their job. There is a tense environment of paranoia with fear of reporting one another, and a blame culture in the departments which was never there before.

I see that everyone is working very hard to keep smiling, but the high-strung, critical situation is not helpful to patients.

I feel so sorry for the staff as I know they are going above and beyond for their patients. I understand that it is a very difficult environment to work in and they should be praised for their devotion and commitment.

I wish before you are leaving this place you will bring some happiness to the staff and I think there needs to be good communication between staff and patients; when all these things are brought together, the patient is safe.

Lots of the staff want to meet you and it would be great if you could come and talk to people, to relax the attitude.

A number of staff briefing sessions have taken place across the Trust since Sir David arrived. These sessions gave Sir David the opportunity to get out and meet as many staff as possible and allowed staff to be updated face to face and ask questions about any issues they may have.

Sessions were also videoed and placed on the intranet for those staff who couldn’t attend the session to view. Further sessions have been arranged across the Trust for the end of this month.

Paul Brown

Since the FT came into being, we have had governors questions / issues raised at each CoG meeting. I would suggest that we might list these together with therespective response and/or progress to date andundertake a form of governance progress or audit.

Discussion to take place regarding the above suggestions

Paul Brown

We have recently been advised ofissues which, apparently, result from a financial appraisal of the Trust. I would appreciatea breakdown ofclinical, administrative and management costs for the Trust from its formationto date, with the necessary financial data beingextracted from the Annual reports and audits.

Response to be provided at the meeting

Issues raised by Governors

University Hospitals of Morecambe Bay Hospitals NHS Foundation Trust- Page 1 -

Council of Governors Meeting (20 July 2012)