To receive an updated presentation on the work of the Wye Valley NHS Trust.

The Committee received a presentation from the Wye Valley NHS Trust.

Howard Oddy, Director of Resources (DoR) and Deputy Chief Executive of the Trust, gave the presentation. This included information on  performance against quality measures, key performance measures, progress on delivering the new model of care, the Trust’s  financial position and action in response to that position.

He highlighted that the Trust faced a very serious financial position.  The Trust had only broken even for 2011/12 with a payment of £5m of non-recurrent support from the West Mercia NHS PCT Cluster.  There was a funding gap of £9.5m for 2012/13 and the outlook for 2013/14 identified the need for an injection of £6.4m of recurrent funding.

A copy of the presentation has been placed with the agenda papers on the Minute Book.

In discussion the following principal points were made:

·         A Member had informed the Committee in March that he had been told that a patient had been inappropriately discharged in the middle of the night.  The Trust’s Director of Operations reported that he had been unable to discover the patient’s identity and investigate the case.  However, following national coverage of concerns about discharges from hospitals at night he had commissioned an audit of hospital discharges. It was requested that the findings be circulated to Members.

·         Members requested that future reports on performance should be expanded to provide details of performance each month to enable Members to assess performance trends.

·         The DoR explained that some of the performance measures including the one relating to carers receiving needs assessments were distorted by data collection issues.  The volume of demand had also had an impact on the ability to respond within the target. The Director of People’s Services commented on the pressures that the significant increase in caseloads had placed on staff and the bearing this had had on the capacity to meet performance targets.

·         One of the proposed responses to the financial pressure was to consider creating sustainable acute services through strategic partnerships.  The DoR confirmed that if material service changes were proposed these would be subject to consultation.  A strategic review was taking place with the clinical Commissioning Consortium to establish the clinical and financial viability of services.   In cases where services were currently provided by a single consultant one option might be to secure provision of the service from another organisation but for the service to continue to be delivered from local premises.

·         In response to a suggestion that the presentation had painted a gloomy picture, the DoR commented that performance in 2011/12 had been good and the Trust performed well compared with others.   The financial position needed to be addressed but the Trust was providing good services.  Members suggested that it would be important to receive assurance that the financial pressures were not having and would not have a detrimental impact on the service quality.

·         The upward trend in activity at the hospital was discussed.  The DoO commented that the demand for acute care would be stemmed by having local access to services and continuing the measures to reduce the number of emergency admissions.  The longer term solution over the next 2-4 years was the redesign of services and a focus on health and wellbeing at the primary care level.  Investment in neighbourhood teams including nurses and occupational therapists was needed to drive that change.  A bid for £4m had been made.  The analysis indicated that this would be cost effective given the high cost of acute care.

·         It was noted that a review of Private Finance Initiative Schemes by the Department of Health (DoH) had not found the Hereford Hospital Scheme to be especially problematic.  Some organisations had received additional support from the DoH following that review.  The Trust could not therefore renegotiate the contract but was seeking to manage the contract as effectively as possible.  Savings had been identified that would contribute to the financial shortfall.

RESOLVED:

That    (a)   a further update be provided to the Committee in three months’ time;

            (b) a briefing paper be circulated to Members of the Committee on the findings of the audit of hospital discharges;

            (c)  the Task and Finish Group established to seek more information on aspects of the Trust’s work should also seek assurance that the financial pressures were not having and would not have a detrimental impact on the service quality;

            (d) the future performance reports should be expanded to  provide the Committee with a clearer understanding of performance trends, and should include readmission rates;

            (e)   it be requested that a seminar should be held for all Councillors on the relationship between Wye Valley Trust and the Council; and

            (f)    a briefing note be circulated on the performance of Primecare.

(The meeting adjourned between 12.08 and 12.20 pm)