To receive a presentation on the work of the Wye ValleyNHS Trust.

The Committee received a presentation from Derek Smith, Chief Executive of the Wye Valley NHS Trust.

During his presentation, Mr Smith highlighted the following areas:

·           The financial position of the Trust for the current financial year, and for 2013/14.  The funding gap represented 5.5% of the turnover of the Trust, and additional outside non-recurrent funding of £10m would once again be required.  It would not therefore be possible to seek Foundation status, and alternative ways would be considered as to how this could be best reached.  Work was underway on a plan for strategic change, and a business case would be in place in the Spring. ­Consultation would be undertaken with all partners and a determination arrived at within eighteen months.  The pathways to achieve the agreed end would be set within six months.  At the end of this period the Wye Valley NHS Trust would cease to exist in its present form.

·           The current arrangements for the Chaplaincy Service, which he believed to be sufficient; there was a minimum level that could be reached that would be unsatisfactory, but the service was not in this position.  The service also received support from  the local clergy and Imam. 

·           The key service delivery challenges that faced the Trust.   These ranged from Community Services, Acute Services, Social Care and Midwifery investment.

·           The Trust’s performance against key indicator areas.  Whilst the Summary Hospital-level Mortality indicator (SHMI) remained high, reporting against this had been late, so it was expected to decrease.   This was high on the Trust’s agenda, and would be kept under review.

·           The two week response rates for appointments for GP referrals for breast cancer  patients was impacted by both the broad spectrum of referrals from GPs, most of which did not have the disease, and the non appearance of patients for appointments.  Initiatives were in hand with Healthwatch and the GPs in order to ensure a greater number of patients attended.

·           That a an additional neurologist had been employed by the Trust who would be reviewing the Stroke Service in the New Year.

·           That a conditional warning notice issued by the Care Quality Commission (CQC) as a result of an error on a patient survey whereby mismatched patient names and addresses had been sent to 372 patients had been dealt with and all complaints had been addressed.  The CQC had also undertaken an unannounced visit and had pronounced themselves satisfied with the documentation they had reviewed.

·           The Trust was concerned with the Car parking charges had been reviewed, but the contract was valid until 2018.  A dialogue was in hand with the PFI provider on the matter, but the Trust had no power over the car parks, and received no revenue from them.

·           That contrary to recent articles in the local press, the Hospital was not a fire trap, and that the issue that existed was one of fire compartmentalisation in areas above the ceiling height that did not meet current regulations.  The Trust was working with Mercia Health Care to remedy the situation.  The Fire and Rescue Service were satisfied with the work that was being undertaken to remedy the situation.

In the ensuing discussion, the following points were raised:

In reply to a Member’s question regarding the announcements made about the Minor Injury Units (MIUs) in Ross-on-Wye and Leominster, Mr Smith said that people had come to use the Units for a broad range of issues that they weren’t technically capable of dealing with.  Staff had been put in a position where they had to leave patients on the wards in order to deal with those who dropped in to use the MIU. There had been an incident at the Ross MIU in which a patient had died.  As a result, safety procedures had been reviewed and where there was insufficient local medical advice, patients were at risk.  This was the reason for the decision to rapidly change the opening hours of the MIUs, and the decision was communicated as quickly as possible.  Further discussions were in hand with GPs in order to look at widening the role of the MIUs in the future.  He undertook to ensure that Ward Members were informed of these decisions as soon as possible in the future.

In reply to a further series of questions, Mr Smith said that there were no plans for Ward reductions and closures, unless services could be reconfigured in such a way as to allow for the closure of the hutted wards at the rear of the hospital.  There was no additional space in the wards in the main building, and additional beds for stroke victims, for example would not be feasible.  The decisions that were made at the time of admission were crucial, as was the correct timing to allow patients to return home.  Whilst there was currently no major stroke service available at weekends, this was being reviewed, and consideration was being given to using beds in Ross and Leominster hospitals with linkages directly to the County Hospital.  The intention was to increasingly provide community based services, going to visit people in their homes and care homes, rather than running services from a one point in the community.

The Chairman thanked Mr Smith for his presentation.