To receive a report on the work of the Wye Valley NHS Trust.

The Committee received a presentation from Mr Derek Smith, Chief Executive of the Wye Valley NHS Trust.  During his presentation, he highlighted the following areas:

·         That the Accident and Emergency 4 hour target had been 94.49% in 2012/13, when it should have reached 100%.  Since Christmas, there had been more demand for the service, which, combined with longer stay patients blocking beds, meant that targets had not been met.

·         Access targets for cancer patients had been met, apart from in the case of breast cancer, where patients had all been offered appointments, but not all had taken these up.

·         That the Commissioning for Quality and Innovation (CQUIN) target of 100% had been met.

·         That the Hospital Standardised Mortality Ratios (HSMR) was higher than expected.  This was an indication of the expected number of patients who would die in the hospital.  This was a complex statistical measure, and the Trust was above the national average, but inside expected national levels.

·         That the hospital was performing better than its peers on day case surgery rates, and the readmission rates for patients were also lower.

·         That changes to the urgent care pathway were required, as well as an improvement to both efficiency and performance.

·         The underlying financial pressures for 2013/14.  The financial position had been stabilized, but as support of £9.7m would be required in the current year, it had not improved.

·         That it was unlikely that the Trust could achieve Foundation Status on its own, and a number of options were being considered.

The Chairman said that he had attended the stakeholder events that had been staged to consider options for a way forward for the Trust and pointed out that were another organisation to consider merging with the Trust, it would expect additional funding.  He asked from where this funding would be forthcoming.  Mr Smith said that any additional funds would have to come from NHS England, and would be scrutinised by both the Treasury and the NHS.   Both bodies would prefer any such deal not to include a financial cost to the public purse.

In reply to a question from a Member about the payment received by the Trust for patient care, the Chief Executive said that A&E patients were paid for at a national tariffs which were adjusted for market rates.  This meant that London hospitals were paid at a higher rate.  Larger A&E Departments, with throughputs of 150,000 patients were able to cover their costs.  The Trust had only 40,000 people through the door.  The out of hour’s service was provided by Prime Care at the moment, although the contract would be retendered this year. Commissioners would be considering this contract in the autumn.

That servicing the PFI contract represented 10% of the hospital’s turnover.  There was a contract in place with the provider to ensure that the building was kept in good order.

Members questioned the waiting levels in A&E. Mr Smith said that the situation would improve over the summer, as the cold weather did affect patients.  Most of the change in the demand was driven by the system, however, not the population.  There was something wrong with the system in England, where there was a much higher propensity to admit patients than there was in Scotland, for example.

In reply to a question from a Member, Mr Smith said that whilst he would like to see the Wye Valley Trust configured as a standalone Foundation Trust, but that there were real difficulties associated with such an outcome.

The Chairman thanked Mr Smith for his presentation.