Agenda item

To receive and consider the following –

(i) CQC Inspection report for Oldham (Appendix 1).

(ii) In connection with the Oldham report, the full CQC report circulated at the previous Scritiny Board meeting (Appendix 2).

The received and considered the Care Quality Commission (CQC) inspection report in respect of Oldham Hospital which was presented by Karen Coverley, Director of Nursing, Oldham Care Organisation.

The report indicated that the Northern Care Alliance (NCA) overarching action plan was developed and replicated by each care organisation. Set out were the ‘Must’ and ‘Should’ actions for the NCA, Oldham Care Organisation and Maternity Services.

Progress to date is as follows:

·         All divisions have reviewed the 79 NCA Must and Should Dos

·         Actions have been linked to any improvement plans / work ongoing to support and monitor the development of improvements across the services.

·         Oldham have 57 completed actions of which 22 are business as usual (BAU) / risk register, 11 in progress BAU/risk. These actions are being monitored via related workstreams / or added onto a risk register (Group or Care Organisation depending on the action).

·         Oldham Care Organisation mandatory training is at 92.2% and My Time (appraisal) at 85.37%.

·         Divisions /specialities are reviewing policies and working towards harmonisation of policies across the NCA.

·         A harmonised Medicines policy has been finalised across the NCA, with maternity services working closely with Pharmacy colleagues to develop a maternity medicines policy.

·         Nursing assessment and accreditation scheme, NAAS action plans are being cross referenced with the CQC action plan and ongoing work, ward F6 achieved Green in all 14 domains and good practice is being shared across all divisions. The Oldham theatres had their first TAAS assessment and achieved amber status.

·         As part of the Urgent and Emergency Care workstream a Continuous Flow Model (CFM) has commenced within the division of medicine and shared learning across the NCA with other Care Organisation exploring the model.

·         The Oldham Emergency Department have implemented the Patient First Improvement dashboard / toolkit and this has been shared with the other EDs across the NCA for implementation.

·         The Maternity Improvement Board monitors the action plans / improvements within the maternity improvement plan.

·         Patient Safety Incident Response Framework (PSIRF) implementation phase has been moved to 01 November 2023 and transition will be completed by 31 December 2023. Training has been commenced and workshops are under way in preparation for the implementation phase. Divisions across the Care Organisation are presently piloting PSIRF toolkits both Maternity and the Division of Medicine are completing an investigation using the SEIPS model.

·         The NCA has transition to a new risk management policy in September 2023. The policy aims to create a risk management approach that is simple, realistic and feasible for all and one which brings value in terms of improvement. The policy champions the importance of proactive risk management at all levels.

·         The transition for the risk scoring is September 2023 to December 2023 when all risks need to be in the new scoring matrix, within the first 4 weeks the divisions have rescored 67% of risks.

·         Oldham Urgent and Emergency Care services (ED/SDEC) have had a recent mock inspection in June 2023 and the formal report was received in September. Improvements have been made in the Responsive and Well Led domains.

Details of each ‘Must’ and Should’ action were shown together with the progress on each indicating whether the action was completed or still in progress.

Circulated at the meeting was a progress a further detailed progress summary of the CQC Action Plan.

Karen Coverley informed the Board that she was very positive about the Action Plan. She advised that fundamental standards are monitored every day. She acknowledged the importance of staffing levels and referred to the  pressures current staff were under in absorbing Action Plan work.

Alistair Craig, NCA, underlined the need for quality assurance at all times. He advised that 24 new midwives were recruited recently in a continuing drive to uplift staffing levels across the nursing spectrum. He added that they were currently looking into the use of apprenticeships.

With regard to a reference relating to concrete problems within the hospital Alistair Craig assured the Board that patients and staff are and will remain  safe. He also advised that any expenditure in dealing with the hospital’s concrete issues would not be funded from current budgets and any additional funding would be met from central government.

With regard to the issue of outside support for patient care, Alistair Craig informed the Board that the NCA is working with Community Health organisations with a view to alleviating the pressures on the Accident and Emergency (A and E) department and acknowledged the need for publicity and signposting to ensure that patients are aware of the choices available with A and E being the last resort. He also emphasized the need to assess each neighbourhood to establish their needs.

Jayne Ratcliffe, Director Adults and Social care Services referred to the Integrated Care Partnerships Board and Urgent Care Delivery Board which both had a major part to work together with the NCA and play a supporting role to the hospital.

Referring to the possibility of reinstating a Joint Health Scrutiny Committee comprising Member representatives from Bury, Salford, Rochdale and Oldham Councils view to presenting a consolidated view to the NCA on the current care system, Alistair Craig felt that there would be some benefits but emphasised that each Council area had unique health characteristics and needs which needed to be addressed but acknowledged that some health needs would overlap.

Resolved: that

(i)            the report be received and noted; and

(ii)          the Oldham Care Organisation Action Progress set out in the report be noted and endorsed.