Agenda item

7.1

John Reid, Director of Nursing and Clinical Operations, Sheffield Children’s Hospital Foundation Trust, reported on the Quality Account for the Sheffield Children’s Hospital for 2012/13.

7.2

The report summarised the performance of the Trust in 2012/13 with regard to the quality of care, and also set out details of the quality priorities for 2013/14, in consultation with the Trust’s families, governors and agency partners.

7.3

Mr Reid reported that Sheffield Children’s NHS Foundation Trust was one of the best performing Foundation Trusts in the country, as recorded by Monitor (the Foundation Trust regulator) and the Care Quality Commission (CQC), and that the Trust had responsibility for most aspects of child health care in Sheffield, including hospital, community and mental health, as well as being a major provider of specialist hospital care for South Yorkshire and beyond.  He reported that the reputation was built on the high satisfaction survey results and the quality of care provided.  Reference was made to the construction of a new £40 million patient wing, which was due to commence in Summer 2013, and would result in material improvements to those areas of below average experience, such as parking, privacy and dignity, parental accommodation and way-finding.

7.4

He reported that the Trust’s community services and its Child and Adolescent Mental Health Service (CAMHS) were key components of a holistic child health system in Sheffield and beyond, and the Trust had been working closely with local authority partners to ensure that its teams were integrated with social care and education to obtain the best outcomes for families.  This was carried out through joint child protection arrangements, shared public health priorities and good communication.  He referred specifically to complaints which had been received during 2012/13, which had showed an increase from the previous year, with the most common grounds for complaint relating to  a diagnosis or a treatment plan, or in relation to complications of treatment.

7.5

Members of the Committee and representatives of Sheffield LINk raised questions and the following responses were provided:-

·            It had been accepted, as highlighted by a recent case, that communication between clinicians has not always been effective.  In response to this, a Paediatric Early Warning Tool had been developed, which comprised a system of coloured bands to enable consistency in terms of the assessments of different types of care, as well as setting down time limits in terms of doctors’ responses and the levels of seniority of doctors dealing with different types of care.

·            It was agreed that complaints should be dealt with as a form of customer feedback. As mentioned earlier, the number of complaints received had increased in the last few years, with the majority relating to a diagnosis or treatment plan.  Whilst both issues were considered to be subjective, it had been agreed that all complaints should be viewed as valid, and a number of such complaints had been seen to be justified.  An increasing number of issues were dealt with by the Patient Advisory and Liaison Service (PALS), which aimed to resolve as many issues as possible, prior to them becoming formal complaints.

·            Despite the recent news regarding the Leeds Cardiac Unit, the Trust did not have any concerns with regard to the ability and safety of surgeons at Leeds, and was currently the Trust’s preferred partner in terms of cardiac surgery.

·            There had been considerable adverse publicity regarding the events at the actions of the Mid Staffordshire NHS Trust, where a high number of patients had died as a result of the alleged substandard care and staff failings.  The mortality rate had been considerably higher than other hospitals of a similar size.   Standardised mortality rates for children were heavily dependent on specialities at each hospital. The low numbers of children’s deaths do not readily lend themselves to statistical interpretation and consequently, an independent investigation into each child death was conducted by the Child Death Overview Panel. The Trust does report standardised mortality figures for its intensive care unit and these were published on the PICANET website. The figures for the Trust were about average for the mix of specialities.

·            The Trust has worked with GP and midwifery colleagues to improve their access to paediatric medical advice. A paediatrician is available each day to discuss cases and avoid unnecessary attendance at A&E. 

·            The Trust had worked with health visitors in order to integrate them into the workforce.  There had always been tension regarding whether health visitors should concentrate on a universal service or prioritise care for those families of greatest need. The Trust was carrying out a 1200 family community satisfaction survey and it was hoped that this would help provide the Trust with evidence to support the best balance between these approaches.

·            It was accepted that there was no reference to meningitis in the report. Mr Reid undertook to supply the Committee with data on meningitis diagnosis locally and nationally. The success rate for dealing with cases of meningitis depended predominantly on what stage it was identified.

·            In terms of the car parking on Western Bank, the Trust had prioritised this for people attending A&E, as having an acutely ill child and therefore, an urgent need to seek clinical attention.

·            In terms of equality and diversity issues, the Trust’s Equality Scheme was published on its website on an annual basis.  Any language needs were addressed by the operation of an interpretation service, which comprised both face to face interpretation and a telephone-based language line in the emergency admissions department.  Research has shown that more BME families tended to attend the Hospital at similar times in the mornings and afternoons, and the Trust had attempted to address this by changing staff shift patterns and talking to NHS Sheffield regarding the out of hours GP based at the Hospital.  Some BME communities used the A&E service differently from the general population and the Trust was working with commissioners to see how this could be modified. The results of the A&E Survey, which was targeted at families attending A&E, had been published on the Trust’s website.

·            It was accepted that the Trust had failed a target on the issue of providing relevant information for asthma sufferers leaving the hospital.  This was a relatively small audit, but had resulted in changes to discharge arrangements to ensure that patients had all the relevant advice. 

·            In terms of the quality improvement priorities identified for 2013/14, specifically regarding the implementation of the Department of Health response to the Mid Staffordshire NHS Trust Public Enquiry – ‘Patients First and Foremost’, the Trust would involve non-executive Board Members, as well as Governors and families in any inspection and oversight of the Trust’s services.

·            The number of 265 local clinical audits and service evaluations may appear high. The Trust carried out nationally commissioned audits and some Trust commissioned audits. These were to quantify poorly understood risks. Most audits were carried out by trainee health staff, as part of their educational program and relate to areas of interest for them personally. 

·            Although the Committee recognised that Quality Accounts had to be drafted in a standard format, the Trust would consider producing an easy-read version of the Quality Account that was more accessible to the public.

·            There had been a number of issues regarding the planning applications required for the hospital redevelopment on the basis that the Hospital was situated within a Conservation Area.  Having underground parking below the Out-patient Department was one way to get round the strict limitations regarding Conservation Area planning consent.  There were also plans to provide car parking on the triangular piece of land next to the Octagon, as well as providing off-site parking, with a shuttle bus service between the Hospital, the nearest Supertram stop and the proposed Tapton area car park.

7.6

RESOLVED: That this Committee:-

(a)       notes the contents of the report now submitted on the draft Quality Account 2012/13, together with the responses to the questions raised;

(b)       thanks John Reid for attending the meeting and responding to   the questions raised; and

(c)        requests (i) the Policy Officer (Scrutiny) to liaise with John Reid, with the aim of arranging a visit by Members to the new Home from Home villas and other areas of new build at the Hospital and (ii) John Reid to provide details of the results of the asthma audit which would be repeated in terms of the provision of advice to child asthma sufferers, to this Committee.