Agenda item

5.1

The Committee received a report of Dr David Throssell, Medical Director, Sheffield Teaching Hospitals NHS Foundation Trust, which provided information on the quality of services delivered by the Sheffield Teaching Hospitals NHS Foundation Trust during 2013/14 and identified Quality Report Objectives for 2014/15.  Appended to the report was a draft of the Quality Report 2013/14.

5.2

The report was supported by a presentation by Sandi Carman, Head of Patient and Healthcare Governance, and also in attendance for this item were Neil Reilly, Assistant Chief Executive, and Kirsten Major, Executive Director of Strategy and Operations, Sheffield Teaching Hospitals NHS Foundation Trust. The Committee noted Dr Throssell’s apologies, due to him having to attend a meeting with the Secretary of State at short notice.

5.3

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

·                The Trust took the issue of cancelled operations very seriously due to both the adverse effect on the patient and the inconvenience caused to friends and relatives.  It was accepted that the target figure of 4% represented a significant challenge for the Trust, and a number of actions had been put in place in an attempt to ensure this target was reached.  Although the target figure was not reached in 2013/14, the number of cancellations was less than in 2012/13.  In terms of the top five reasons for cancellations, ‘Operation Not Required’ referred to those cases where the patient’s clinical position had changed, such as if they had experienced some form of spontaneous improvement or a significant deterioration prior to the operation.  ‘Lack of Theatre Time’ referred to those cases where previous operations or procedures had taken longer than expected, and when the shift of the staff involved had come to an end.  The Trust accepted that there was a need to manage availability/theatre time better in order to overcome this.

·                The Trust was also aware of the frustration and inconvenience caused by the delays in dispensing medication for patients discharged from hospital. It also presented the Trust with problems in that patients often waited on the wards, thereby preventing admissions.  The procedure regarding the dispensing of medication involved a number of stages and there were  delays in each stage.  One action taken by the Trust had involved having a Pharmacy Technician in the Discharge Lounge, and this had helped to speed the procedure up.

·                The objective in terms of the assessment of patients in Accident and Emergency in under four hours means that the patient will  have been assessed, and a definitive point of care delivered, be that discharge, admission or in receipt of active treatment. 

·                Mortality rates in Sheffield were no higher at weekends than during the week, although it was acknowledged that such rates were higher in other parts of the Country.

·                The Trust was making a considerable effort to improve its performance in terms of the reporting of, and dealing with, complaints or concerns raised by patients or their families.  As part of this work, there were now a number of opportunities for people to provide feedback in terms of their treatment.  The Trust also agreed with the issue raised regarding the requirement to log all complaints or concerns raised by patients or their families, however they were reported.

·                Whilst communication between Accident and Emergency Units and GPs was still sent in paper form, the Trust had recently introduced a facility whereby feedback could be provided electronically, and it was the plan to move to the electric format only in the near future.  The Trust’s firewall would stop anyone without authority from accessing such information.

·                All patients were coded for data purposes. This information is obtained from medical records and entered onto a database. The standard is 90% correct reporting of the primary diagnosis and procedure and 80% correct recording of secondary diagnosis and procedures. The incorrect items detailed in the Quality Report (8% to 23%) relate to the incorrect interpretation of the notes for coding purposes, and not clinical errors relating to a patient’s care.

·                Whilst waiting times were a national target, the Trust also wanted to review the impact of waiting times on the patient experience, specifically those patients waiting over 18 weeks for treatment, in order to capture how they were affected.  The Trust would have dialogue with those patients who had not received treatment within specified waiting times, and this would be detailed in the next Quality Report. 

5.4

RESOLVED: That the Committee:-

(a)       notes the contents of the report now submitted, the information reported as part of the presentation and the responses to the questions raised;

(b)       requests the Policy and Improvement Officer to summarise the comments made, to be shared with the Chair, and then with the Committee, prior to being submitted to the Trust; and

(c)        thanks Neil Reily, Sandi Carman and Kirsten Major for the presentation made and for responding to the questions raised.