Agenda item

Royal Berkshire NHS Foundation Trust - Annual Report and Quality Report

This item will focus on:

·         A&E and Waiting Lists

·         Winter Pressure

·         Staffing

Minutes:

Dominic Hardy, Chief Operating Officer, Royal Berkshire NHS Foundation Trust, attended the meeting and gave a presentation on Winter Preparedness.

The Royal Berkshire Hospital was currently in its peak period and focus was on the safe and timely care of patents.  Additional ward capacity had been provided with Mortimer ward re-opening, Redlands ward being used for medical patients and the Emergency Department Minors Unit using the Primary Care Unit space to see minor illness patients and maximise the number of patients seen in the Ambulatory Care Unit.  The hospital was under pressure but was coping well.  £1m had been received from NHS England and was being used to fund staff in the Emergency Department and across the hospital, including at weekends.  In the Accident and Emergency Department 320 to 400 patients were being seen every day with the peak time being between 1.00pm and 7.00pm; the department had been built to deal with half this number of patients.  The majority of patients were seen within four hours but, it took more time to deal with those who needed long term care.  In November 2019 72.04% of patients had been seen within four hours, this compared to 86.13% in the previous year, but there had been a 10% increase in attendance compared to the previous year.  The number of breaches had also increased from 1,351 in November 2018 to 3,019 in November 2019.

With regard to clinical services for children and young people, services included a Paediatric Emergency Department which treated over 30,000 patients per year and included an eight bedded paediatric short stay unit.  There was also a Neonatal unit with 20 intensive care high dependency and special care cots, a 39 bedded inpatient paediatric ward, that included two oncology suites and a four bedded High Dependency Unit, and a ten bedded nurse led paediatric day care unit for elective day surgery, diagnostics and minor treatments.  The hospital also worked closely with Oxford and Southampton for really specialist care.  In December 2019, an Organisational Children’s and Young People Strategy had been approved as part of a vision of ‘working together to provide outstanding care for our community’.  The Strategy was driven by the NHS long term plan and the specific needs of children and young people and had been built around four broad themes as follows:

·         Innovation in Services;

·         Experience and Environment;

·         Careers;

·         Communications and Engagement.

The Committee discussed the presentation and a number of points were raised including the following:

·         There was a relatively low number of delayed transfers of care, with around 25 currently.  The Trust worked very closely with the Council to understand patient needs and to get them to the right setting as soon as possible;

·         In the Emergency Department staff worked very hard to get patients off trolleys and into a bed as soon as possible, patients would be under constant nursing care during this time, and no one would be on a trolley in a corridor;

·         With regard to the ‘four hour’ target the aim was for patients to be seen, diagnosed and treated within four hours.  Patients would be ‘triaged’ within 15 minutes of arrival and would be seen by a senior medical consultant from the start as this was the best way to find out what they needed;

·         Children were being seen who, compared to a few years previously, were more seriously unwell and a greater number were presenting with mental health issues;

·         A serious effort was being made in respect of the recruitment of staff and work was also being carried out to identify what mattered to staff and to ensure they were happy.  Work was also being carried out to encourage nurses into the hospital through apprenticeships; recruitment also took place internationally and help was provided with residency.

Resolved –    That Dominic Hardy be thanked for attending the meeting and his presentation.