Presentation by Head of Planning and Business Development, Tees, Esk and Wear Valleys NHS Foundation Trust
The Director of Quality Governance and Head of Planning and Business Development, Tees, Esk and Wear Valleys NHS Foundation Trust gave a presentation on the Quality Account 2020/21 and 2021/22, updating Members on the progress made on the Quality Account improvement metrics and priorities for 2020/21 and outlining the proposed quality improvement priorities for 2021/22.
Members were advised that the four quality improvement priorities for 2020/21 were supported by 40 actions, of which ten were either completed; and 26 were not completed.
In relation to the priority ‘Further Improve the clinical effectiveness and patient experience at times of transition from CYP to AMH services’ Members were advised that the work of the Transitions Project has been superseded by the Trust-wide work requested by the Trust’s Senior Leadership Group on ‘Improving Transitions and Service Provision for People aged 16 to 25 years in Tees, Esk and Wear Valleys NHS Foundation Trust’, and as a result four of the planned actions were no longer required.
Members noted that work on the priority ‘Improve the personalisation of Care Planning’ had been impacted by redeployment of staff to undertake actions relating to the Covid-19 pandemic; and that this work would continue in 2021/22; and in relation to the priority ‘Reduce the number of Preventable Deaths (with a focus on learning from deaths’, whilst a Family Conference could not be held in 2020 due to COVID-19, work continued to be undertaken with individual families; and a Family Conference would be held in 2021 as soon as social distancing restrictions allow.
In relation to the priority ‘Increasing the proportion of inpatients who report feeling safe on our wards’, Members were advised that specific actions relating to this priority were put on hold due or delayed to COVID19, however these would be carried over into 2021/22 as part of the ‘Feeling Safe’ quality improvement priority; and reference was made to the work undertaken to address patient safety in relation to drug use on wards, including the introduction of drug detection dogs.
Details were provided of the Quality Metrics as of Quarter 3 2020/21, of which there was data available for nine of the ten quality metrics. It was reported that three of the quality metrics were reporting Green whilst six were reporting Red; and all six of the Red metrics were showing an improvement when compared to 2019/20.
In relation to Metric 1– Percentage of patients who report ‘yes, always’ to the question ‘Do you feel safe on the ward?’, it was reported that whilst still below the Trust target of 88 per cent, this metric had seen a significant improvement from 62.39 per cent in 2019/20 to 64.66 per cent in Q3.
Regarding Metric 2 - Number of incidents of falls (level 3 and above) per 1000 occupied bed days (OBDs) – for inpatients, Members were advised that the number of falls would be included for future reports.
In relation to Metric 3 – Number of incidents of physical intervention/restraint per 1000 occupied bed days, it was reported that the Trusts position had also seen an improvement, from 30.45 per cent in 2019/20 to 20.90 per cent in Q3, and that Durham and Darlington had achieved the Trust target of 19.25 per cent in Q3 at 17.84 per cent.
With regard to Metric 6b – Average length of stay for patients in Mental Health Services for Older People Assessment and Treatment wards, it was reported that the target was not being met, however the average length of stay was significantly less than in previous years.
In relation to the patient experience Metric 7 – Percentage of patients who reported their overall experience as excellent or good, it was reported that whilst still below the Trust target of 94 per cent, this metric had shown no significant changes, with a slight increase from 91.65 per cent in 2019/20 to 93.21 per cent in Q3.
With regard to Metric 8 – Percentage of patients that report that staff treated them with dignity and respect, it was reported that whilst still below the Trust target of 94 per cent, this metric had remained static over the past few years, with a slight increase from 85.80 per cent in 2019/20 to 86.77 per cent in Q3.
In relation to Metric 9 – Percentage of patients that would recommend our service to friends and family if they needed similar care or treatment, this had shown an increase from 86.70 per cent in 2019/20 to 91.60 per cent in Q3.
Discussion ensued on the Quality Metrics; Members requested comparative data be included to enable Members to understand the performance of Durham and Darlington against the Trust and against NHS Trusts countrywide; with a specific request for comparative data in respect of patient safety. Members were advised that patient safety was not a mandated measure and as such was not measured consistently across trusts however contact had been made with other trusts to obtain comparative data; and a collaborative patient forum had been formed with Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust to enable comparisons at a regional level.
Members requested further information in relation to Quality Metric 7 ‘Percentage of patients who reported their overall experience as excellent or good’; and were advised that whilst there had been a reduction in responses to due COVID-19; this metric continued to be measured; improvement work had been undertaken which included triangulation of information with complaints and PALS to identify specific themes; and a toolkit had been developed for each locality and was supported by plans specific to each locality.
Details were provided of proposed quality improvement priorities for 2021/22 which were Care Planning; Feeling Safe; and Compassionate Care; and the detailed planning actions for each priority were outlined.
Members were advised that the suite of Quality Metrics were under review; that these would be aligned more closely to the improvement priorities; and some of the metrics would remain the same.
Following a question regarding the pilot of the body cameras in relation to the Feeling Safe priority, Members were assured that vigorous information governance checks had been undertaken prior to the commencement of the trial; patients were made aware of the presence of body cameras on arrival to the ward; and that an evaluation of the pilot would be undertaken before further roll-out. Members welcomed an update on the results of the pilot at a future meeting.
Member requested further information in respect of the CAMHS inpatient facilities and waiting times for Darlington CAMHS service; and Members noted that a new 10 bed unit, Acklam Road Hospital, had been commissioned by Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust and would be opening on 19 April 2021.
Following a question regarding staff surveys Members were advised that staff turnover/vacancy rates, morale and wellbeing were monitored; and that a new trust strategy ‘Our Journey to Change’ which had a priority relating to staff experience, was in place.
RESOLVED – That the thanks of this Scrutiny Committee be extended to the Director of Quality Governance and Head of Planning and Business Development, Tees, Esk and Wear Valleys NHS Foundation Trust for their informative presentation.