Agenda item

Report of the Assistant Director Law and Governance and Presentation by the Director of Quality, Tees, Esk and Wear Valley NHS Foundation Trust

The Director of Quality Governance, Tees, Esk and Wear Valley NHS Foundation Trust Gave a presentation updating Members on Tees, Esk and Wear Valley NHS Foundation Trust quality journey and quality improvement priorities for 2023/24.

It was reported that the National Quality Board had refreshed the definition of quality, a shared single view of quality where people working in systems deliver care that is safe, effective, a positive experience – responsive and personalized, well led, sustainably resourced and equitable; reference was made to the NHS Patient Safety Strategy which had been published in 2021 and was underpinned by Insight, Involvement and Improvement; and the three goals for the Trust’s journey to change were outlined.

In relation to the Trust’s quality journey to safer care, it was reported that the key areas of focus were suicide prevention and self harm reduction, reducing physical restraint and seclusion, promoting harm free care, improving psychological and sexual safety and providing a safe environment and promoting physical health; and the key actions to achieve the Trust’s goals for each area of focus were outlined.  Particular reference was made to the implementation of the national patient safety incident reporting which had a mandated deadline of September 2023.

The presentation outlined the key actions being undertaken to deliver on the Trust’s key areas of focus for their journey to effective care; Members noted that each service would have a suite of clinical outcome measures and patient reported outcomes in place; and a key priority was the digital systems and solutions, with CITO going live in the summer; and the key actions being undertaken to deliver on the Trust’s key areas of focus for their journey to excellence in patient experience and involvement were also outlined.

Details were provided of the quality and learning dashboard; Members were informed of the positive response in relation to the Friends and Family Test, with 91 per cent of people rating the Trust’s services as good or very good; and a positive and safe dashboard had been developed, showing the individual detail for each patient.

The presentation outlined the key quality markers and details of performance against the quality metrics for Quarters 1 to 3 2022/23. In relation to the quality metric – Number of incidents of physical intervention/restraint per 1000 bed days, Members were advised that whilst this remained above target, it had started to reduce and 75 per cent of the incidents related to Learning Disability services, mostly relating to one patient. Members were assured that the Trust were working with Mersey Care to reduce restrictive interventions and promote the least restrictive practices and that levels had decreased by 50 per cent in the last three months for that individual.

Reference was also made to the quality metric – Percentage of patients who report ‘yes, always’ to the question ‘Do you feel safe on the ward?’ which was not achieving its target; details were provided of the work being undertaken to improve performance, including focus groups, and the range of key factors identified to help patients to feel safe were outlined.  Members also noted that a programme of work had commenced which included block booking agency staff, enhanced recruitment and additional peer support workers, activity coordinators and gym instructors.

In relation to the quality metric – Percentage of patients who reported their overall experience as very good or good, Members were informed that patients experience had been impacted by increased length of stay as a result of challenges in securing accommodation for patients and that the Trust worked closely with Local authorities in trying to address this issue.

The key quality risks, the key actions from the 3 published Niche reports and learnings about patient safety from West Lane Hospital were outlined; and details were provided of the Quality Account improvement priorities.

Discussion ensued regarding the Trust’s ability to deliver on all of the actions identified to deliver on the priority for safer care; Members were assured that these were long term actions and that continuous improvements were being made. Members were also advised that positive developments had been made in the community and a video demonstrating engagement of the voluntary sector could be shared with Members. 

Members raised concern regarding the Trust’s performance against the quality metrics and were disappointed to note that the electronic system had not yet gone live; discussion also ensued regarding the actions undertaken following the focus groups; Members request benchmarking with other trusts; and following a question, Members were informed that personalized care plans were recognized as best practice and there was a key focus on lived experience.