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Trust Board Meeting Chief Executive’s Briefing. Tom Taylor 27 th November 2008. The Care Quality Commission Ensuring better care for people Touching 50 million lives. What is CQC ?. Registration for the NHS. A new concept for the NHS
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Trust BoardMeetingChief Executive’s Briefing Tom Taylor 27th November 2008
The Care Quality Commission Ensuring better care for people Touching 50 million lives
Registration for the NHS • A new concept for the NHS • Registration already happens in independent healthcare and social care • A “licence to operate” • 2009/10: transitional year • 2010/11: integrated system for ALL sectors
Steps to improvement • Trusts: • Review and plan improvements • Apply to register • CQC: • Decides registration status • Publishes information • Both: • Continue to monitor HCAI • Expect improvements
Registration decisions – the weight of evidence Balance of probabilities Beyond reasonable doubt
Application form The regulation requirement: (See guidance document page 18)
Application form (continued…) One of the criteria: (See guidance document page 19)
Application form (continued…) Sign-off: (See guidance document page 20)
Annual Health Check 2007/08 … Quality of Services 2005/06 2006/07 2007/08 • Clinical Services • including • Meeting Core Standards Fully Met • Existing National Targets Fully Met • New National Targets Good • 6 out of 9 “achieved” • 3 “under achieved”: MRSA bacteraemia target Reduce health inequalities (with PCTs) Improve long term conditions and reduce emergency bed days through improved primary and community care (with PCTs) • 0 “failed” GOOD GOOD GOOD
Annual Health Check 2007/08 … Use of Resources 2005/06 2006/07 2007/08 • Use of Resources • “FAIR” was the highest score possible given our deficit in 2006/07 • Auditors Local Evaluation • Financial Reporting 1 2 3 • Financial Management 2 3 3 • Financial Standing 1 2 2 • Internal Control 2 2 3 • Value for Money 1 1 3 • Overall Score 1 1 2 WEAK WEAK FAIR (7/20) (10/20) (14/20)
Health Care Commission Ratings • SaTH have asked for a joint Health Economy monthly report on projected ratings • Draft presented at Shropshire and Telford Executive Group (STEG) 26/11/08 • Internal SaTH report to be included in Finance and Performance / Trust Board Committee reports
Hospital Activity • Unprecedented levels of activity in November – Level 4 Escalation • Emergency inpatients/ bed capacity not a simple function of A&E attenders • All SaTH capacity fully utilised:- • private patients cancelled • day surgery cancelled • additional ward rounds • staff response has been fantastic
Hospital Activity • Over 70 “medically fit” people in community and acute beds • Ambulance turnaround times extended • A&E target not maintained in month • SHA reviewing all Health Economy plans • Most of West Midlands under pressure • Shropshire Local Health Economy Summit 28/11/08 • SHA expressing serious concern re A&E and category A&B ambulance response times • SHA confident re waiting times, MRSA, C Diff and financial targets
Hospital Activity All activity – elective inpatients, day cases, emergency inpatients, maternity, outpatients (new and follow up), A&E 2003/4 457,217 2004/5 464,825 2005/6 470,587 2006/7 469,155 2007/8 475,789 Increase 18,572 or 4.1%
Hospital Activity 2008/9 straight line projection based on activity to 31 October: = 494,525 = 37,308 growth since 2003/4 = 8.2%
Last 3 years:-At 4 years? Day cases 62% 80% 82% Day cases 33%+ 40%+ Elective IP 17%- 17%- Emergency IP 0% 3%+ Maternity 5%+ 6%+ Outpatients 0% 4%+ A&E attendances 4%+ 6%+
Hospital Activity • 2009/10 Operating Framework delayed because of Pre Budget Report (PBR) was due 31/10/08 now expected 8/12/08 • New PCT allocations 8/12/08 • New Payment by Results (PBR) tariff 12/01/09 • Unbundling/ A&E/ Market Forces Factor??? • Challenge to agree 2009/10 Local Delivery Plan whilst FT HDD being undertaken
Other Issues • Mike Hallworth presented with the 2008 Healthcare Scientist of the Year Award by the NHS Medical Director, Professor Sir Bruce Keogh. Primarily for work done to make information about pathology tests accessible to patients through a web site developed by him and a small team • Mike Hallworth and Heidi Smith have attended a special Royal Reception at Buckingham Palace for NHS staff
Other Issues • Melvyn Birch has received his MBE from Prince Charles • Nigel Capps invited to join the CLRN Executive Group • 100th birth at Oswestry Maternity Unit