To receive a 6 month progress presentation from the Bedfordshire Clinical Commissioning Group in relation to the delivery of their commissioning intentions for 2013/14.

The Chairman informed the Committee that Stephen Conroy, Acting Chief Executive of the Bedford Hospital Trust, had been invited to attend the meeting to provide Members with a verbal update on the critical Care Quality Commission’s (CQC) report on Bedford Hospital.

Members were informed that the CQC had issued their inspection report at the end of August 2013 following visits to Bedford Hospital made by inspectors to observe how people were being cared for.  The visit following on from concerns raised by the post graduate Dean about clinical supervision and was more in depth than previous inspections with 11 inspectors visiting at various times over 4 days.  The report highlighted actions that were required to be taken by Bedford Hospital.  The issue of safeguarding vulnerable adults on a dementia ward had caused alarm and the hospital had acted quickly to put things right.  The Hospital had implemented a cultural change on all wards which had included:

·        Daily matron meetings to check staff were available to cover shifts;

·        The monitoring of nutrition and hydration on patient notes;

·        The introduction of a dashboard on wards as an early warning system of problems.  A rapid response team would be brought onto wards if a matron was unable to resolve difficulties;

·        Monthly Board meetings to be open to the public.

Diane Gray, Director of Strategy and System Redesign, Bedfordshire Clinical Commissioning Group (BCCG) endorsed the action taken by Bedford Hospital Trust and confirmed the BCCG was working with Councils and Bedford Hospital on safeguarding and other issues.  The BCCG would take a further look at performance data sets and the comments made by Members and GPs on patient experiences.

In light of the update Members discussed the following:-

·        Whether the Bedford Hospital Trust Board failed over a number of months to put right the issues on Riverbank Ward.  The Chief Executive, Bedford Hospital Trust commented that the independent reviews would establish who was at fault for the issues.  The Hospital recorded all incidents which range from ward level, serious incidents and ‘never events’,  Bedford Hospital’s performance was one of the lowest in the country for ‘never events’.

·        The problems being encountered by patients with other providers following discharge from hospital.  In response, the Chief Executive, Bedford Hospital Trust commented that the Hospital’s record was good in this area, with a low figure for readmissions after 7 days from discharge, however, performance for readmissions after 30 days from discharge was higher, which gave cause for concern. 

·        The need for a team to work across the hospital and community was needed and was being considered by the BCCG and Hospital Trust, however, this would take time to implement. 

·        The importance of listening and learning from GPs and family members and to accept help from visitors willing to support hospital staff.

·        The inconsistency of care by nursing staff was highlighted and questions raised about the standards of training and supervision of nurses at Bedford Hospital.  In response the Chief Executive said there had been issues regarding consistency on the wards and this would be put right.  The Hospital’s action plan dealt with the issue and the Hospital had used the Royal College of Nursing standards as a benchmark for basic nursing care.  The number of nurses employed had been increased and the changes in leadership on the ward had made a huge impact.

The Chairman thanked Stephen Conroy for the update and invited Dr Diane Gray to provide an update on progress of the BCCG

Diane Gray, Director of Strategy and System Redesign, BCCG, gave a presentation on progress of BCCG at six months.  The presentation outlined results for Central Bedfordshire patients which included the redesign of some services, development of stronger partnerships and procurement of new services.  Plans for continued improved outcomes for patients were outlined and included the redesign of paediatrics care pathway, the procurement of local 111 telephone service and redesigning local stoke care pathways.

The challenges faced by BCCG included the delivery of high quality care now and in the future, subject to financial restraints and to ensure the patient and public voice can be heard and listened to.

In response to the presentation and further clarification was  provided by the Director of Strategy and System Redesign the Members of the Committee discussed the following:

·        The lack of confidence in the current SEPT contract based on the experiences of Members.

·        The need to ensure that the BCCG consulted with the voluntary sector.

·        BCCG funding for 2014/15 would not be known until December 2013 but it was not expected to increase significantly.  It would be necessary to procure better services and funding arrangements within budget and manage patient expectations in some services areas.

NOTED the updates and requested that the Bedford Hospital action plan be circulated to Members.  The Chief Executive was invited to the next meeting to update Members.