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Agenda item

South London & Maudsley NHS Foundation Trust

The Sub-Committee are presented with a copy of the Quality Report for the South London and Maudsley NHS Foundation Trust (SLaM) for noting.

 

An update on will also be provided on Slam’s priorities for the forthcoming year.

Minutes:

The Sub-Committee was presented with the Quality Report for the South London and Maudsley NHS Foundation Trust (SLaM) for their information and comments. A presentation summarising the Quality Report along with an update on the plans for SLaM in the forthcoming twelve months was given by the Interim Service Director for Croydon and the BDP Operations Directorate, Doctor Faisil Sethi. During the presentation delivered by Doctor Sethi the following pointes were noted:-

·         SLaM was in the second year of a three year plan to deliver on identified priorities. These priorities included the reduction of violence, reducing restrictive practices, improving access to care, increasing the involvement of patients and carers in service improvement and planning, and improving the satisfaction of patients and staff.

·         The report included a summary of the Care Quality Commission (CQC) inspection results. The overall rating for SLaM remained ‘Good’, but the CQC had given a warning notice last year relating to acute pathways which required improvement to be made by April 2019. This had led to a range of planned work to deliver the required improvement, with the service recently re-inspected by the CQC. Initial feedback from the CQC indicated that the required improvement had been made, which once confirmed would mean that the service was no longer on notice.

·         SLaM would be delivering a number of big programmes linked to the quality agenda in the forthcoming year. Key areas targeted in Croydon included improving the patient experience particularly the flow through the service and also the recruitment and retention of staff.

Following the presentation from Doctor Sethi, the Sub-Committee was given the opportunity to ask questions on the content of the Quality Report. The first related to the status of Croydon as one of the boroughs covered by SLaM as the Quality Report seemed to have less of a focus upon Croydon than other boroughs. In response Doctor Sethi highlighted that as Service Director for Croydon it had not been his experience that Croydon was treated differently. There was currently a lot of activity in Croydon involving work with stakeholders and in particular Community Care. It was noted that Croydon was at the start of its journey whereas other areas had progressed further, which may give the impression that they were being given a greater focus.

As a follow up it was questioned whether there were targeted local action plans for each directorate. It was confirmed that action plans were being developed in a number of different areas including patient flow. It was intended that these plans would have both a Trust wide and a local focus.

Members were pleased to note that the pace of change in delivering service improvement was starting to increase. However it was questioned when this would start to be seen on a practical level. It was advised that improvement could already be seen through changes in how staff dealt with violence intervention including a reduction in the use of restraint. In other areas initial work had focussed on implementing improved reporting, which would lead to more noticeable improvement in the longer term. It was recognised that the path to achieving most of the high level targets would span more than one year.

It was questioned whether patient feedback was used to influence service change, as this was not explicit in the report. In response it was highlighted that the Quality Report did reference the use of patient feedback. Going forward SLaM would be looking at a number of different ways of using feedback from both patients and their friends and families. There were two patient carer leads within the directorate who worked with the senior management team to review feedback which would lead to the creation of new objectives. As well as general feedback other data such as complaints was also being used to inform service delivery.

As the CCG and Croydon Health Service were proceeding with the alignment of their services with a view to delivering a more coordinated healthcare system in Croydon, it was questioned whether SLaM had any similar plans for their own workforce in the borough. It was advised that community transformation was a key priority, with community care being looked at in every directorate. Work with stakeholders on designing this priority had commenced within the past three months, as there was an increasing need to look at other ways of delivering services due to ongoing workforce issues across the healthcare sector.

It was highlighted that the statistics included within the report seemed to indicate that the level of violence on wards was increasing rather than decreasing and as such it was questioned whether this should be a cause for concern. In response it was advised that the reduction of violence and the use of restriction was a complex area and in some instances an increase would not necessarily be negative if it led to a greater level of control. It would be of greater concern if the numbers were lower as this would not be a true reflection of what was happening on the wards and would raise concern about the reporting of incidents of violence.

The Chair thanked Doctor Sethi for attending the meeting of the Sub-Committee to present the SLaM Quality Report and his engagement with Member’s questions. It was suggested that it would be useful for the Sub-Committee to visit SLaM services to gain a greater understanding of how they worked. It was agreed that opportunities for this would be explored outside of the meeting.

Conclusions:

Following discussion of the report, the Sub-Committee reached the following conclusions:-

1.    As the Quality Report was written on a Trust wide basis, it was difficult to scrutinise the service provided on a local level.

2.    The commitment to provide more local, qualitative data in future reports was welcomed.

3.    That it would be informative for the members of the Sub-Committee to visit SLaM services in the borough, with arrangements for this to be made after the meeting.

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