Board Matters - January 2015

Board Matters
Welcome to Board Matters
The Board was opened with a thank you to all the school choirs and other groups that performed at The Whittington Hospital over the Christmas period. Arsenal Football Club and players were also thanked for their visit to the children’s ward and neonatal unit before Christmas. This is the 20th year they have visited the hospital which always causes much excitement and is very special for patients and colleagues.

I recently had lunch on one of our wards with some of our patients. The food was very good and I received some very positive feedback on the quality and range of food available from patients.

The Board were informed that Barbara Windsor MBE was due to officially open the new Macmillan Cancer Information and Support Centre at the hospital on January 8th. The centre provides information and emotional support to people with or affected by cancer.

As we continue to work on our new five year strategy, we have further events in January for our patients, members, community and anyone with an interest in Whittington Health to give feedback on their health priorities, concerns and suggestions. Details are on our website.

We are running our first ever voluntary sector event for health and social care groups and organisations in Islington and Haringey on 28 January.

The Board thanked Caroline Thomsett, director of communications, who leaves the Trust at the end of January, for her work and wished her the very best for the future.
Steve Hitchins
Chair of Whittington Health
I would like to hear your thoughts
If you have any comments or views on any agenda items, please get in touch by clicking on the ‘email Steve’ button below or give me a ring on 0780 1106860.
Patient story   1
Phidieas Jiassemides, the father of one our patients Christina, told the Board her story. Christina has severe learning disabilities (LD) and complex physical health needs and is under the care of our learning disability team. Christina has difficulties communicating what she needs or wants which can be difficult when she is in a healthcare environment. She has been supported by several Whittington Health services, with several admissions over the past couple of years.

Hellen Odiembo, acute liaison LD Nurse has provided support for each of these admissions. Phidieas told the Board that overall the care and treatment Christina has received had been very good. However they have faced challenges, in particular when staff change over they often need to explain Christina's needs all over again because the information is not shared.

Hellen told the Board about the important support the Trust offers to patients with learning disabilities. Initially patients receive an assessment by a learning disability nurse to understand their complex health needs. The learning disability team are an integrated team made up of nurses, occupational therapists and physiotherapists, who work closely with mental health teams and colleagues within the local authority. The LD team support people like Christina by raising awareness amongst colleagues and introduced ‘purple folders’ which LD patients that has all their health needs and treatment details. All of this supports health professionals treat LD patients and ensure they get the best treatment and outcomes.
Christina's father,
Phidieas Jiassemides tells her story
2   Chief executive's report
Simon Pleydell
Simon told the Board that 78 per cent of colleagues had now had their flu vaccine, with a target of 80 per cent. This is very positive. 

Simon told the Board that we have dramatically improved our performance on responding to complaints, responding to 77 per cent within timescales for September and 79 per cent for October, compared with 21 per cent last year. The team is working hard to hit the target of 80 per cent within 25 days.

We have successfully tendered for new community gynaecology service, winning a three-year contract to provide a community gynaecology service across Islington and Haringey. The overall aim is provide a high quality and innovative consultant-led service to deliver safe clinical outcomes, improved patient experience with reduced intervention and follow up rates.
Winter pressures in emergency department   3
We are continuing, like most trusts, to experience a high level of pressure on our emergency department (ED).

This has meant that we did not achieve the national four hour standard of treating 95 per cent of patients in ED within four hours in November (92.4 per cent). This was due to a high number of patients and demand for acute inpatient and community-based beds. A number of actions have been put in place including additional resources, increased capacity in district nursing and extra medical and nursing staff in the ED and ambulatory care pathways. 

Chief executive Simon Pleydell told the Board that our resilience plans had been supporting the department and we were continuing to receive positive patient feedback.

The Board thanked the ED team for their hard work over the past month. It had been a difficult few weeks with unprecedented demand. 
High demand for the
emergency department 
4   Musculoskeletal update
Better service for
our patients
The Board heard about the recent improvements to the musculoskeletal (MSK) service. 

The service aims to see all patients within six weeks which had been achieved for 90 per cent of patients. Every week the service receives between 650 and 950 referrals. The variation has proved a challenge and the service has been analysing different models to cope with the fluctuation in demand.

A new Trust access policy is ensuring fair treatment for all patients. This has led to reduced waiting times and fewer patients who did not attend their appointment.

At the end of last year a new website (pictured left) was launched providing patients with information on MSK, physiotherapy and podiatry services. The website particularly promotes self-help and self-management as well as giving referral information for GPs and other professionals. The team are developing a central call and referral management service to handle all MSK referrals to improve the service further.
District nursing update   5
Our district nursing team has seen a 30 per cent increase in activity over the past three years which has increased pressure on the service. The Board heard about the improvements the service had made which were resulting in a better service for patients. These include:
  • A successful recruitment campaign has led to our vacancy rate reducing from 30 per cent to five per cent. This has given a more stable workforce.
  • A new head of nursing role for the community with the focus on quality assurance and improvement across the service.
  • Development of an efficient and effective team structure.
These changes have improved efficiency, productivity and communication with local GPs and other stakeholders. 

The roll out of iPads has also had a positive impact on the service, enabling the virtual handover of patients which had reduced travel time. The team’s use of clinical apps has also saved duplication and time.
Improvements across the service
6   Our financial performance
Finance update
The Board heard how, like many other NHS trusts across England, we are facing a challenging financial position this year. We had a deficit of £6.7m at the end of November and are forecasting a deficit of up to £7.4m at the end of March. The financial position was a combination of income underperformance and expenditure pressures.
This is a major concern and we are working across the organisation to reduce the deficit as far as possible this financial year while at the same time ensuring our commitment to safe high quality care.
We are working on a robust plan to bring us back into balance within the next 18 months without impacting on patient care. The Trust continues to have further productive discussions with our commissioners and is exploring all options for additional funding to improve the position.
Working on it!