A further brief update was provided to Members in:
· CQC undertook a visit of the whole trust in July and August 2021.
· Visited Emergency Department at Southend Hospital, Medicine at Basildon and Surgery and Maternity across all three sites.
· Report had been published early December 2021.
· The report identified the trust had been rated “requires improvement” overall with ratings of good in caring and effective. The rest required improvement.
· Key highlights had been listed as part of the general services and some of the areas for improvement.
· Pleasing to note there had been a lot of positives around the leadership and good for caring and for the care provided to patients.
· Positive of the removal of the inadequate rating for maternity in Basildon which was due to the hard work of all the staff in that area.
· Noted some outstanding practices.
· There were areas for improvement but positive and there were no surprises as the leadership group were aware of those and had plans in place.
· Listed some areas for improvement in maternity which was across all three sites.
· Next steps – CQC improvement plan reported to quality governance committee which was a sub-committee of the board. This was being revamped to include all the actions. With a particular focus to make sure any actions taken were sustainable moving forward not just a tick box and not just for one particular area but across the whole trust.
Councillor Ralph gave thanks for the updates and questioned whether there was a robust procedure for prioritising those women in triage to which Diane Sarkar stated was correct and a lot of work had been undertaken alongside safety teams from NHSI to offer support around maternity services and gain best practices from other trusts and was being rolled out across the Broomfield and Southend sites. There was also evidence of a good sign of sustainability which was monitored as part of the Section 31 report.
Councillor Ralph questioned what steps had been taken in regard to the cleaning of the hospital and whether this had been a lack of staff or an oversight. Diane Sarkar stated this had not been an oversight there had been a number of challenges during Covid with audits being reduced which had now been picked up. There had been some issues around consistency and continuity of staff but was well on track to ensuring the sustainability of cleaning standards.
Councillor Fish stated his shock on the amount of issues in the report especially those basic issues such as storing of medicines and staff appraisals, but the report had stated the trust had been aware of those problems. He questioned how the trust could be aware there was an issue on how medicines were being stored but took no action. Councillor Ralph agreed with Councillor Fish on these points. Diane Sarkar agreed during Covid the number of times items were checked had been reduced and had been an on-going challenge to ensure checks were undertaken. Diane Sarkar stated it was a challenge but would continue to ensure these were audited and monitored. In regard to staff appraisals there were reductions in the trajectory, the local trajectory had been changed during Covid recognising that these would have been a challenge to achieve during the pandemic. Councillor Fish stated he was not happy with the response and stated there should be an ethos that where these things could happen, everyone should be aware on how they would be sorted out. Diane Sarkar stated the ethos was the leadership team were clear on what the trajectories were, the performance targets and each division were held to account at monthly accountability meetings. These were monitored by the leadership team on a monthly basis, with clear trajectories to achieve them.
Councillor Ralph questioned whether the 40 new members of staff would be for maternity to which Diane Sarkar stated 40 student midwifes, newly qualified, had been employed into the maternity unit. This was very positive that the student midwives had been retained.
Councillor Ralph referred to the lack of staffing in the hospital and those shortfalls being cover by general practitioners from other areas and abroad to cover the gaps and asked what that percentage was. Diane Sarkar did not have the exact figure to hand but stated in terms of nursing and medical cover, a report had been presented that demonstrated that safe staffing levels had been maintained for both nursing and midwifery on every shift in January and these were monitored on a daily basis.
Councillor Ralph questioned whether there was a period of training for new members of staff to undertake before starting to which Diane Sarkar stated every new member, agency or locum staff would undergo an induction period, an induction checklist and would be signed off by the relevant departmental manager.
Councillor Polley questioned where she could find the performance ratings of the Cath Lab in the report to which Diane Sarkar stated Cath Lab would be covered under core medical services but had not been part of this CQC inspection.
Neil Woodbridge stated some comments made by the Thurrock Coalition. Those people they supported got quite alarmed when they saw a lot of requiring improvement ratings and a report as this was quite hard for some to understand. A compliment made was they felt well supported through the learning disability extra assistance which had been working very well and pleaded to keep this going as this worked well for vulnerable people. Asked what would be undertaken to ensure the service would be well led going forward to which Diane Sarkar stated the next visit from CQC they would be able to demonstrate a well led leadership for the sustainability for the improvements that had been made.
Diane Sarkar left the meeting at 8.03pm.