To receive a presentation from Jayne Reynolds, Deputy Director of Nursing, on the Berkshire Healthcare NHS Foundation Trust’s Quality Account.

The item was introduced by Jayne Reynolds, Deputy Director of Nursing at Berkshire Healthcare NHS Foundation Trust, who explained that each Trust is legally required to produce a Quality Account each year. She outlined the highlights of the Quality Account to Members.

Jayne Reynolds explained that satisfaction rates amongst patients had generally improved since 2015/16, with the exception being from mental health inpatients. She stated that she believed the lower rates of satisfaction came from patients who had used the Trust’s smoking cessation services. She said that the Trust had had challenges in recruiting staff over the last year, particularly in the inpatients area at Prospect Park Hospital. She said that the Trust was currently operating with 20 per cent of posts vacant, although this was down from the previous figure of 35 per cent vacancies. She said that the Trust had managed to successfully retain staff, but was working on ways of improving the recruitment process.

Jayne Reynolds explained that the Trust had scored well across all areas on its most recent CQC inspection in December 2016 and all service areas were now considered compliant. At the previous inspection in 2015 some concerns had been raised in relation to inpatient safety at Prospect Park Hospital, which had been rated as requiring improvement.

Jayne Reynolds stated that the Trust had done particularly well in meeting its targets in relation to patient safety. It was noted that the number of incidents of pressure ulcers due to a lapse in care by the Trust and falls by inpatients was significantly lower than the annual targets that had been set. Jayne Reynolds explained that when an incident of pressure ulcer caused by a lapse in care was recorded, a learning event would also be created in order to improve future actions. The learning event would then be circulated across the whole of the Trust area. Jayne Reynolds stated that although there was no pattern in relation to pressure ulcers, there was an overall downward trend in their numbers. She confirmed that the figures related to the number of patients with ulcers, rather than the number of individual ulcers recorded.

Jayne Reynolds stated that the Trust had met all of its targets in relation to NICE technology appraisals, and 84 per cent of all NICE guidance. She explained that examples where the Trust did not meet a piece of guidance might be choosing not to implement a particular type of medication due to unaffordability. She stated that the Trust’s aim is to see a year on year increase in guidance implementation, rather than setting a target of meeting 100 per cent implementation.

Following a query from Cllr Jones, Jayne Reynolds stated that numbers in relation to incidents of falls in different unit rates and categories of pressure ulcers were fed back to the CCG and numeric figures specific to Royal Borough patients could be made available to Members.

The Chairman asked for more information on the Trust’s Zero Suicide Project. Jayne Reynolds explained that crisis plans were created with individuals with mental health problems, whereby triggers to suicidal ideation could be identified and the patient would then know when to get in contact with services, using contact details that they would be supplied with. The patient details would then be uploaded into the Trust’s systems. Jayne Reynolds explained that the target was for no suicides within the Trust’s area because, while getting the number down was an achievable target, doing so gave the impression that it was considered acceptable for there to be some suicides. She added there had been 22 recorded suicides of patients known to Trust services in 2016/17. She said there had been an initial increase in suicides since the recession and that incidents were decreasing; however, the current numbers were higher than they were four years ago. She said men were more likely to commit suicide than women, and they were more likely to take place in a community setting. Suicides within an inpatient environment were extremely rare.

Cllr Hollingsworth asked if the Trust was confident its IT servers were secure, in light of the hacking of various NHS Trusts the previous week. Jayne Reynolds said the Trust had been unaffected by the hacking and reminders about IT security risks, along with warnings to remain vigilant, had been sent to all staff.

Cllr Jones asked what was being done to improve waiting list times for the CAMHS service. Jayne Reynolds said a transformation project was underway with a specific aim of improving access for youngsters with an autistic spectrum disorder, by creating a pathway that included specialist mental health teams and an out of hours urgent care response unit. She said there was an aim for patients to be seen within 12 weeks. At the moment the average wait within Berkshire was 15-18 months, while the national average was three years. It was hoped a specialist unit for this service could be housed at Prospect Park Hospital. Cllr Jones stated that CAMHS provided a fantastic service for youngsters and asked if there was anything the Panel could do to improve matters and ensure the affected youngsters’ schooling did not suffer as a result of waiting for specialist intervention.

The Chairman asked which area needed the biggest prioritisation in terms of learning from complaints. Jayne Reynolds said mental health services had been identified as the area which had the lowest levels of patient satisfaction. She said the Trust was looking to ask patients for feedback on services at a later date, rather than at the point of discharge, which was the current standard practice.

The Chairman thanked Jayne Reynolds for attending the meeting and addressing the Panel.