Agenda item

For members information a copy of the CQC Inspection report is included in the pack.

The Committee received a presentation from Julia Young, Director of Quality and Patient Safety NEAS, on the findings of the CQC inspection report and the action taken in response to the findings (for copy of presentation see file of minutes).

Introducing the presentation, the Director of Quality caveated that the inspection took place in light of the impact of the Covid-19 pandemic.  A summary of the ratings was provided, with safety and effectiveness being downgraded from ‘good’ to ‘requires improvement’ and the rating for leadership being downgraded from ‘good’ to ‘inadequate’.  Since then, a number of changes had been made to the leadership team and a great deal of work had been done in response to the findings.  On a more positive note, the ratings for caring and responsiveness both remained ‘good’.

The Director of Quality outlined the four key findings of the inspection which were that medicine management was not operating effectively, improvements were required in respect of the processes for the investigation of incidents and responding to staff feedback and governance systems were not operating effectively.  The Committee received details of the actions taken to address the key issues. The actions in respect of medicine management included an audit of internal practice and reinforcement of policies. In response to the finding in respect of improving the investigation of incidents, additional capacity had been put in place to implement a new framework, the Patient Safety Incident Response Framework, by September 2023.  A new Head of Culture and Staff Experience had recently been appointed in response to the finding in relation to staff feedback.  A governance review had been undertaken and new board members had been appointed to strengthen leadership. The Committee received information on how the North East Commissioning Support Unit is providing independent scrutiny and a CQC steering group was established which will become the Trust Improvement Board from 1 April, which will enhance external scrutiny.

The Director of Quality also provided information on ambulance response times and spoke of the work that had been done to improve the number of crew hours lost since December, which was testament to the good working relationship with health and social care colleagues. 

Members of the Committee made comments and questions as follows.

Councillor Stubbs asked why it was necessary to create a new Head of Culture and Staff Experience and how the effectiveness of the post would be measured.   The Director of Quality explained that the post was established to respond to reports from staff that they feel reluctant to speak up due to a lack of feedback. 

Therefore, a culture survey which includes a culture measure will be disseminated to staff and this will gauge whether the culture is improving, as changes are implemented.  The Director added that a full action plan in response to the CQC report will be reported to the Trust Improvement Board and progress on actions would be shared with the Committee at a future meeting.

In response to a question from Rosemary Gott as to how controlled drugs are logged in emergency situations, the Director of Quality clarified that an electronic patient care report is completed at the time of an incident and both crew members must record and sign for controlled drugs, used and discarded. 

Councillor Haney referred to the changes to the executive board and commented that it would be in the public interest for the non-executive board to be subject to the same scrutiny. The Director of Quality commented that some changes had been made to the non-executive board and funding had been secured for training for non-executive board members on the Patient Safety Response Framework.

Members acknowledged the pressures on staff in the aftermath of the pandemic and stressed that it was important to ensure staff did not feel demoralised by the  report. The Director agreed with the sentiments and acknowledged the need to improve staff morale and recognise their value within the organisation as a whole. To that end, improvements were being put in place to ensure staff are listened to and that when an issue of concern is raised, that they are informed when action is taken.

Councillor Gunn remarked that the risk of the non-recurrent financial settlement will be crucial to success in the future.

The Director of Quality concluded by explaining that the CQC steering group will become the Trust Improvement Board on 1 April and the Trust Improvement Board will review the findings of the independent enquiry, the CQC findings and other system improvements.

Resolved

a)    That the information detailed in the presentation be noted.

b)    That an update report on progress against the Improvement Action Plan be included in the Committee’s work programme for 2023/24.