Minutes:
The Chair welcomed Ms Lesley Watts, Chief Executive at both The Hillingdon Hospitals NHS Foundation Trust (THH) and Chelsea and Westminster NHS Foundation Trust (Chelwest), to the meeting. She had been at Chelwest for about ten years and had joined at the same time as the organisation had come together with West Middlesex. Ms Watts had previously been working with Hillingdon Hospital as a maternity advisor. She reassured Members that her responsibility to patients at THH would be equal to that of those at Chelwest – both were equally important.
It was noted that Hillingdon Hospital had a number of challenges, including those relating to infrastructure and had some real strengths and fragilities which would be better supported through joined up working with Chelwest. The Government had announced that Hillingdon would be getting a new hospital. This had given staff a boost and infrastructure changes had already been made, including the move to using the Cerner system. It was noted that the new hospital development was now in phase one of acceptance but that work on the design was still needed. There would be a financial gap that would need to be bridged and the Trust would need to be as efficient as possible.
Consideration was currently being given to the planning and structure of the proposed new hospital building. Ms Watts assured Members that there would not be any huge changes and that this was more about the interior design and layout. There had been an acceptance that the design was the right one but that the hospital needed to be made as efficient as possible. She suggested that Mr Jason Seez, THH’s Deputy Chief Executive, be invited to attend a future meeting to talk to the Committee about the hospital redevelopment.
Ms Watts noted that hospitals received more money from their elective work. THH needed to get a better balance between its emergency and elective work. Consideration would also need to be given to the Trust’s governance arrangements and back office functions to identify economies of scale and ensure that they were as efficient as possible.
Members noted that, in the past, the Committee had expressed concern about a number of performance issues at THH but these had never really improved. It was queried how improvements would be made at THH and whether the current set up would be part of a more permanent merger of the Trusts. Ms Watts advised that there were no plans around a merger at the moment as this could be a distraction as there was more to do. From a Chelwest perspective, action would need to be taken to address the quality of care, funding and performance at THH before this would be considered, otherwise it could result in further instability. Ms Watts stated that she would ensure that the quality of care at THH was as good as it should be. Whilst operational performance at THH was good in some areas, this needed to be addressed in the Emergency Department.
Ms Watts advised that she took staff welfare very seriously and was data and evidence driven. If the staff were well looked after, they would look after the patients properly and deliver a good quality of care. Given the work that needed to be undertaken at THH, it was suggested that it might take a little while for the Trust to be operating within the required financial envelope and effort would be needed to ensure that the service areas understood the need to work within these parameters.
Members asked about the day-to-day experience of service users in areas such as ENT and rheumatology. Specialist services would be reviewed with a level of forensic detail. Furthermore, the ‘ology’ services were often not emergency services so consideration could be given to liaising with other hospitals to see if they had capacity to assist with the waiting lists, particularly in relation to those individuals on the lists that were from deprived communities.
It was noted that it was important for staff to call out inappropriate things. Ms Watts had been rightly challenged in a recent NWL ICB meeting that providers needed to be aware of their failings without needing a CQC report to point it out. Staff needed to speak up and be listened to.
Ms Watts recognised that THH had strong relations with the local authority and that they would continue to undertake engagement together as the Council had a better understanding of the local communities. THH would be able to learn from Chelwest with regard to its stakeholder engagement work. The Trust would be open and transparent and Ms Watts looked forward to working with the local authority.
The Chair noted that, in the past, the Committee had received a lot of PowerPoint presentations from the Trust. However, the Members were keen to ensure that, going forward, they received honest accounts of the challenges being faced and the action that was being taken to address this, as well as the positive work that was being undertaken. The Committee thanked Ms Patricia Wright, former THH Chief Executive, for her engagement with the Committee and looked forward to continuing its work with Mr Seez and Ms Watts. Ms Watts’ honesty about the Trust’s journey was appreciated.
RESOLVED: That the discussion be noted.