Princess Alexandra Hospital is in special measures after its services were rated ‘inadequate’ by the Care Quality Commission. Senior staff from Princess Alexandra met with Epping Forest District councillors at the meeting of the Overview and Scrutiny Committee on Tuesday 6 June for an improvement plan update.
- Lance McCarthy – Chief Executive
- Stephanie Lawton – Chief Operations Manager
- Nancy Fontaine – Chief Nurse
A&E waiting times and delays in bed allocation were raised by Councillor Stephen Murray. Stephanie Lawton apologised for the long waiting times but confirmed that patients remain safe. She said that some improvements had been made to flow and discharge of patients with support from community teams. Building works have been commissioned to extend admission facilities. Together with other plans these improvements should improve admission times. Nancy Fontaine added that where elderly patients are being admitted there is some discretion in allowing family members extra access to provide support.
Recruitment and retention
Responding to a question by councillor Aniket Patel, Nancy Fontaine outlined a number of new ward management and leadership training programmes. Councillor Yolanda Knight praised hospital staff following a ‘faultless’ recent visit. However, she also knew from experience that the quality of service varies greatly across different areas of the hospital. She raised the issue of staff morale, staff retention and the training provided to staff in dealing with difficult members of the public.
Nancy Fontaine was pleased to report that some members of staff have been with the Trust for many years. In some instances, three generations from a family are working in different areas of the hospital while many staff trained at Harlow coming back as more senior staff in later years. However, Lance McCarthy did acknowledge that recruitment was affected by the special measures issue.
Safeguarding for children
Councillor Steven Neville sought reassurance on safeguarding for children. Nancy Fontaine responded with a discussion around a culture of failing to follow policy and training. Safeguarding is now more embedded into hospital standards. She said that policies were now tough but it is probably never possible to ’do enough’.
Responding to a question by Councillor Holly Whitbread, Nancy Lawton described methods of recruitment including links with local colleges and interviews by Skype. Councillor Roger Baldwin asked about the financial deficit and plans to reduce reliance on agency workers. Nancy Fontaine responded that there is a very clear direction to reduce reliance on temporary staff. Lance McCarthy was able to provide figures illustrating the drop in agency expenditure from more than £20m a few years ago to somewhere nearer £13m more recently.
Responding to Councillor Nigel Bedford, Lance McCarthy said that the hospital managed the recent cyber attack on the NHS thanks to internal IT protecting services and installing the relevant patches very quickly. Stephanie Lawton outlined the processes and partner agencies working together to coordinate patient discharge in a timely way. She said this was not ‘cracked yet’ but improvements were being made.
Nancy Fontaine and Lance McCarthy outlined in more depth the health and social care solutions used to address issues of patient isolation raised by Councillor Aniket Patel. Stephanie Lawton also confirmed the regular update, review and training for emergency planning situations such as the recent terrorist attacks in London and Manchester.
Lance McCarthy acknowledged the Trust has a long way to go in moving out of special measures but felt the hospital was in a much more positive position. He is also looking at the long term redevelopment or relocation of Princess Alexandra to a better site.
Committee Chairman Councillor Mary Sartin thanked Lance McCarthy, Stephanie Lawton and Nancy Fontaine for answering so many questions and offered best wishes for the future. She said that whatever the issues, the CQC report made clear that Princess Alexandra Hospital was a ‘caring’ hospital.
In other business Council Leader Chris Whitbread reminded committee members of some of the key achievements of previous years including the freeze on Council Tax for a seventh year and the development of new assets such as the Epping Forest Shopping Park. He said that the delivery of keys to residents for the first newly built council houses had taken place. Focusing on community services he also applauded the work of the Council in attracting external funding. Local Plan development continues. The Council has listened and consulted with residents.
Councillor Whitbread continued with a description of the transformational changes being implemented across the Council leading to modern working, better use of technology and the facilitation of future service improvements. He also reminded fellow councillors of the benefits of the new leisure contract with a projected income of £20m over the next 20 years.
Other items covered by Overview and Scrutiny included:
- Select Committees Terms of Reference
- Select Committee membership
- Task and Finish Panels
- Annual Report of Overview and Scrutiny