www.slh.nhs.uk

South London Healthcare South London Healthcare NHS TrustNHS Trust

Service changesService changes

March 2011March 2011

Strategic objective for next 12 months

Move towards FT status to provide locally managed service for outer SE London patients.

To achieve this by: • Continued progress on safety and quality• Significantly increased clinical productivity• Consolidation of some specialties in line with merger

Trust’s merger has produced quality and financial improvements, –other NHS trusts are now looking at merger options to get to FT status

Where now?; APOH

• NHS London and the review by local GPs have both concluded that the Secretary of State’s four tests have been met

• Andrew Lansley in a letter to Bexley MP James Brokenshire has confirmed that he will not intervene in the decisions made by the GPs

• GPs, Bexley Care Trust and Bexley Council have been given until the end of March to produce a blueprint for a Bexley Campus on the QMS site; to include diagnostics, mental health, urgent care, paediatric assessment, elective surgery, outpatients

Summary: changes across SLHT

• A series of service moves were completed throughout November and December 2010

• Emergency and acute care services were relocated from QMS to QEH and PRUH, along with complex elective surgery

• General, orthopaedic and gynaecology elective surgeries have relocated to QMS, along with the temporary move of post acute ortho-geriatrics and medically fit patients

• Maternity and neo natal services, including the early pregnancy and foetal assessment units, relocated from QMS to QEH and PRUH, along with paediatric inpatient services. Ante natal and postnatal services, along with community midwives, have remained at QMS

Trust improvements in past 12 months

• Mortality rates – patients now have a better survival rate at SLHT than the national average

• A&E target for year reached, with more than 95% of patients waiting less than four hours

• Hospital acquired infection rates exceptional – only one case of MRSA this year, one case of Cdiff in February 2011

• Maternity – current Midwife:birth ratio is 1.33- recommended clinical target is 1.32

The above quality improvements achieved while reducing over spend by £40m

Staffing and spacing improvements to

QEH and PRUH A&E

QEH:• New mobile clinic (assess patients with minor injuries and houses

the UCC)• New temporary resus area• Recently opened acute and surgical assessment units – support

A&E activity• More children being referred to Happy Hippo assessment area to be

quickly seen by paediatricians

Staffing and spacing improvements to

QEH and PRUH A&E (cont.)

PRUH:• Opened the UCC• Expanded the paediatric assessment area

Staffing:• More A&E Consultants working across QE and PRUH than when

we had three sites open• Working to recruit more emergency medicine consultants

Measures to sustain improvement in A&E waiting times

• Opened extra capacity at PRU w/c 17 Jan• Capital works continue to expand space at QEH• QEH now has nine A&E Consultants, five at PRU with a sixth to start

shortly• Employed a team of nursing staff on a short term basis while

recruiting to fill the permanent roles

Mortality rates

• HSMRs [Hospital Standardised Mortality Ratio] measures the expected deaths at a hospital

• Trust’s measurement has improved in past 12 months, and QEH rate separately has improved significantly

• 100 is where trusts would be at an average rate, above is considered too high, below is considered good

• 12 month average for whole Trust to Nov 2010 is 93.5%; an improvement of 15.5%

• Taken on a month by month basis, figure is 73.6% trust-wide• Most marked improvement on QEH site; Nov HSMR at 74.9%

Maternity improvements

Clinical review commissioned by NHS London in January into the QMS maternity closure, praised SLHT maternity:

• Substantially reduced Midwifery vacancy rate

• Increased Consultant supervision

• Fewer serious incidents

• Higher Midwife to birth ratio