Agenda item

A report on the activities of the HOSC working group established to scrutinise the ESHT Quality Improvement Plan

8.1       Members considered a report from a HOSC working group which recommended the establishment of a Scrutiny Review Board to scrutinise the East Sussex Healthcare Trust (ESHT) CQC reports and the trust’s subsequent implementation of its Quality Improvement Plan.

8.2       The Chair told members that he had purposely not invited ESHT to this meeting as there was no new news of the CQC process; and the item being considered, although relating to the scrutiny of ESHT, did not require ESHT’s active participation at this point.

8.3       The Chair informed the committee that the CQC was anticipating holding a Quality Summit in the week commencing July 13. The second inspection report would be published shortly after the Quality Summit. The Chair proposed reserving July 23 for a special meeting to consider the second CQC report, should the report be published on time. Cllr Ensor also stressed his eagerness that future scrutiny of this issue is undertaken in co-operation with Healthwatch and with East Sussex CCGs, suggesting that HOSC members might consider signing-up as Healthwatch members.

8.4       Julie Eason commented that she was frustrated that the Chair and Chief Executive of ESHT remained in post and that it was not possible for local stakeholders, including the HOSC, the county council, or district and borough councils, to influence this situation. She wanted it recorded that there was consensus amongst HOSC members that the ESHT Chief Executive and Chair should stand down, but that HOSC had no powers to enforce this.

8.5       The Chair responded that, in his view, it was a better for the HOSC to wait until the publication of the second CQC report before making further comments on the management of ESHT. The intention was that the ESHT Chair and Chief Executive would be invited to attend the special HOSC meeting on 23 July, should this meeting go ahead as planned.

8.6       Cllr John Ungar noted that he was concerned that the faults identified by the CQC may have had an adverse impact upon the care and safety of ESHT patients, and called for the Secretary of State to be asked to investigate ESHT mortality and morbidity data to see if care had in fact been adversely affected. Amanda Philpott noted that, whilst the CQC report provided very useful information on quality at ESHT, it was only one part of a suite of indicators. Looking at the full range of data, there is no strong case for escalating the matter to the Secretary of State. East Sussex CCGs are happy to work with the proposed Scrutiny Review Board to help members better understand how commissioners use the full range of quality data. The Chief Nurse has offered to lead on this.

8.7       Amanda Philpott noted that it was disappointing that the initial Quality Summit had not taken place, and there had consequently not been the opportunity for stakeholders to come together to explore the implications of the inspection report prior to its publication. It was to be hoped that there would be a more effective dialogue process for the second report. East Sussex CCGs also hope to be fully involved in conversations about quality between ESHT and the Trust Development Authority (TDA) going forward.

8.8       In response to a question about the value of the Better Beginnings Implementation Board in light of the continuing quality issues in ESHT maternity services highlighted by the CQC report, Amanda Philpott told members that the Board had been valuable in terms of providing assurance, although in future it was clear that a more robust assurance process was required – for example focusing more on daily operational data to determine the degree to which changes had in fact been implemented. It was also important to bear in mind that some of the failure to fully implement Better Beginnings actions has been due to a lack of anticipated external investment in services. There is a lesson to be learned here in terms of ensuring that, when an action is required of an NHS trust, all parts of that action are within the trust’s gift.

8.9       Amanda Philpott informed the committee that unfortunately CCG Chief Officers and Chairs would be unable to attend a meeting on July 23 as they had to attend a regional NHS event.

8.10     RESOLVED – that a Scrutiny Review Board be established to scrutinise the CQC inspection of ESHT and ESHT’s quality improvement actions in response. The Board will set its own detailed terms of reference, but will include the themes outlined in the relevant report (To June 16 HOSC).