To review the Quality Account for 2022/24 and provide feedback to Torbay and South Devon NHS Foundation Trust.

Additional key lines of enquiry:

·         How is the process for managing mental capacity working across all areas with Torbay Hospital;

·         How is the change of mental health medication being monitored and information transferred to GP surgeries?

·         How quickly are the SARS reports and care packages being done for adult social care when people are being discharged into the community? 

·         Is there a guided timeframe and what are the statistics?

(Note: Liz Davenport, Chief Executive Officer and Deborah Kelly, Chief Nurse, both of Torbay and South Devon NHS Foundation Trust will present this item).

Ms Shelly Machin, System Care Group Director and Ms Nicola McMinn, Deputy Chief Nurse for the Torbay and South Devon NHS Foundation Trust, presented the Torbay and South Devon NHS Foundation Trust Quality Account 2022/23.  A Quality Account sets out the quality of services and improvements offered by an NHS healthcare provider.

Members were informed that the Quality Account for 2022/23 reflected on the strategic changes taking place to address systemic issues and challenges that impacted the quality and safety of care.  In addition, the Quality Account shared the improvements being made against the clinical improvement priorities agreed and against quality goals relating to sepsis; deteriorating patient; falls; nutrition and hydration and experience of patients upon discharge.  It was recognised that the impact of Covid on waiting times had been significant and reducing delays were also a focus for the year ahead.

Ms Machin and Ms McMinn responded to the following questions:

·         How is the process for managing mental capacity working across all areas within the Hospital?

·         How quickly are the SARS reports and care packages being done for adult social care when people are being discharged into the community? 

·         Is there a guided timeframe and what are the statistics?

·         What are the key measures in place to reduce emergency care waiting times and delays in ambulance patient handover?

·         Is there data to show the amount of days when Torbay Hospital Emergency Department is full to capacity and how do these figures compare against its peer group? ?

·         Does Torbay Hospital Emergency Department have more or less reserve capacity than its peer group?

·         Does an elderly population contribute to longer hospital stays which affect benchmarking particularly over the winter months where infection and respiratory conditions may be more prevalent?

·         Is the acute unit always fully staffed?

·         Is there a delay in discharge time for patients with mobility issues?

·         How will the Nightingale Hospital be staffed when it re-opens?

·         Where can information and statistics be found in relation to social discharge from Torbay Hospital?

·         Is reducing waiting times to 65 weeks for planned care realistically achievable?

·         In relation to stroke care, time spent on stroke wards has fallen from 90.2% in 2019/20 to 57.5% in 2022/23 – what is the reason for this?

·         How many agency staff in the clinical row of nursing are currently employed by the Trust within Torbay?

Resolved (unanimously):

1.         Members noted the Torbay and South Devon NHS Foundation Trust Quality Account 2022/23 report.

2.        A representative from the Devon Partnership Trust and the Integrated Care Board, Social Services team to be invited to attend the meeting of the Sub-Board on the 12 October 2023 to address how the change of mental health medication is being monitored and information being transferred to GP surgeries.

3.        Torbay and South Devon NHS Foundation Trust to share their report detailing performance data and measures implemented to reduce waiting times in the Emergency Department and in respect of ambulance handover delays for patients awaiting emergency care.

4.        Torbay and South Devon NHS Foundation Trust to provide a data dashboard to show the number of days where Torbay Hospital Emergency Department is full to capacity; how long it takes to recover to business as usual and how these figures compare against its peer groups. This will allow understanding of whether at times of maximum demand Torbay has more or less reserve capacity than its peer group.?

5.        Torbay and South Devon NHS Foundation Trust to provide information in respect of the level of emergency referrals from other Hospital Emergency Departments to Torbay Hospital Emergency Department and from Torbay Hospital Emergency Department to other Hospital Emergency Departments and in particular highlighting average and worst day data.

6.        Torbay and South Devon NHS Foundation Trust to share their report in relation to Hospital Standardised Mortality Ratio (HSMR).

7.        Torbay and South Devon NHS Foundation Trust to provide details of the number of agency staff that are currently employed by the Trust within Torbay and are in the clinical row of nursing.