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Performance Report Q3 2020/21

Dear Stakeholder

We have now reached the third quarter (September – December) in which we are working to the strategic objectives laid out in our five-year Corporate Strategy, launched in April 2020.

As part of this, we’re committed to sharing how the Trust has performed at the end of each quarter. Below we have outlined the Trust’s achievements during Quarter Three (Q3) and also highlighted some areas for continued focus.

Q3 saw the Trust continue to make real progress in each of its six strategic objectives, against a backdrop of rising COVID-19 cases, restoration of our services after the first wave of COVID-19 and winter pressures.

This progress is being made alongside other significant external recognition for our improvement journey. Following two unannounced visits to the Trust in September 2020 the CQC lifted our ‘Inadequate’ or ‘Requires Improvement’ rating on core services, which are all now rated as ‘Good’ for Caring. In addition, following the CQC’s unannounced Autumn 2020 inspection, the CQC has recognised the substantial progress made in Maternity Services and lifted five Section 31 notices that were placed on our Maternity Services 18 months ago.

Here are just a few examples of our achievements which can be read alongside our detailed summary and associated papers from our February Board of Directors' meeting.

Quality

Strategic Objective One – to consistently provide safe and compassionate care to our patients and their families

  • As part of its SAFER programme, the number of discharges before midday increased from 13% in September 2020 to 27% in December 2020 across core ward areas.
  • The first Electronic Observations (E-Obs) Project Board meeting took place in November 2020 to agree a list of functional specification requirements. The business case is expected to be submitted by the end of Quarter 4.
  • As of 29 November 2020, 61.78% of required staff have completed their National Early Warning Score (NEWS 2) training.

Strategic Objective Two – Modernising our Hospital (estate, digital infrastructure and medical equipment) to support delivery of optimal care

  • The Trust has appointed IDP to support the development of its Strategic Outline Case for its large-scale national capital investment – the Trust’s ‘Back our Bid: Build our Future’, is being supported by the local media. QEH is supporting the regional approach to managing and mitigating the Trust’s structural integrity issues in the mean-time which are presently increasing operational challenges.
  • The Estates workplan for 2021/22 is under development and on track to be submitted to the Board of Directors in March 2021.
  • There have been positive developments in many areas of the Trust’s key digital priorities including Electronic Patient Record, Electronic Observations and Electronic Prescribing and Medicines Administration.
  • Meetings of the Norfolk and Waveney Hospital Group Committees are taking place. The Hospital Services Strategy policy Convergence and Alignment workstream continues with a focus on Mandatory Training, Consent; Infection Prevention & Control; Thromboprophylaxis and an over-arching framework for Policy Development.
  • QEH continues to support the regional Sustainability and Transformation Partnership led development for a single digital care record (Electronic Patient Record) for the region.

Engagement

Strategic Objective Three – Strengthening staff engagement to create an open culture with trust at the centre

  • The full 2020 National Staff Survey and Medical Engagement Survey results will be published in Q4. The Trust had a 45% response rate to the National Staff Survey 2020, which is an increase on 2019 (42%) and is in line with the national average. More staff are feeling valued and appreciated as a result of positive changes the Trust has made. The Trust’s latest CQC Report (December 2020) provided external evidence of tangible improvements to staff engagement and culture in the Trust.
  • The Trust’s vacancy rate fell under 10% for the first time in 2020/21 to 8.14%.
  • The next phase of the Trust’s recruitment campaign has been launched focussing on QEH being in a rural/coastal location. The Culture Transformation programme is progressing improvements to pre-hire, on-boarding and induction of new staff to ensure the best possible start at QEH.

Strategic Objective Four – Working with patients and system partners to improve patient pathways and ensure future financial and clinical sustainability

  • In order to drive forward the development of the School of Nursing, the College of West Anglia (COWA) and the Trust have appointed a Band 8A Senior Nurse who will start in post in February 2021. COWA has registered with the NMC through Anglia Ruskin University.
  • The Trust is proactively working with Norfolk and Norwich University Hospital (NNUH) and James Paget University Hospitals (JPUH) in relation to the development of a Diagnostic Assessment Centre on site. System-wide work continues in relation to the development of an Integrated Care System. In addition, the Trust continues to proactively engage with the Local Delivery Group which is re-focusing its work to recognise the importance of developing Place-Based care within West Norfolk.
  • An external stakeholder perception review was undertaken and completed in Q3, showing progress in this area, with feedback informing our Year Two Corporate Strategy milestones.
  • A detailed Memorandum of Understanding has been developed and signed by the three Trusts in relation to an Acute Procurement Collaborative, the Norfolk & Waveney Pound. This will ensure that we have robust processes in place to deliver co-ordinated procurement services across Norfolk and Waveney, leading to the sharing of best practice and future financial savings through delivery of economies of scale.

Healthy Lives

Strategic Objective Five – Supporting our patients to improve health and clinical outcomes

  • QEH has successfully restored its screening service in line with pre-COVID-19 standards and was one of the first Trusts nationally to clear its backlog.
  • To drive delivery of the Health and Wellbeing Centre a project group has been established with operational, clinical and estates colleagues. Work commenced on site on 25 January 2021.
  • In order to support mental health and wellbeing an initial meeting took place in November 2020 with Norfolk and Suffolk NHS Foundation Trust (NSFT), clinicians and senior leaders. Further work will focus on a joint action plan between NSFT and QEH. The main themes for improvement include workforce, education and enhanced care.
  • The Trust has developed a comprehensive action plan to improve outcomes for mothers and babies and to strengthen the culture within the service aligned with the requirements of the independent review of maternity services at the Shrewsbury and Telford Hospital NHS Trust.
  • The Trust has increased the number of patients recruited to research trials by 178% increase from 2019/20.

Strategic Objective Six – maximising opportunities for our staff to achieve their true potential so that we can deliver outstanding care

  • QEH’s staff and wellbeing programme has been further strengthened during COVID-19 and has received national recognition.
  • 100% of frontline staff had their flu jab (QEH was the best performer regionally and nationally) and the Trust commenced its COVID-19 vaccination programme in late December, with over 12,000 people currently vaccinated (February 2021).
  • The Trust’s Head of Learning and Development is now in post and is focussing on the development of the e-Learning portal. Work continues with our STP to align the Mandatory Training policy across the three acute Trusts in Norfolk and Waveney which will streamline the processes and enable a digital passport to be created.
  • An Associate Director of Quality Improvement post, to be shared across QEH and NNUH, has been appointed with the start date to be confirmed. This is a vital post in driving forward the QI Faculty which will support improvement and transformation across both Trusts and sharing of learning.

We recognise that we are not where we need to be for some key metrics that were identified as priorities. We continue to work on these important KPIs and high level plans have been put in place to focus on improvement in these key areas, which include:

Quality

  • The number of complaints in relation to staff manner and attitude and the fundamentals of care remains above the target for Q3.
  • There has been a significant increase in the number of patient falls compared to Q2 (181 in Q2 and 217 in Q3).

Engagement

  • The vacancy rate and turnover for Allied Health Professionals is 14.28% and 14.24% respectively against a target of 12% and 12.4%.
  • Mandatory training compliance rate is 77.03% against a target of 82.16%.
  • Appraisal compliance is 80.52% against a target of 87.85%.

Healthy Lives

  • Our overall sickness absence rate is 6.09% against a target of 4.4%.
  • Our sickness absence rate relating to stress, anxiety and depression is 24% against a target of 12%.

Despite the COVID-19 pandemic continuing and winter pressures setting in we are more determined than ever to meet our objectives to ensure our patients, their families, the local community and our staff get the experience they rightly expect and deserve when they come to QEH.

We look forward to continuing to share our progress with you over the coming months. If you would like to discuss any aspect of this update please do not hesitate to get in touch.

Yours sincerely,

Professor Steve Barnett

Chairman

Caroline Shaw CBE

Chief Executive

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