Agenda item

Hisham Abdel-Rahman, Chief Executive of Hinchingbrooke Hospital, will present the Hospital’s Action Plan.

The Chairman welcomed Mr H Abdel-Rahman, Chief Executive Officer and Clinical Chairman, Mr M Burrows, Chair of the Hinchingbrooke Trust Board, Mrs D Fowler, Director of Nursing, Midwifery and Quality and Mr C Davidson, Franchise Manager, who had been invited to present the Hospital Action Plan.

The Chairman informed the Panel that the presentation would be in two sections: how Hinchingbrooke had got to its present position with questions and then the future for the Hospital with questions. The Panel then received a presentation which was led by Mr H Abdel-Rahman on the history of Hinchingbrooke and present position. The following points were highlighted:

  Hinchingbrooke had recorded high levels of patient satisfaction as well as low levels of serious incidents including zero “Never Events”.

  There had been particular problems with Accident and Emergency (A&E), as there had been nationwide.

  The Care Quality Commission (CQC) report highlighted that the areas of critical care, maternity and gynaecology and outpatients and diagnostic imaging were good, however the areas of A&E and Medical Care were inadequate.

  The CQC report on Critical Care highlighted that the environment of the department led to poorer patient experience and that at times there had been capacity issues. However Mr Abdel-Rahman informed the Panel that the new Critical Care unit would open in July and this would address these concerns.

The Chairman informed the Panel that questions had been submitted by Mr Lynch and Mr Sweeney, though some questions overlapped. The first question was why had no-one accepted responsibility and resigned following the CQC report? In response the Panel were told that the CQC had not inspected Hinchingbrooke because of concerns raised but because it was a low risk hospital. In addition the Chief Executive and Board would stay at the Hospital to work with the NHS Trust Development Authority to make the system work.

Mr Abdel-Rahman was asked, since his appointment, what proportion of his time he spent on the designated role of Chief Executive? Mr Abdel-Rahman told the Panel that he became Chief Executive last year and currently spent one day a week as a consultant.

Mr Abdel-Rahman and the Board were then asked if they had past and present shares in Circle holdings or held membership of a political party. Mr Abdel-Rahman responded saying that he had no shares in any company, he did not receive a salary from Circle and he was not affiliated to any political party. Mr Burrows, Mrs Fowler and Mr Davidson informed the Panel that none of them had shares in Circle and or were affiliated to a political party.

The Board were asked about the finances of the Hospital. In response the Board said that they were concerned about the finances of the trust and that the deficit in the budget was as a result of a number of factors including increases in staffing costs to cope with higher than expected emergency activity. The Hospital had been rated as a low risk organisation but there was a need to address variations in performance. The Panel were informed that since the CQC inspection there had been six inspection visits, which had identified improvements.

The Board were then asked why they had employed a Director of Governance and whether governance was the responsibility of Board members. Mr Abdel-Rahman responded by saying that the NHS valued good governance and the fact that a Director of Governance had been appointed was a sign that the Hospital viewed governance as being important.

A question was asked about how many Management and Health consultants had been employed during Circle’s franchise period and at what cost? Mr Abdel-Rahman confirmed that no management and health consultants had been employed during Circle’s franchise period.

The final question from Mr Lynch and Mr Sweeney was regarding the historical £40m debt and whether there was substance in the claim that the Trust had asked the Government for an additional £10m loan. The Board informed the Panel that once surpluses had been made, the debt would start to be repaid. The Hospital had approached the government for an additional £10m through the NHS funding system. Mr Abdel-Rahman added that it was important to remember that Cambridgeshire and Peterborough had historically been underfunded and there was a funding gap as a result.

A Member asked about staffing levels and in particular how many agency staff had been appointed by the Hospital and at what cost. In response Mrs Fowler informed the Panel that the cost of employing agency staff was double that of employing a permanent member of staff. There was a national shortage of nurses and Hinchingbrooke was not been immune from that situation. The current vacancy rate was 12% which represented 21 full time equivalents but the turnover of nurses had reduced from 13% to 10%. In addition the Panel were told that the additional problems with A&E added to the staffing pressures.

The Board were asked about the reported perception of patients that the Hospital had a good cafe but needed more nurses on the wards. In response the Panel was informed that the Hospital received an income from the café franchise. Throughout Cambridgeshire there were vacancies for nurses, although £1.2m has been invested to make sure there were enough nurses on each ward. The Hospital had gone to great lengths to recruit nurses and now had 16 international nurses in an induction programme.

A concern was raised that there were patients turning up at A&E who should be going to their GPs but did not do so because they could not get an appointment. Mr Abdel-Rahman responded by saying that that it was difficult to assess if this was the case but that co-ordinated efforts were required to ensure that patients obtained services in the most appropriate way.

A Member asked about the CQC’s final report to which response was that the report had been published but the CQC had accepted it contained 200 inaccuracies. However this didnot change the rating the Hospital received.

The Board were asked about staff moral and how the management was going to engage with staff now Circle had withdrawn. In response Mr Abdel-Rahman stated that when Circle joined staff morale was low, however it was now rising with more consultants and nurses than before. The trade unions had been supportive and were meeting with management regularly. In addition the sickness absence rates had fallen.

The £10m loan through the NHS funding system was raised and in response the Board stated that the terms had not yet been agreed but it would not be repaid until the Hospital’s financial circumstances permitted it.

The Chairman thanked the Panel, Mr Lynch and Mr Sweeney for their questions and moved onto the second section of the item. The Panel was informed of the direction the Hospital intended to take. The following points were highlighted:

  Since the CQC’s report there had been progress and the quality improvement plan could be viewed on the Hospital’s website.

  The Board was continuing to monitor the Hospital’s finances as well as making sure that it adhered to operational performance standards.

  Patients remained at the core of the business strategy.

  The Hospital aimed to become one of the top 10 District General Hospitals.

A Member stated that in their personal experience the hospital employed good practices.

The Chairman thanked Mr Abdel-Rahman, Mr Burrows, Mrs Fowler and Mr Davidson for attending and presenting the Hospital Action Plan. The Panel agreed that the item would be followed up at a later date. The Chairman informed the Panel that he was on the Oversight Group at the Hospital.

(At 20:28, during discussion on this item, Councillor Mrs P A Jordan left the meeting. At 21:03, after the conclusion of the item, Councillor A J Hardy left the meeting.)