Alison Robertson, Chief Nurse gave an overview on the recent work within St Georges, focussing on the Quality Improvement Strategy and Patient Experience.

Peter Jenkinson, The Director of Corporate Affairs reported that an inspection from Care Quality Commission raised some areas of concern.  The Trust took this very seriously and an action plan was developed.  Significant improvements were found when the Care Quality Commission revisited in August this year.

St Georges will also be one of the first Trust’s to go through the Care Quality Commission’s new inspection regime. Also the Trust is now in the lowest band of risk across the country for quality of services.

A panel member said they were concerned that there was no additional funding for excess winter deaths yet there is a high incidence of this problem in Merton.

The Chief Nurse reported that the funding is being directed to the areas with the most challenges. They will be working closely with the Clinical Commissioning Group to mitigate the challenges.

A panel member asked about levels of temporary staffing within the Trust, it was reported that there is a policy on the numbers of trained and untrained nurses. This year they have trained one hundred intensive care nurses and managed to retain seventy.

A Panel member asked if the Trust use relatives or carers to help with feeding. The Chief Nurse agreed this was the case they also use volunteers, especially in the older people’s wards. However they still believe that feeding and nutrition is the nurse’s responsibility.

A panel member asked why the Care Quality Commission had an issue with their record management. The Chief Nurse reported that they had found that some records were not kept securely and were left on Nurse’s stations. Also a patient’s observation chart was found to be marked incorrectly. Nothing happened as a result of this although it could have put the patient at risk.

A panel member asked about the Care Quality Commission’s ratings on management of medicines and care to patients. The Chief Nurse reported that they did not have a consistent process for monitoring temperature on drugs fridges, although the  Care Quality Commission were satisfied that there had been no harm to patients. In regards to care to patients, patients in the cancer ward particularly reported low ratings for experience, even though the clinical outcomes were very good. As a result of this an action plan was developed.  It was recognised that there was a poor clinical environment. The action plan includes more contact with specialist nurses and training for staff.

A panel member said there is huge variation in service between wards; therefore instant electronic feedback would be helpful.

The Chief Nurse said important signals come from family and friends. A number of changes have been put in place to tackle variation in service between wards including uniforms to make senior staff visible and ensuring that they spend at least half their time supervising the wards.  There is also a leadership development programme.