NHS Lanarkshire review published
Expert team to help health board make improvements.
Health Secretary Alex Neil has established an expert Governance and Improvement Support team to help NHS Lanarkshire make improvements as a result of an assessment of patient safety and the quality of care.
The rapid review, which was commissioned by the Scottish Government and undertaken by Healthcare Improvement Scotland (HIS), has resulted in 21 recommendations for improvement by the health board.
These recommendations are being urgently addressed by NHS Lanarkshire, and the board will be supported by the improvement team, made up of health experts from across Scotland.
The expert team will be headed up by Jeane Freeman, Chair of the Golden Jubilee National Hospital, Malcolm Wright, Chief Executive of NHS Education Scotland and Professor Sir Lewis Ritchie, Director of Public Health at NHS Grampian.
It will focus on supporting the development and implementation of the delivery plan to be put in place by NHS Lanarkshire to fulfil all 21 recommendations.
The HIS review was initiated by the Scottish Government in August when monitoring of Hospital Standardised Mortality Ratios (HSMR) through the Scottish Patient Safety Programme indicated that while the fall in hospital mortality over the last five years at all three hospitals in the NHS Lanarkshire area was welcome, Monklands Hospital had not progressed sufficiently.
The HIS review also looked at Hairmyres and Wishaw hospitals.
HSMR has fallen by 4.3 per cent at Monklands Hospital since 2007, which compares to the Scotland-wide reduction of 12.4 per cent and falls of 7.1 per cent at Hairmyres and 17.6 per cent at Wishaw.
The HIS report highlights the need to improve the way in which the health board supports quality monitoring, governance and improvement activity and the need to have a more robust approach to identifying and supporting patients whose clinical condition is deteriorating.
The HIS report also draws out a number of examples of positive practice, and praised dedicated and hard-working members of staff who are committed to delivering the highest standards of health care.
NHS Lanarkshire currently has its highest ever staffing levels, including a record number of nursing and midwifery staff.
Health Secretary Alex Neil said: “This report highlights the importance of the Scottish Patient Safety Programme. It also shows that at times the standards of care have fallen short of the Scottish Government’s expectations for patients.
“That is why we commissioned this report and I have spoken to both the Chairman and Chief Executive already this morning, and I will be meeting the board of NHS Lanarkshire shortly.
“From my conversations this morning I know that NHS Lanarkshire is committed to tackling the report’s recommendations quickly and robustly, and that they are already making progress in a number of key areas.
“It is right that NHS Lanarkshire has indicated they will accept all 21 recommendations made by HIS. Today I am announcing that we are providing a Governance and Improvement Support Team to work with NHS Lanarkshire to help them deliver the rapid and sustained improvements which are needed.
“I expect those improvements to be made urgently, and I have asked to be updated regularly. I have also asked for a formal review of progress against the recommendations by the end of March.
“We should not lose sight of the commitment and dedication of staff across NHS Lanarkshire and the whole of our health service.
“This report highlights positive experiences alongside the negative ones. And when we deal with issues like those which NHS Lanarkshire must now address, we should reflect that hundreds of thousands of patients every day are cared for safely and effectively by our NHS.”
NHSScotland Clinical Director Prof Jason Leitch said: “We expect all health boards to ensure patient safety is their top priority and the Scottish Patient Safety Programme has been working for over five years to deliver ways to make healthcare safer.
“It should be remembered that we are only aware of this thanks to our patient safety programme. We instigated the rapid review on the basis of our concern over HSMR figures collected as part of the programme and our response has been swift.
“Although a high hospital standardised mortality ratio is not by itself a definitive measure of the quality and safety of care, it serves as an important prompt for further investigation.
“We should be clear that while the reduction in HSMR in Lanarkshire is to be welcomed and the safety programme is having a positive effect, we now need to see faster progress in line with the improvements made across the rest of Scotland.
“The review and our response should reflect our absolute commitment to shine a light on areas where our NHS does not live up to the standards we expect.
“NHS Lanarkshire, working with this expert team, are now urgently working on an action plan to address the issues highlighted in the rapid review.”
Staffing figures in NHS Lanarkshire:
- 9.3 per cent increase whole time equivalent (WTE) in staffing in NHS Lanarkshire under this Government.
- 9.8 per cent increase WTE in qualified nurses in NHS Lanarkshire under this Government. As at Sept 2013 NHS Lanarkshire has 4,967.0 WTE staff working in Nursing and Midwifery (qualified and support staff) – this is the highest nursing staff levels there have ever been in NHS Lanarkshire.
- 55.7 per cent increase in WTE medical consultants under this Government. This includes a 263.1 per cent increase in A&E consultants (21.1 WTE more, from 8.0 to 29.1).
- 7 per cent increase in GPs in NHS Lanarkshire under this Government.
- As of September 2013 NHS Lanarkshire has 10.131.2 WTE staff – this is the highest staffing levels have ever been in NHS Lanarkshire.
General statistics for NHS Lanarkshire:
- NHS Lanarkshire is seeing considerably more inpatients and day cases now than in 2006/07.
- Day cases have grown by over 5,600 (11.5 per cent) to 48,829 in 2012/13.
- Inpatient cases have increased by over 920 (or 2.2 per cent) to 41,124 in 2012/13.
- Lanarkshire have reduced the size of the waiting list by more than two thirds by treating patients faster – from 13,204 patients waiting in March 2006 to 4,051 in March 2013.
- Between 2010/11 and 2015/16 the NHS Lanarkshire resource budget will have risen by 3.5 per cent in real terms.
- NHS Lanarkshire are investing £8.7 million, including the recruitment of 54 WTE consultants, nursing and other clinical support staff in 2013/14.
Jeane Freeman, Chair, Golden Jubilee National Hospital
Jeane Freeman is a senior consultant in public policy and government, specialising in providing strategic policy advice to private and public sector organisations. In 1987 she established the criminal justice employment organisation, Apex Scotland and was its Chief Executive for 12 years. In 1995 she was awarded the OBE for services to criminal justice. For just over four years until 2005, Ms Freeman was senior special adviser to the First Minister, working on the Scottish Budget, the government's legislative programme, relations with the UK government and in the Finance, Health and Justice portfolios. Ms Freeman is currently a member of the Judicial Appointments Board for Scotland and a member of the Scottish Police Services Authority Board.
Malcolm Wright, Chief Executive of National Education Scotland
Malcolm has spent his career in the National Health Service. Starting as an Administrative Trainee with Lothian Health Board in 1975 he progressed through a range of managerial positions. He then went to the Hospital for Sick Children at Great Ormond Street as Hospital Manager, was subsequently appointed as Chief Executive of the Edinburgh Sick Children's NHS Trust. Following, this he worked in NHS Dumfries & Galloway firstly as Chief Executive of the Acute Hospitals Trust and lastly as Chief Executive of Dumfries& Galloway Health Board. He is also Chair of the Institute of Healthcare Management, Scottish Division and Vice-Chair of IHM UK. Malcolm was awarded an Honorary Doctorate at the University of Paisley in 2007, an Honorary Fellowship of The Royal College of General Practitioners in 2007 and an OBE in the New Years Honours List in 2008.
Professor Sir Lewis Ritchie, Director of Public Health, NHS Grampian
Lewis Ritchie is a graduate of Medicine and Chemistry of the University of Aberdeen and in Community Medicine of the University of Aberdeen. He has undertaken specialty training in both general practice and public health medicine. Since 1984 he has served as a general practitioner at Peterhead Health Centre and Community Hospital. In 1992 he was appointed to the Mackenzie Chair of General Practice, University of Aberdeen. He was appointed Director of Public Health NHS Grampian in 2012. He has chaired a number of national committees on research, eHealth, cardiovascular prevention, immunisation, community hospitals, quality, professionalism and excellence in medicine, community pharmacy, ME-CFS, telecare (NHS 24), quality, and academic general practice career development. He presently chairs the Scottish Medical and Scientific Advisory Committee to the Scottish Government (SMASAC) and formerly chaired the Biomedical and Therapeutic Research Committee of the Chief Scientist Office.