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Nottinghamshire and the Keogh Report

Chief operating officer, Amanda Sullivan responds to the publication of the Keogh Report – an independent review commissioned by the Government into the 14 NHS trusts in the UK where there were higher than average death rates in the last two years. Sherwood Forest Hospitals NHS Trust, which runs the King’s Mill Hospital and Newark Hospital was one of the trusts subject to the review.

“As commissioners, the CCG welcomes the publication of the Keogh review and’ we have engaged with the process throughout. The findings support and build on improvements that we are already working on with Sherwood Forest Hospitals NHS Trust which runs King’s Mill Hospital and Newark Hospital. This report will actually help to give that work added momentum. I am pleased that the trust has accepted the findings in full and the CCG will hold joint regular listening events with the hospital, so that local people can share their views and experiences of the hospitals and their care with us.

“I am aware that the public and health professionals may have questions about the role of the commissioning group in bringing about the changes necessary as a result of the Keogh Report.”I have examined each of the categories of concerns the report refers to so I have attempted to demonstrate how the CCG can help bring about those improvements.”

Board instability at the trust and a lack of focus on quality at board level
“I welcome the appointment of the new board which has already strengthened the focus on quality and we are pleased that board meetings will all be held in public from now on.”

Lack of strategic direction for the trust
“The two CCGs that plan and buy health services on behalf of the populations they serve in Mid Nottinghamshire are working together to develop a clear plan for the way that services are delivered in the communities we serve which also includes the services received at hospitals. We have agreed a plan to work with the public to find out what they think about those plans in the coming months. We will advertise events in local newspapers and would encourage people to get involved and let us know what they think about those plans.”

Lack of a clear direction / future for Newark Hospital and lack of trust attention to Newark as a site in its own right “The CCG asked the review team to look specifically at Newark Hospital because we are aware of local concerns. We continue to see Newark Hospital as a vibrant centre for healthcare in Newark – providing a wide range of services such as rehabilitation, outpatients, Minor Injuries Unit, surgery and diagnostics.”

“We have succeeded in providing more services for local people, such as Fernwood rehabilitation, which has been commended nationally.”
“More local people are having appointments at Newark Hospital year on year, so that saves considerable travel for people. 70% of urgent and emergency attendances can still be catered for at Newark Hospital, as evidenced by continued good attendance rates at the Minor Injury Unit and low transfer rates to other hospitals – less than one in twenty.”

“The CCG has a vision for Newark Hospital as continuing to provide a wide range of services for local people and will always put safety first when making decisions about what additional services can be provided there. “Poor governance at Newark Hospital and on-going concerns about mortality rates for Newark residents “Mansfield and Ashfield and Newark and Sherwood CCGs have commissioned an independent review into mortality rates and will publish the findings in September. The findings will inform how services develop over the coming months and years.”

“We now have a golden opportunity to decide on the future of Newark Hospital now that the trust that operates the hospital has a permanent board and has committed to specific leadership and stronger management. This will be in line with the work we are doing to develop sustainable services across Mid-Nottinghamshire as a whole.”

Poor systems and monitoring in the hospital
“The CCG regularly visit King’s Mill Hospital and Newark Hospital to look at the quality of care provided. We also check lots of aspects of quality, such as infection rates and falls in hospital. We have specific quality standards in our contract with the hospital and regularly monitor these to ensure that standards are being met.”

Poor complaints process
“The CCG shares public concerns about the way that complaints have been handled in the past. We have committed to be involved in the development of new systems and attitudes towards complaints to make sure that people who need to complain can have their concerns addressed in a timely manner and feel as though they are being treated fairly.”

Lack of doctors and nurses across both sites
“Safety is always our first priority. We will be reviewing this with the trust and looking to see where changes need to be made. The trust will be using fewer temporary agency staff and will recruit to permanent positions where necessary.”

Safety concerns regarding surgery at Newark Hospital (hip replacements) and lack of medical cover.
“This is a concern we share so we are reviewing medical cover at Newark Hospital as a matter of urgency. We will work with the trust to ensure that no one is put at unnecessary risk. We know that the surgical services at Newark Hospital have a good track record and no serious incidents have been reported. Patients have report that they like the service and feel well cared for.”

Amanda Sullivan, Chief Operating Officer for Newark and Sherwood and Mansfield and Ashfield Clinical Commissioning Groups

Further information about the report can be found on the NHS Choices Web site www.nhs.uk.

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