The man at the helm of improving Sherwood Forest Hospitals NHS Foundation Trust says the organisation is making substantial improvements but was on a journey which will take several years.
Dr Andy Haynes is the new executive medical director at the trust which runs King’s Mill Hospital.
He is charged with making the hospital flourish again after it was placed in special measures last year, by Sir Bruce Keogh and given an action plan to improve.
Last week Dr Haynes told the Chad the Trust has already made significant progress to improve the issues around mortality rates which sent it into special measures.
In the second part of his interview he discusses nursing levels and the challenge of meeting the financial demands of PFI charges which have saddled the Trust with an annual bill of £46 million.
A report by the Quality Care Commission (CQC) criticised staffing levels at the Trust, which it said had too many untrained nurses relative to the number of trained nurses.
An urgent review of the nursing skill mix was needed with immediate plans to ensure it was adequate to provide safe patient care.
Dr Haynes said: “The Keogh reviews highlighted that the number of nursing staff that we considered adequate historically actually might not have been right.
“Most trusts have had a look at their nursing ratios and enhanced them.”
He said King’s Mill had a particular issue as it contained a lot of single rooms.
“This is great for patients, but means that nursing ratios need to be little higher than normal to nurse those areas safely.”
He added: “Reviews prior to Keogh suggested that nursing numbers were adequate .
“They have now been corrected and improved and that is an ongoing thing that we need to monitor.
He said there had been “substantial investment” in nursing staff at the trust.
“We have enormously improved nursing ratios and deliver excellent care now and that is backed up by the CQC re-visit which happened in December.
“It recognised that significant changes had happened at the hospital and it felt a very different place from their the initial review.”
More than £320 million was spent on new facilities at King’s Mill Hospital through the Private Finance Initiative (PFI)in November 2005.
The trust paid £46 million in PFI charges in 2012-13 and its contract ends in 2043.
Dr Haynes said PFI was an issue faced by many Trusts, but did not impinge on the equality of care at King’s Mill. He says the Trust is working on a long term solution.
He explained: “There were agreements which were signed off in history and the economy has changed.
“As a result we now have a series of problems which at the time the PFI deals were made were perhaps not anticipated.
“Health care finances at the moment are under pressure all over the country.
“Quite a number of trusts, both foundation trusts and non-foundation trusts are needing to receive financial support. About 30 per cent of acute trusts in those sectors are needing financial support.”
He said financial pressure reflected health funding in general: “Although it has increased by one per cent, in real terms with the increase in inflation and the increase in demand that actually means there is less money available .
“We can improve the efficiency of care in health and that’s an important requirement and some of the things I’ve described are a part of that - trying to give good quality service as efficiently as possible.”
“All these things I’ve described; the clinical process improvement, the redesign of processes and the sorting out of the finances - are at the start of a journey.
“We are early in that. It’s not a journey that’s going to take a year it’s a journey which will take a number of years and we need to develop the headroom now to deliver that journey.
That requires a consistency of management across the hospital which I believe we now have and the headroom from the external agencies and we need to earn that - meeting their requirements to escape the special measures.
“That is what the trust is determined and working very hard to do.”
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