Health trust 'needs intensive help'
A Northern Ireland health trust which left patients waiting on trolleys is in a poor position and needs intensive support to improve, a report has said.
Patients flowed poorly through the system at Northern Health and Social Care Trust (NHSCT) and did not undergo a daily review.
Weak relationships between staff and a lack of leadership were also identified by health expert Sue Page's review.
The trust has been under considerable pressure, mainly due to problems at Antrim Area Hospital's emergency department. For successive winters Antrim Hospital experienced excessive trolley waits, with regular breaches of both its four and 12-hour targets. Health Minister Edwin Poots said he is determined to see the trust improve.
The report said: "The analysis identified that NHSCT is in a poor position in relation to performance and the trust has sub-optimal capacity to improve, placing the trust in a category that requires intensive support to improve."
A review team, reporting to Mr Poots and led by Cumbria NHS chief executive Ms Page, has made five recommendations. These include giving more power to clinicians to lead change and ensuring clear consequences for non-delivery. The panel was appointed to oversee change, beginning with Antrim Area Hospital and Causeway Hospital in Coleraine, and in community care.
The report said: "Throughout the analysis the team came across many cases of good practice. However, variation in models of care and silo working of clinical teams has created a chronic poor flow of patients through the system. Patients do not undergo a daily review of their progress and clinical job plans are not aligned to the needs of the service. There is no embedded planning and commitment to delivery of financial plans by frontline clinicians and staff and planned savings are largely optimistic cost improvements rather than strategic transformational plans. Volumes of commissioned activity do not match the current level of demand or capacity available at the trust."
Previous reviews in unplanned care have only been partly delivered and have not achieved the desired outcomes. The document said this is likely to be due to the plans not being "owned" at clinical level.
The trust said it has strengthened day-to-day management including the development of daily performance information which the senior team uses to support daily decision making. Already there have been some promising improvements in performance in the Emergency Department.
Dr Calum MacLeod, interim trust medical director, said: "We want to provide the very best care for our patients. This report is very welcome and we are looking forward to tackling the challenges ahead and making sure patients can rely on the highest quality care."