Friday, 27 September 2013

My questions at the AGM (Buckinghamshire Healthcare NHS Trust)

In the previous blog I gave my own highlights of the Buckinghamshire Healthcare NHS Trust AGM.

After the Chief Executive gave her presentation and the finance director gave his summary of the financial situation we heard from the leaders of the emergency surgery teams. They described how they had changed the service, what is called reconfiguration, and how the new service was producing better outcomes for patients & reducing mortality rates.  Good news.

At the end of the event there was time set aside for the public to ask questions.  I have no idea how many members of the public were present but I was virtually the only person who asked questions. 

Why is it that people don’t ask questions in formal board meetings?  I reckon most people know the answer to that one.

I asked a couple of questions:

The first was about the campaign to restore an A&E department to the High Wycombe Hospital site. A petition with 16,000 signatures has been organised.

There are 16,000 people in the south of the county who believe that there should be an A & E on the Wycombe Hospital site.

Can I ask that the Communications teams from the Clinical Commissioning Groups and the trust remind us, on a regular basis, about the good clinical, organisational and financial reasons why, in the present circumstances, there can only be one A & E in the county?

This is an on-going issue for those who live in High Wycombe.  The A&E department was closed in 2005 after a public consultation and replace with a minor injuries type of service.

As we know from other examples of such closures the local population is incredibly loyal to their local hospital. MPs too! So the story here is how to sell the difficult and complex reasons, hopefully evidence based, for such closures.

In my opinion the only way to tell the story is to keep it simple and be persistent.

However the audience was asked what else could be done to explain the reasons why there are only resources for one A&E department in the hospital.

My suggestion is that the leaders of the campaign should meet with senior clinicians and managers (and the commissioners) to have an informal, facilitated discussion and look at the evidence. 

As for how to improve the conversation between the hospital executives and the patients is something to explore in another blog.


The second question I asked was about the way they manage complaints.

Can I ask that the board measures its performance on managing complaints by using the following as outcome measures?

a)    Is the complainant satisfied at the end of the process
b)     has the trust learnt from the complaints  
c)    has the trust acted on the learning.

Normally the first thing that the board reports is that they replied to people within the required time. This is important of course, but I reckon that most people would say the best test of a good complaints service is: was I happy with the result?

  I hope that the trust may consider that a different approach will improve the way people think about the way complaints are managed.

They expressed some interest in this approach and said that they are trying to do something like this.  They have been contacting people by telephone after the complaint has been closed, especially complex complaints. But they have not been recording this activity. It sounds as if they are looking to improve the experience of complaining.

They did say that they get many more accolades than complaints. This is good to hear. 

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