Quality Governance Committee Assurance Report - November 2024
Meeting: Public Meeting
Date: 6 November 2024
Report Title: Quality Governance Committee Assurance Report
Agenda Item: PUB24/11/5.2
Committee Date: 25 September 2024
Meeting Chair: Catherine Glickman – Non-Executive Director
Meeting Quorate: Yes
Purpose: Assurance
Recommendation: The Board is asked to receive assurance from the business discussed at the meeting and to review the matters for escalation and referral.
Link to Strategic Objective:
- Provide outstanding quality of care and performance
Summary of Items Considered at the Meeting
| Issue | Consideration | Resolution/Outcome | Assurance |
|---|---|---|---|
| Committee Update | Following discussions about balance of responsibilities, the QGC Terms of Reference and Agenda Plan were discussed, specifically that Patient Safety will move to QGC from Performance Committee. | The Committee agreed the Terms of Reference and Agenda Plan, subject to some final additions to be added by the Director of Quality and Chief Paramedic. | |
| Stroke Video Triage Project | Stroke video triage, set up during Covid, has been highly effective, both in speeding up treatment at the right location and stopping unnecessary conveyance. Funding (of around £150k for a clinical lead and London hospital support) was confirmed for 2024/25 but is uncertain for 2025/26. | The Committee were very supportive that this project continue because of its proven efficacy: this was supported by the Chief Paramedic and Director of Quality and Medical Director. This was an early discussion as funding from NHSE has still to be confirmed for 2025/26 and the ELT have yet to discuss it as part of the 2025/26 budget. | Substantial |
| PSIRF – Missed STEMIs | This was the first PSIR Thematic Review to be presented to the Committee. It covered incidents of missed STEMIs, the questionnaire that had been sent to paramedics and the results, together with the action plan. An update on how the actions were being implemented was shared with the Committee. | The Committee congratulated the Patient Safety team on an excellent report. The actions on updating training, refresher and induction training for new and existing staff and the investment in technology, together with upskilling the clinical advice line, had all resulted in no more missed STEMIs since the report was completed. The Corpuls software, subject to final licence discussions, would be rolled out to monitors as they came in for servicing: timelines would be confirmed by Paul Gates. It was agreed that all thematic reviews should be discussed at the Quality Governance, the next one being non-conveyance. | Substantial |
| Quality Metrics | The Director of Quality gave an overview of the metrics, including the ACQIs, patient complaints (specifically on transport and driving on PTS) and safeguarding training | The Committee received the report. Complaint resolution was longer than target and should be a focus to improve. | Substantial |
| Civil Contingencies Act | The CP/DoQ updated the Committee on the statutory requirements to respond to major incidents, confirming that compliance had improved since the last update. The MAI Resilience Manager and 6 Assistant Resilience Managers remained outstanding due to budget challenges. | The Committee reviewed the areas of compliance and the areas still to be completed, agreeing there was improved compliance. There was a recognition that to meet the requirements of the Manchester Arena enquiry would require substantial additional funding. | Substantial |
| Private Ambulance Service (PAS) Update | The Committee were updated on the performance of PAS: no increase in complaints had been experienced, there was improving shift fill in August and two Quality Managers had been appointed to support the GM with compliance and delivery of the contract terms. Discharge and patient care remained the main issues. | The Committee discussed the performance, recognising that the issues identified in the Audit were being addressed and tighter control and monitoring was being implemented. The Committee agreed to continue to monitor the PAS performance. | Reasonable |
| Access to Stack | The Director of Operations talked through the current work, specifically how the operation was working and how to provide data to the ICBs so they could resource the right skills to deliver services in their locality, eg. falls provision. There was a discussion on NHSE’s ‘Minimum Viable Product’, including on the ambulance staff skill mix laid out in the document. | The Committee discussed what commitments had been made to the ICBs on staffing the Hubs, specifically on rostering of Advanced Practitioners. This role was also included in the ‘Minimum Viable Product’ document. The Director of Operations confirmed that they were working on the processes in the Hubs, how to collate information to inform ICBs on skill requirements and how the Hubs can access different pathways. She was meeting the UEC to discuss the Hub operation, including the skill mix of staff, and would update the Committee as the discussions progressed. | Substantial |
| Independent Review: Frequent Ambulance User | Simon Chase talked through the implementation of the recommendations – an update will come to the committee in January 2025. The staff member involved would be updated in October. | The Committee noted the progress. | Substantial |
| Regulatory Assurance | The Committee reviewed and noted the progress against the CQC Quality Improvement Programme. | The Committee supported the progress made and will continue to monitor progress against the Must Dos and Should Dos. | Moderate |
| Collaboration with External Bodies | Collaboration with bodies including CQC, NICE, NHSE and HSE were explained to the Committee. | The Committee noted the report. | Moderate |
| Board Assurance Framework | The residual risks remain high. | The committee supported the conclusions of the paper | Moderate |
| Group Assurance Report | The Committee reviewed the report. | Groups are meeting regularly with good attendance, providing comprehensive updates: this reassured the Committee. | Moderate |
| Medicines Management Annual Report 2023/24 | The report was presented for discussion and approval. | The Committee were impressed by the control over medicines in the last year and the work to avoid wastage, which was recognised as hard. The priorities for 2024/25 were approved. | Approved Report for publication |
| Safeguarding Annual Report 2023/24 | The report was presented for discussion and approval. | The progress on training to the required standards was recognised, and the priorities for 2024/25 supported. | Approved Report for publication |
