The Joint Overview and Scrutiny Committee on Health met on 6 June 2025 to discuss several items, including the scrutiny of NHS quality accounts. A key focus was the Royal Free London NHS Foundation Trust's Quality Account for 2024-25, which detailed achievements, priorities, and statements of assurance. The committee also scheduled time to discuss the Whittington Health NHS Trust Quality Account.

Royal Free London NHS Foundation Trust Quality Account 2024-25

The committee was scheduled to review the Royal Free London NHS Foundation Trust's Quality Account for 2024-25, which was organised into three main parts: achievements in quality, priorities for improvement, and an overview of the quality of care.

Achievements in Quality

The report pack included a statement from Peter Landstrom, Group chief executive of the Royal Free London NHS Foundation Trust, thanking staff for their efforts and highlighting key milestones, including the merger with North Middlesex University Hospital¹ and the launch of a five-year clinical strategy. The report pack stated that the merger with North Mid aimed to improve care across North London by reducing waiting times and improving access to specialist services. The clinical strategy was described as a 'blueprint for bringing the best of the NHS to all our patients by delivering world class expertise and local care'.

The report pack also stated that the trust launched the Faculty of Population Health, which is leading a three-year culture change programme focusing on smoking, alcohol intake, physical activity, and diet. The Faculty aims to empower staff and patients to have healthy conversations to improve their health and prioritise prevention.

The report pack stated that a new head of nursing for mental health was appointed in November 2024 to improve organisational knowledge of the duty of care to patients with mental health needs, contribute to mental health training and improve clinical practice.

The report pack also stated that a Royal Free London respiratory consultant is working across north central London to improve the experience of care for patients with long-term conditions, including finding ways for consultants to access information safely from across different trusts and update patient records across different hospitals.

Priorities for Improvement

The report pack included a review of the trust's performance against quality priorities and objectives for 2024-25, including those of North Middlesex University Hospital NHS Trust. It also set out quality priorities and objectives for 2025-26, and provided feedback and assurance statements related to key quality measures.

The report pack stated that the trust developed its 2024-25 priorities through engagement with stakeholders and committees, including the Trust Quality Group, Quality Committee, Council of Governors, Group Executive Management Meeting, and the Trust Board.

The trust's priorities for 2024/25 were listed in the report pack as:

• Patient experience
  • Embedding shared principles for involving patients and carers.
  • Ensuring adult inpatients receive appropriate nutrition and hydration.
  • Improving communication with patients regarding cancellation of clinic appointments.
  • Increasing compassion and kindness within the care delivered.
  • Increasing patient experience feedback using digital technology.
• Clinical effectiveness
  • Standardising reporting format within all mortality and morbidity groups.
  • Achieving 75% recruitment in-year to open research studies.
• Patient safety
  • Achieving zero trust attributed Methicillin-resistant Staphylococcus aureus bacteraemia (MRSA) cases and reducing Gram negative bacteraemia in line with NHS Long Term Plan objective of 50% by 2024/25.
  • Achieving zero trust attributable Clostridium difficile (C. diff) infection cases with a lapse in care.
  • Getting escalation for patients with deteriorating conditions always right.
  • Ensuring all ward areas and divisions have an established practice of reviewing shared learning and produce their own improvement plans.

The report pack stated that the trust is committed to delivering world-class clinical care, education, and research that enhances the health and well-being of the local community and the wider populations it serves. It also stated that the trust's quality priorities for 2025–26 align with overarching strategies and have been integrated across the trust through executive assurance committees.

The trust's priorities for 2025-2026 were listed in the report pack as:

• Patient experience
  • Patient involvement: Embedding shared principles for involving patients and carers.
  • Fundamentals of care: nutrition: Ensuring all adult inpatients receive appropriate nutrition and hydration.
  • Improving communication with patients and the trust's response to patients seeking to reschedule their outpatient appointments.
  • Compassion and Kindness: Delivering a civility and kindness project.
  • Dignity and Kindness for End-of Life Care (EoLC).
• Clinical effectiveness
  • Patients with additional support needs and learning disabilities: In patient, safety events, elimination of the identification as a contributory factors: a)where English was not the patient's first language or b) navigate our appointment system was identified for patients with a learning disability.
  • Research and development: Achieving 75% recruitment in-year to open research studies.
• Patient safety
  • Infection Control: Optimising the use of antimicrobials.
  • Patients with deteriorating conditions: Getting escalation for patients with deteriorating conditions always right.
  • Learning from safety incidents: Ensuring all ward areas and divisions have an established practice of reviewing shared learning and produce their own improvement plans.

Statements of Assurance from the Board

The report pack included statements concerning the quality of services provided by the Royal Free London NHS Foundation Trust, including a review of services, participation in clinical audits and national confidential enquiries, participation in clinical research, the CQUIN payment framework, registration with the Care Quality Commission (CQC), information on the quality of data, the Royal Free London NHS Foundation Trust Information Governance Assessment Report, payment by results, action taken to improve data quality, learning from deaths, seven-day hospital services, and a speaking up declaration.

Performance Against Core Indicators

The report pack included information on performance against eight core indicators: summary hospital-level mortality (SHMI), patient reported outcome measures scores (PROMS), emergency readmissions within 30 days, responsiveness to the personal needs of patients, staff recommendation to friends and family, venous thromboembolism (VTE), C. difficile, and patient safety incidents.

Overview of the Quality of Care in 2024-25

The report pack included an overview of the quality of care offered by the trust based on performance in 2024-25 against indicators and national priorities selected by the board in consultation with stakeholders. It also included information on patient safety, clinical effectiveness, and patient experience.

Whittington Health NHS Trust Quality Account 2024-25

The committee was also scheduled to discuss the Whittington Health NHS Trust's draft Quality Account Priorities for 2025-2026.

The report pack stated that the 2024 – 2025 quality priorities were:

• Ensuring patients are seen by the right person in the right place at the right time and deliver outstanding safe and compassionate care in partnership with patients.
• Access and attendance
• Reducing health inequalities in our local population
• Improving the Trust Environment to improve Patient Experience

The report pack stated that key achievements from 2024/25 included:

• The Birmingham Symptom Specific Obstetric Triage System (BSOTS) has been implemented in Maternity Triage.
• 75% of Trust staff have had Oliver McGowan training delivered.
• The transformation team have been reviewing outpatient letters to ensure that clinic and ward locations match hospital signage. Outpatient letters fully updated in Urology, Gynaecology and elderly care.
• The Virtual ward and rapid response urgent response 2hr/4hr/24hour targets to ensure timely patient care and admission avoidance are being met.
• The new codesigned NCL Community Red Cell (sickle cell) Service with partners and patients in NMUH and UCLH is up and running.
• Providing accessible information to those patients with learning disabilities has been achieved and the Trust webpage is live and is being used
• Virtual ward beds are being fully utilised. There are currently 44 beds at WH (20 acute split between Haringey and Islington), 16 remote monitoring beds, 8 Islington Complex VW beds.
• In conjunction with our Mental Health partners at the North London NHS Foundation Trust violence reduction team, training is being provided to all staff to support mental health patients waiting for a mental health bed.
• Training sessions on the use of restrictive practice and de-escalation techniques for adults have been provided to date.

The report pack stated that the draft quality priorities for 2025/26 were:

• Ensuring patients receive safe and effective care that is delivered with kindness, compassion and in collaboration with patients and carers
• Improving the Trust Environment to enhance Patient Experience
• Reducing health inequalities in our local population by ensuring that when patients need to access our services, they have clear guidance, accessible routes and supported and listened to throughout
• We will continue to develop services to meet the needs of our population

The report pack stated that the goals for Priority 1 were:

• Develop a suite of 'What matters to me' quotes to include pictures to educate staff these will be on screen savers and posters
• Promote the attendance of staff to the Ops School which provides a comprehensive programme of learning and development for staff working on acute pathways
• To continued work in line with Patient Flow Board objectives
• Improve the FFT scores to ensure all areas are above the NHS benchmark of 85%
• Implement systems to ensure learning and service improvement from complaints
• Meet national Standards for cleaning and see a reduction in hospital acquired infections

The report pack stated that the goals for Priority 2 were:

• Continue to improve PLACE outcomes
• Monitor the patient experience through FFT, complaints and PALS feedback to improve demonstrating the positive work to improve environment
• Clearer signage and access routes through Trust premises

The report pack stated that the goals for Priority 3 were:

• To reduce outpatient letters from 891
• Create clinical pathways that incorporate one – stop shop models reducing the number of attendances and comprehensive diagnosis and treatment plans for patients
• Addressing Long waits for ASD/ADHD
• Improving the care we provide to people with mental health needs through additional staff education

The report pack stated that the goals for Priority 4 were:

• Promote self-management and prevention to keep patients well at home
• Expand community-based care, early discharge, and rehabilitation services.
• Reduce long waits in the community
• Continue implementing the Start Well programme to support mothers through pregnancy
• Delivery of MIS