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STATES OF JERSEY
REVIEW OF HEALTH AND COMMUNITY SERVICES (HCS) CLINICAL GOVERNANCE ARRANGEMENTS WITHIN SECONDARY CARE: MINISTER'S RESPONSE
Presented to the States on 26th August 2022 by the Minister for Health and Social Services
STATES GREFFE
2022 R.117 Res.
REPORT
Background
In mid-2021, the Director General for Health and Community Services at the request of the Medical Director and Chief Nurse, and with support from the then Minister for Health and Social Services, commissioned Professor Mascie- Taylor to review the governance and quality of clinical care at the hospital. The review commenced in October 2021 in accordance with the terms of reference, which can be found in appendix 2 of the report. The costs incurred were £85,250.
A draft version of Professor Mascie- Taylor 's report was received by the Minister for Health and Social Services, Deputy Karen Wilson , on Tuesday 19 July 2022. The Minister then met with Professor Mascie- Taylor on Friday 29 July 2022. Subsequently the Minister met with the Chief Executive Officer for the Government of Jersey and, in the temporary absence of the Chief Minister, separately with the Deputy Chief Minister on Thursday 11 August 2022. The Minister received a final version of the report on Friday 19 August 2022.
Following her meetings, the Minister instructed that:
- a copy of the report be provided to the Council of Ministers, States Employment Board, and the Health and Social Services Scrutiny Panel
- a private briefing be arranged for the Health and Social Services Scrutiny Panel with Professor Mascie- Taylor , and
- a copy of the report, and the Minister's response, is presented to the public and the States Assembly.
Biography for Professor Mascie- Taylor
Professor Hugo Mascie- Taylor is an experienced clinician and board level executive with experience as a healthcare provider, commissioner, regulator, and advisor in local, national and international settings. Further information can be found within appendix 1 to his report.
Response
In his report, Professor Mascie- Taylor makes sixty-one recommendations to which relate to the governance, quality, safety, and operational management in the Jersey General Hospital. His report, when taken alongside previous reviews into theatre services1, maternity services2 and governance arrangements3, provides clarity as to the scale of improvements required.
Professor Mascie- Taylor rightly states that Islanders need and deserve high quality and safe healthcare and, having considered his report, I must concur with him that, regrettably, the Island does not yet receive the standard of healthcare it deserves, despite the hard work and dedication of staff employed in the service.
1 States of Jersey Health and Community Services, Theatre Service Review, 14 May 2021
2 Review of Maternity Services, Health and Social Security Scrutiny Panel (S.R.9/2021), 6 July 2021
3 Governance Arrangements for Health and Social Care – Follow up, Comptroller & Auditor General, 13 September 2021
3
Islanders will rightly expect that, as the new Minister for Health and Social Services, I will ensure that urgent, clear and direct action is taken to address the report's recommendations, all of which I accept. Our health service must become an exemplar of safe and effective care, be of good quality, and its performance accounted for in an open and transparent way.
In light of this, I will bring forward plans to establish an independent health board. This board will drive reform, improve governance and address the cultural, structural and practice issues affecting the quality and safety of the care provided. The Board will also be tasked with providing assurance to myself, the Assembly and the public about the progress made in advancing the quality of care, in order that senior managers and clinicians are held to account for their delivery.
Additionally, it is my intention to strengthen the policy function within HCS so that we have the skill and expertise required to establish the policy and governance frameworks Professor Mascie- Taylor highlights as necessary to improving clinical governance. This will include capacity and capability to determine government policy across the whole health system, including developing the policies needed to ensure that HCS and other providers can better work in partnership to deliver joined up health and care services.
Furthermore, I have asked Chief Executive Officer of the Government of Jersey to oversee and develop a turn-around plan and I expect this to be ready by the end of September 2022. This plan will address arrangements for resourcing the clinical leadership and management requirements throughout HCS, accompanied by a detailed accountability framework.
Finally, it is my intention to commission a follow up review in in one years' time to track our progress.
These actions will require additional funding; hence I will be seeking the support of my colleagues on the Council of Ministers and the States Assembly to make the necessary monies available. We must recognise that it is a false economy to fail to invest in good clinical and good organisational governance.
Concurrently, I will work with the Health and Social Services Scrutiny Panel to provide them every opportunity to examine the workings of the department, the plans to improve, and the funding required to do so. I am confident that the Panel will support me in this crucial work and as, a critical friend, will ensure that any changes are to the benefit of Islanders.
When I stood for Minister in July this year[4] I made clear my belief that Ministers, and members of the Assembly must set the tone if we are to create a positive culture in our public service; one in which all people at all levels of the organisation feel supported to do their best work. I know that this report will impact the confidence of Islanders, Assembly Members and staff but we will not build a better HCS if we do not hold people to account but rather if our focus is on blame. We must fix the problems that Professor Mascie- Taylor identifies and that will require us to enhance existing skills, capacity and
knowledge, and fix systems and processes within HCS that have led to a lack of accountability and the safety issues Professor Mascie- Taylor refers to.
Professor Mascie- Taylor provides us with a very clear message; patients must be at the heart of all we do, and I am confident that the Department – which supported us through the pandemic and whose staff who work tirelessly, 24 hours a day, and 7 days a week – will use this message as their reference point as we bring forward much-needed change. I would like to thank Professor Mascie- Taylor for his robust and well considered report and to acknowledge HCS's Director General, Medical Director and Chief Nurse for commissioning him to do so. Whilst this report offers a sobering commentary on our health service, it also provides the impetus to bring about the change which many Islanders believe is long overdue.