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University Hospitals Birmingham NHS Foundation Trust

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University Hospitals Birmingham NHS Foundation Trust
TypeNHS Foundation Trust
Region servedWest Midlands
Hospitals
ChairDame Yve Buckland
Chief executiveJonathan Brotherton [1]
Websitewww.uhb.nhs.uk

The University Hospitals Birmingham NHS Foundation Trust provides adult district general hospital services for Birmingham as well as specialist treatments for the West Midlands.

The trust operates the Queen Elizabeth Hospital in Edgbaston (QEHB), adjacent to its older namesake and connected to it by a footbridge. QEHB began receiving patients at its Emergency Department on 16 June 2010, and replaced Queen Elizabeth Hospital and Selly Oak Hospital. The trust is under the leadership of Chair Dame Yve Buckland and chief executive Jonathan Brotherton [1] On 30 June 2004, the Trust received authorisation to become one of the first NHS Foundation Trusts in England, under the leadership of ex-chief executive Dame Julie Moore, who succeeded Mark Britnell.[2] From 2006 to November 2013 the Chair of the Trust was Sir Albert Bore. Former Home Secretary Jacqui Smith took over as chair in December 2013.[3]

On 1 April 2018 it merged with the Heart of England NHS Foundation Trust. The combined organisation will[needs update] have a turnover of £1.6bn and 2,700 beds across four main hospitals.[4]

Development

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In December 2013 it emerged that the Trust was interested[needs update] in expanding into Primary Care, a proposal which was not welcomed by all the local General Practitioners.[5]

In 2013 the trust established a subsidiary company, UHB Facilities Ltd, to which 3 staff were transferred. The intention[needs update] was to achieve VAT benefits which arise because NHS trusts can only claim VAT back on a small subset of goods and services they buy. The Value Added Tax Act 1994 provides a mechanism through which NHS trusts can qualify for refunds on contracted out services.[6]

The trust has one of the 11 Genomics Medicines Centres associated with Genomics England which were planned to open across England in February 2014.[needs update] All the data produced in the 100,000 Genomes project will be made available to drugs companies and researchers to help them create precision drugs for future generations.[7]

It is one of the biggest providers of specialised services in England, which generated an income of £327.7 million in 2014/5.[8]

It arranged a deal with Hospital Corporation of America in 2017 to build 138 bed specialist hospital on the trust's Edgbaston campus. The £65 million development will[needs update] have 66 private beds, run by HCA Healthcare, and 72 NHS beds, run by the trust, a new radiotherapy unit and operating theatres.[9] Construction, by Vinci Construction UK started in May 2019.[10]

The Department of Health and Social Care lent the combined trust £162 million in May 2018. £87 million was for a new ambulatory care and diagnostics centre at Heartlands Hospital.[11]

The trust opened an office in Beijing in October 2018, hoping[needs update] to find business opportunities in China, which could include consultancy, the trust's in-house clinical software, and advice about the construction of new hospitals.[12]

In May 2019 it was negotiating with Babylon Health with plans[needs update] to use the technology for virtual outpatient consultations, chronic disease management, and triage both before and after patients arrived at the emergency department using Babylon's symptom checker app. The ambition was that the symptom checker could refer patients directly to specialist clinics, avoiding its accident & emergency (A&E) department.[13] The Birmingham Local Medical Committee said this was "a truly frightening prospect that is going to be nothing but massively damaging for healthcare in Birmingham".[14]

The trust was one of the biggest beneficiaries of capital funding for the NHS in August 2019, with an allocation of £97.1 million for a purpose built building for outpatient, treatment and diagnostic services.[15]

It began trials of a Remote Diagnostic Station in 2020. This enables multi-disciplinary teams to give remote clinical support using digital stethoscopes and ECGs to review and provide diagnoses for patients.[16]

During the COVID pandemic, the trust made numerous changes and reorganisations to its hospital services to ensure patient care in safe environments while also treating COVID-19 patients. In March 2020, a Birmingham children's A&E department was temporarily shut.[17] In April 2020 supportive care and chemotherapy treatment of cancer patients was relocated to Solihull. At the same time Heartlands Hospital's Gynaecology Assessment Unit was temporarily moved to Good Hope with home-birth services being suspended.[18]

In June 2021, a senior delegation of NHS England and NHSX visited University Hospitals Birmingham to assess the feasibility of a comprehensive extension of an AI triage model, based on that used by Babylon, which had already been used by NHS University Hospitals Birmingham NHS Foundation Trust (UHB) since April 2020.[19]

In October 2021, Professor David Rosser, chief executive at University Hospitals Birmingham NHS Foundation Trust, at the Digital Health's Autumn Leadership Summit reported that the trusts' digital programmes, which included Babylon's Ask A&E chat service had cut the number of preventable hospital visits by 63%.[20]

In December 2021, as the Trust reported an increase of nearly 50% demand on A&E to pre-pandemic levels, as well as highlighting its knock-on effect that COVID-19 had on ward space and how COVID-19 measures affected patient flow through A&E, it increased capacity opening two additional wards at Good Hope, Heartlands and Queen Elizabeth hospitals as well as further theatres at Solihull Hospital as the ‘cold’ Covid-free site for elective surgery.[21]

In January 2022 it became known that the Trust had submitted plans to Birmingham City Council to build a top-class training centre at Good Hope Hospital, which was needed due to the increased number of medical students. The 1.9m investment would provide support to existing and future staff as well as the local community.[22]

Performance

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Four-hour target in the emergency department quarterly figures from NHS England Data from https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-times-and-activity/

In December 2013 the Trust was one of thirteen hospital trusts named by Dr Foster Intelligence as having higher than expected mortality indicator scores for the period April 2012 to March 2013 in their Hospital Guide 2013.[23]

In August 2014 the trust wrote to local Clinical Commissioning Groups advising them that it would no longer accept referrals into pain, dermatology and general surgery from GPs outside the boundary of the trust because of capacity problems. The Trust had been forced to fully re-open the former Queen Elizabeth Hospital, which was supposed to be closed after the new site was opened in 2010.[24] In October 2014 Julie Moore called for a major overhaul of financial rules to help popular hospitals cope with the extra demand their reputations attract.[25]

The trust expected[needs update] to finish 2015–16 with a deficit of more than £31 million as a result of changes to the NHS tariff.[26]

In June 2014 the trust reported that Accident and Emergency Department activity had continued to rise with more than 102,000 attendances, a 4.9% increase over the previous year.[27]

It was named by the Health Service Journal as one of the top hundred NHS trusts to work for in 2015. At that time it had 7712 full-time equivalent staff and a sickness absence rate of 3.86%. 82% of staff recommend it as a place for treatment and 70% recommended it as a place to work.[28]

In March 2016 the Trust's cardiac surgery service was heavily criticised in a Care Quality Commission report, having been identified as a significant mortality outlier when compared to similar services.[29]

In September 2016, the trust was selected by NHS England as one of twelve Global Digital Exemplars.[30]

Birmingham was close to target for planned operations and care but missed targets for seeing A&E patients within 4 hours and also missed targets for cancer care which should start within 62 days.[31]

In December 2019, as the Trust plummeted to its lowest performance, amongst the worst nationally, in their treatment of A&E patients it encouraged patients to consult Ask A&E for guidance on where to go after providing their symptoms.[32]

In July 2021, the General Medical Council issued a warning to the trust's then medical director David Rosser after falsely reporting to the regulator that he was not aware that a doctor he referred in 2017 was a whistleblower. They stated that his action risked "bringing the profession into disrepute ".[33][34] The GMC took no further action against the doctor reported and they went on to win an employment tribunal for wrongful dismissal.[35]

The board is ethnically diverse with 7 out of 17 directors from ethnic minority groups.[1] There has not been a director who was not white in the last 20 years[when?] In 2017, 36% of the trust's overall workforce were from a BAME background and in 2020 about half the medical staff.[36]

Overseas patients

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The trust issued invoices to patients thought to be ineligible for NHS treatment totalling £2.3 million in 2018–9, but only collected £0.5 million.[37]

See also

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References

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  1. ^ a b c "Board of Directors". www.uhb.nhs.uk.
  2. ^ "Wave 1 NHS foundation trusts". 31 March 2005. Archived from the original on 31 March 2005.
  3. ^ Jacqui, Smith. "Former MP Jacqui Smith gets top job at QE Hospital". Retrieved 27 October 2013.
  4. ^ "Trusts and NHS Improvement reach hospital takeover deal". Health Service Journal. 28 March 2018. Retrieved 27 May 2018.
  5. ^ "Leading foundation trusts explore moves into primary care". Health Service Journal. 13 December 2013. Retrieved 14 December 2013.
  6. ^ "In full: Trusts with staff transfer plans". Health Service Journal. 14 February 2017. Retrieved 15 February 2018.
  7. ^ "NHS DNA scheme to fight cancer and genetic diseases". BBC News. 22 December 2014. Retrieved 22 December 2014.
  8. ^ "Analysed: The biggest NHS providers of specialised services". Health Service Journal. 16 October 2015. Retrieved 16 November 2015.
  9. ^ "Regulator clears new hospital venture between trust and US provider". Health Service Journal. 31 August 2017. Retrieved 8 October 2017.
  10. ^ "Building work starts on specialist hospital in Birmingham". Building Better Healthcare. 6 May 2019. Retrieved 9 June 2019.
  11. ^ "Recently merged trust given £162m loan". Health Service Journal. 15 May 2018. Retrieved 14 August 2018.
  12. ^ "University hospital opens China office after CEO trip". Health Service Journal. 2 November 2018. Retrieved 5 December 2018.
  13. ^ "Major trust opens talks with Babylon, claiming GPs unable to stem demand". Health Service Journal. 24 May 2019. Retrieved 8 July 2019.
  14. ^ "Trust's plans to takeover city's primary care 'truly frightening'". Health Service Journal. 30 May 2019. Retrieved 8 July 2019.
  15. ^ "Revealed: The 20 capital projects promised by the PM". Health Service Journal. 5 August 2019. Retrieved 9 September 2019.
  16. ^ "UK's largest NHS trust uses BT technology to treat patients remotely". Building Better Healthcare. 23 June 2020. Retrieved 2 August 2020.
  17. ^ Horner, Nick (27 March 2020). "Children's A&E shuts among changes to cope with coronavirus surge". BirminghamLive. Retrieved 20 January 2022.
  18. ^ Horner, Nick (2 April 2020). "Key changes for cancer patients & pregnant women due to COVID-19". BirminghamLive. Retrieved 20 January 2022.
  19. ^ "NHS assessing Babylon AI triage for wider rollout". Pulse Today. 4 June 2021. Retrieved 20 January 2022.
  20. ^ "Digital guru emphasis the need to focus on culture rather than tech". Digital Health. 7 October 2021. Retrieved 26 January 2022.
  21. ^ Horner, Nick (9 December 2021). "Queue of ambulances outside hospital show 'severe NHS pressures'". BirminghamLive. Retrieved 1 February 2022.
  22. ^ Panter, Matthew. "£1.9m plan revealed for Good Hope Hospital". www.expressandstar.com. Retrieved 29 April 2022.
  23. ^ "Dr Foster identifies 13 trusts with high mortality ratios". Health Service Journal. 6 December 2013. Retrieved 7 December 2013.
  24. ^ "Concerns over Birmingham hospital's refusal to treat Worcestershire patients". Tewkesbury Admag. 6 November 2014. Retrieved 14 November 2014.
  25. ^ "High profile trust chief calls for funding overhaul". Health Service Journal. 22 October 2014. Retrieved 14 November 2014.
  26. ^ "Rollover tariff trusts expect massive deficits". Health Service Journal. 26 May 2015. Retrieved 20 June 2015.
  27. ^ "Birmingham NHS staff reveal fears about state of the health service". Birmingham Mail. 27 June 2015. Retrieved 27 June 2015.
  28. ^ "HSJ reveals the best places to work in 2015". Health Service Journal. 7 July 2015. Retrieved 23 September 2015.
  29. ^ Campbell (8 March 2016). "Bullying stopped staff reporting heart surgery deaths, says CQCfirst = Denis". The Guardian. ISSN 0261-3077. Retrieved 22 March 2016.
  30. ^ "New plans to expand the use of digital technology across the NHS". gov.uk. Department of Health and The Rt Hon Jeremy Hunt MP. Retrieved 9 September 2016.
  31. ^ University Hospitals Birmingham NHS Trust BBC
  32. ^ "Emergency waiting times again the worst on record for Solihull and Birmingham". Solihull Observer. Retrieved 16 February 2022.
  33. ^ Dyer, Clare (5 August 2021). "Trust boss gets GMC warning for failing to mention that doctor he referred had raised concerns". British Medical Journal.
  34. ^ "Public Minutes of the Investigation Committee" (PDF). General Medical Council.
  35. ^ "Climate of fear putting patients at risk, say doctors". BBC News. 1 December 2022.
  36. ^ "Executives all white in city where 40pc of population is BAME". Health Service Journal. 1 September 2020. Retrieved 11 October 2020.
  37. ^ "Trusts missing out on tens of millions from overseas patients". Health Service Journal. 19 November 2019. Retrieved 9 January 2020.
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