Agenda item

This item is to receive a the TRFT Annual Report and a supporting presentation which highlights areas of particular interest for the Health Select Commission, and to assist it to identify areas of TRFT’s work that it would like to consider in more detail.

The Chair welcomed Bob Kirton, Managing Director, Helen Dobson, Chief Nurse, and Dr Mike Richmond, TRFT Board Chair to the meeting and invited the Managing Director to introduce the report and presentation.

The Managing Director, TRFT noted that the annual report had been launched at the Trust’s Annual General Meeting the previous week. They explained that whilst the full presentation at that meeting had included around 80 slides, a condensed version was presented to the Health Select Commission, which focussed on key highlights from the past year.

The Managing Director, TRFT expressed gratitude to all TRFT staff who had contributed to delivering safe care to patients and the public of Rotherham. They emphasised the Trust’s pride in its achievements and its commitment to continuous improvement. Amongst notable accomplishments was the Trust’s strong performance in research and clinical audit. Over 3,000 patients had been recruited into research studies, more than 200 local clinical audits had been reviewed, and the Trust had participated in 95% of national clinical audits and 100% of eligible national confidential inquiries.

Innovative projects were highlighted, including the use of virtual reality goggles during operations to improve patient experience, which had yielded positive outcomes. Another initiative involved the use of an orthopaedic robot to assist with precise limb movements during surgery. The Trust was also exploring the acquisition of a robot for abdominal procedures, commonly used in teaching hospitals, and was preparing a case to secure national funding for this.

Significant progress had been made in the area of learning from deaths and serious incidents. The Trust had minimised delays in death registrations and expanded the medical examiner service to include community deaths. Families had responded positively to being contacted by the medical examiner’s office, and the service had maintained high scrutiny completion rates for all deaths within the Trust.

The Chief Nurse presented workforce developments. They confirmed the appointment of the Trust’s first Director of Midwifery, which was a joint post with Barnsley Hospital, aimed at strengthening maternity services which had come under significant national scrutiny. The Trust had also appointed its first Chief Allied Health Professional, representing nine of the fifteen allied health professions within the organisation, ensuring their voices were heard at senior levels.

The Chief Nurse also reported record recruitment of registered nurses for two consecutive years, primarily from the local population through partnerships with local universities. This proactive approach had allowed the Trust to anticipate and fill workforce gaps, particularly in preparation for winter pressures. In autumn alone, 100 new recruits were being onboarded. Retention efforts had also been successful, with nursing turnover reduced from 13.5% to 8% over three years. Specialty areas such as maternity and children’s nursing were fully staffed with no workforce gaps.

They explained that the Trust had also invested in improving patient experience. Initiatives included a wheelchair hub to address accessibility issues, and a bespoke complaints training tool modelled on a Monopoly board to help staff resolve concerns in real time. There was also the “This Is Me” campaign which introduced a passport system for patients with additional needs, which ensured they received personalised care and the Purple Butterfly scheme which supported bereavement care with culturally sensitive resources available in every clinical area. Additionally, the Carers Partner Promise was launched to improve support for carers, including 24/7 visiting access and practical assistance such as parking support.

The Chief Nurse outlined the Trust’s three quality priorities for the year. The first was diabetes management, addressing a condition which affected 16% of the local population. This initiative aimed to improve care and reduce hospital stays and was extended into a second year due to its scale and success. The second priority focused on pain management, which had been completed successfully and was nominated for a national award. The third priority addressed frailty. While some progress had been made, the targets were ambitious and not fully met, prompting continuation of the work into the current year.

The Managing Director, TRFT resumed the presentation and discussed operational performance. They acknowledged that while the Trust was not yet where it aspired to be, it was performing ahead of national expectations. Urgent and emergency care had seen a significant rise in attendances, leading to increased admissions. Despite these pressures, performance had improved, particularly in ambulance handover times, which was a key safety indicator.

Elective care performance had been previously presented in detail to the Commission, and while benchmarks were being met, the Trust aimed for further improvement. In cancer and diagnostic services, the Trust had made notable progress, especially in meeting the Faster Diagnostic Standard. The diagnostics team had been commended for their exceptional national performance, which was critical to timely cancer treatment.

The Managing Director, TRFT highlighted the Trust’s role as an integrated provider, with increasing activity in community services. A major development was the multi-agency approach to transfer of care, ensuring patients received support in the most appropriate setting. The virtual ward initiative had been so successful that the Trust planned to rebrand it as “Hospital at Home,” reflecting the hands-on care provided in patients’ homes. This approach aimed to reduce unnecessary hospital admissions and build public confidence in community-based care.

They also discussed the Trust’s involvement in a national neighbourhood programme, which sought to integrate health, care, and voluntary sector services at the local level. Although the programme did not come with substantial funding, it offered valuable resources and networking opportunities. The Trust committed to reporting on its progress in due course.

The Chair thanked the Managing Director and Chief Nurse for the report and presentation and invited comments and questions from Members.

Councillor Thorp enquired about the professionalisation of nursing, specifically the impact of degree-led qualifications.

The Chief Nurse responded by affirming that nursing had been a graduate profession for decades and that this was essential for developing the critical thinking and clinical leadership required in modern healthcare. However, she stressed that compassion and care were equally vital and could not be taught through academic study alone. The Trust valued its support staff, including nursing associates and healthcare assistants, and ensured that caring values were embedded across all roles, regardless of qualification level.

Councillor Thorp also reflected on the increased use of digital technologies, including chatbots, AI-assisted radiology booking, and other innovations mentioned in the report.

The Managing Director, TRFT explained that the Trust had received a global award for clinician satisfaction with its digital systems. They described the implementation of Netcall in imaging services, which efficiently managed high volumes of calls, particularly on Monday mornings, by automatically allocating appointment slots. AI was being piloted in clinical areas such as endoscopy, where it enhanced surveillance for polyps during routine procedures and AI was also used to predict missed appointments (DNAs), allowing the Trust to proactively engage patients and improve attendance rates.

Councillor Thorp expressed concern about chatbots potentially alienating patients, especially those less comfortable with technology and the potential for those approaches to deepen digital exclusion.

The Managing Director, TRFT acknowledged the issue and reassured the Commission that the Trust monitored digital engagement closely. If patients failed to respond to messages via the NHS app within 48 hours, the Trust followed up using traditional methods such as letters and phone calls. He also highlighted collaborative work with the Council and commissioners to address digital exclusion, including free SIM card provision and digital literacy support through libraries.

Councillor Havard raised a question about the increasing use of weight loss injections and whether this trend had impacted public health in Rotherham.

The Managing Director, TRFT noted that while specific local data was unavailable, regional commissioning conversations confirmed rising usage. The Chief Nurse added that most prescriptions were private, raising concerns about a two-tier system. NHS access was limited and tightly regulated, with few cases seen in hospital settings. No adverse side effects had been reported locally, but the Trust would continue monitoring the situation.

Councillor Havard also asked a question about physiotherapy services. They were aware that residents had travelled to Rotherham Hospital only to receive leaflets rather than hands-on treatment. She asked whether such services could be decentralised to neighbourhood health hubs.

The Managing Director, TRFT acknowledged the concern and described existing community services such as Breathing Space and the Park Rehab Centre, which included gyms and a hydrotherapy pool. These facilities supported cancer patients through the Active Together programme. They agreed that neighbourhood-level expansion was a priority and welcomed further feedback.

Councillor Duncan referred to the Trust’s response to health inequalities and asked for clarification on digital weight management tools, smoking cessation services and the impact these had on surgical and wider health outcomes.

The Managing Director, TRFT explained that the Digital Weight Management Service was a national pilot targeting patients for whom weight was a barrier to surgery. Over 400 patients had participated, with positive outcomes including an average weight loss of 9 kg and improved fitness levels. The pilot had reached many residents in deprived areas. Regarding smoking cessation, The Managing Director, TRFT stated that 15% of adults in Rotherham still smoked, with higher rates among manual workers. The Trust participated in the South Yorkshire QUIT programme, reaching 90% of inpatients and offering nicotine replacement therapy to half of those identified as smokers. He emphasised the health benefits of quitting and the importance of linking hospital-based interventions to long-term lifestyle changes.

Councillor Clarke asked about declining staff confidence in reporting unsafe medical practices, referencing a 5% drop in survey scores.

The Chief Nurse responded that while there had been a slight dip, the Trust remained one of the highest-performing organisations regionally and nationally. They noted that staff survey response rates had increased significantly, from 38% to over 60% in recent years. The Trust was working to improve communication about how reported concerns were addressed. The Freedom to Speak Up Guardian played a key role in this, offering anonymous reporting and presenting quarterly updates directly to the board. The Chief Nurse stressed the importance of ensuring all staff felt empowered to raise concerns and were confident that action would be taken.

Councillor Harrison raised a question about financial sustainability. They referred to the Trust’s reliance on non-recurrent savings and asked what steps were being taken to achieve recurrent efficiencies and develop a sustainable financial plan.

The Managing Director, TRFT acknowledged the challenge and stated that whilst the Trust had achieved a balanced position last year, it remained dependent on temporary funding. They outlined several strategic priorities, including reducing sickness absence, cutting non-contracted pay, and improving recruitment and retention. The Trust was also pursuing efficiencies through shared services with Barnsley Foundation Trust, particularly in back-office functions and procurement. The Managing Director, TRFT highlighted the importance of maintaining separate identities for each organisation whilst leveraging their similarities to drive savings. They also mentioned ongoing efforts to develop a shared IT system across the South Yorkshire system.

The Chair thanked the Managing Director and Chief Nurse, TRFT for the responses provided and requested that any further questions members had were provided to the Governance Advisor who would liaise with the Trust in order to obtain responses at a later stage.

Resolved:-

That the Health Select Commission:

1. Noted the contents of the TRFT Annual Report.

2. Requested that TRFT report back to the Commission at appropriate intervals on its progress in respect of reducing waiting times.

3. Requested that TRFT attend a future meeting (date TBA) to provide more detail around its approach to responding to learning from serious incidents and audits, ideally providing examples of where the approach had been evidenced and the targeted improvements realised.