Monthly Archives: July 2013

NHS 111: GP Reassures Berkshire Patients

Dr Andy Ciecierski, Project Board Chair for NHS 111 Berkshire and a Reading GP, would like to advise people that the NHS 111 service in Berkshire is provided by South Central Ambulance Service NHS Foundation Trust, a respected and stable service which also provides 999 call handling.

“The service has a strong clinical presence in the form of nurse practitioners and paramedics supporting the health advisers who respond to calls. We planned the introduction to minimise any risks of a “big bang” approach and the modelling being used to predict demand and staffing is proving to be very accurate and this is being reflected in a good level of service.”

Since phasing in the service, performance has been closely monitored and is meeting NHS England’s standards for strong performance. Across the whole of Berkshire more than 45,000 calls have been received since the service went live. So far there is a 25% reduction in GP Out of Hours activity and below national average referrals to 999 of 7%. Over 96% of calls are answered within 60 seconds.

The service is under continuous review by the clinical commissioning groups in Berkshire to ensure it continues to provide a high quality, safe and effective service for patients.

CQC Report re: Heatherwood & Wexham Park Hospitals NHS Foundation Trust

The CQC report is the outcome of a welcome and thorough inspection into services at Heatherwood and Wexham Park Hospitals NHS Foundation Trust. We accept the findings of the report and will work with the Trust and its clinicians to improve and maintain high standards of patient care and quality.

As Clinical Commissioning Groups, we, along with others, monitor the safety and standard of clinical care at the hospital on behalf of our patients. This includes regular inspection visits to wards and facilities, feedback on patients experience of the hospital’s services and systematic monitoring of clinical standards. We have alert systems in place so that any issues of concern are identified early and can be addressed with the Trust.

As soon as our monitoring process identified the issues of concern, swift action was taken. We have already started to see improvements in many areas that the CQC highlights in its report. We recognise that there is still work to be done but are confident that the Trust’s action plan will deliver the improvements required. We will continue to support and monitor the Trusts services and ensure support for the hospital from the health and social care system in East Berkshire and South Buckinghamshire.

We understand that capacity at the hospital has been highlighted following increased demand for emergency and urgent care services over the winter period. These issues are being addressed both by the hospital and an Urgent Care Programme Board of health and social care partners working with the Trust on expanding capacity as we lead up to next winter.

Although, of course, aspects of the CQC report are of concern, it also provides reassurance that there are many examples of good practice in the quality of medical and nursing care provided by Heatherwood and Wexham Park. We want patients to have full confidence in their local health services and will do everything within our power to ensure that high levels of patient safety, quality and care are achieved.

CQC warns Heatherwood and Wexham Park Hospitals NHS Foundation Trust that it has failed to protect the welfare of patients at Wexham Park Hospital

The Care Quality Commission has told Heatherwood and Wexham Park Hospitals NHS Foundation Trust that it must make urgent improvements to protect patients at Wexham Park Hospital.

CQC has issued a formal warning to the trust following an unannounced inspection at which it failed to meet any of the seven national standards which were reviewed.

A team of inspectors with nursing experience, supported by experts, spent four days at the hospital unannounced in May in response to concerns raised about patient care in the emergency care pathway – including the results of an NHS survey published in April 2013 which found that patients were waiting too long for treatment in Accident & Emergency (A&E).

The team visited the A&E, Emergency Department Decision Unit (EDDU), acute medical unit (AMU), medical interventions day unit (MIDU), acute stroke unit, wards 4, 6, 7, 9 and 18, the paediatrics unit and a number of the hospital’s escalation areas. A full report from this inspection has been published on the CQC website today.

Among CQC’s findings:

  • Inspectors found that a combination of high attendances and a shortage of inpatient beds elsewhere in the hospital meant the A&E was overwhelmed. People could not always be moved on from A&E when they no longer needed to be there – which left A&E crowded and busy, and people at risk of receiving care which did not meet their needs. Patients were waiting up to 11 hours to be admitted to a ward.
  • Inspectors observed that, while staff were trying their best to cope with the volume of patients, they were struggling to do so. While inspectors saw many instances of good care, they also saw a number of instances of poor care. Patients did not always have their needs adequately assessed, planned, and delivered. This was a particular concern for patients who were confused or who were assessed as having dementia. There was no system to ensure patients with dementia had dedicated care and support. Call bells were not always in reach, and were not responded to quickly enough.
  • Privacy and dignity were not always respected throughout the hospital. Inspectors saw people lined up on trolleys by the reception desk when no A&E beds were available, and spotted a bay designed for one person being used for two due to lack of space. Patients and their relatives told inspectors that communication was often poor, and observations of care taking place backed this up.
  • Poor standards of cleanliness and inadequate infection control arrangements were found in some areas of the hospital. Storage of medicines was sometimes poor, with patients and visitors on some wards able to access drugs which should have been locked away.
  • Staff told inspectors that they felt there were not enough staff in the hospital to meet the needs of patients, and said that they felt they were under considerable pressure to work longer hours. A number of staff told inspectors they regularly worked additional hours, sometimes up to two hours a day, which were unpaid. Staff said there was no connection between the needs of patients on the wards and the number of staff required to meet those needs.
  • While there were systems in place to identify risks to patient safety and to maintain quality of service, these were often ineffective. There was a strong emphasis on responding to national and local clinical targets, but little emphasis on ensuring that overall patient experiences were positive.

Adrian Hughes, Regional Director of CQC in the South, said:

“While we would acknowledge that Wexham Park Hospital was under considerable pressure at the time of this inspection, this is not an excuse for the systemic catalogue of failings we identified there. Local people deserve much better from their hospital.

“Our experienced inspectors – the team including trained nurses and a pharmacist in this case – and expert advisors found that there was a clear focus on managing the demand for inpatient beds in the hospital, which sometimes came at the expense of providing the expected level of care. Basic things, such as making sure people’s dignity was respected did not get the attention they deserved. This impacts on the patients and therefore is completely unacceptable and needs to be tackled immediately.

“Patients are entitled to be treated in services which are safe, effective, caring, well run, and responsive to their needs. The trust has assured us that it will take action and make the improvements required. We will keep watch on this, and our inspectors will return unannounced in the near future to check that it has made those changes.”

-ENDS-

For further information please contact the CQC press office on 0207 448 9239 or out of hours on 07917 232143.

NOTES TO EDITORS

CQC has published a full report.

Inspectors found that Heatherwood and Wexham Park Hospitals NHS Foundation Trust was failing to meet seven standards at Wexham Park Hospital:

  • · Respecting and involving people who use services
  • · Care and welfare of people who use services
  • · Staffing
  • · Assessing and monitoring the quality of service provision
  • · Records
  • · Management of medicines
  • · Cleanliness and Infection Control

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England. We make sure health and social care services provide people with safe, effective, compassionate high-quality care and we encourage care services to improve. We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.

Heatwave Alert! South East England

Public Health England issues a Level 3 ‘Heatwave’ alert issue for South East.

Top advice for being sun safe:

  • Try to keep out of the sun between 11.00am and 3.00pm
  • Wear sunscreen
  • Wear loose cotton clothing
  • Drink lots of cool drinks
  • Seek shade
  • Wear sunglasses and a hat
  • Look out for others especially vulnerable groups such as the elderly, young children and babies and those with serious illnesses
  • Never leave anyone in a closed, parked vehicle, especially infants, young children or animals

Remember that it can get uncomfortably hot indoors too. Try to keep your bedroom and living space cool, by closing the curtains on windows that receive the sun and opening your windows at cooler times of the day and overnight when you can. Turn off non-essential lights and electrical items as these generate heat.

For more advice please refer to NHS Choices.