Performance
For June 2013 the Trust is expecting to be rated as “Performing” for the Quality of Services based on the DH performance framework. Key performance points to note include:
- ED in 4 hours was 99.2% for June and has been the best performing of all ED’s in England
- 18 weeks and cancer targets continue to exceed expected standards
- Stroke and #NOF performance remain challenging, partly driven by the high levels of bed occupancy at the Trust which is reflected in the increase in delayed transfers of care to 6%. The trust continues to work with the local health system to significantly reduce the number of patients in the hospital who no longer require acute care. There is important progress in increasing community capacity by winter 2013
- At Month 3 the Trust is slightly favourable to the financial plan with a £0.1m surplus. The forecast remains breakeven. Within workforce, the focus is on continuous recruitment to our nursing vacancies and the most cost effective use of contingent workforce to ensure that the highest quality standards are maintained and deliver financial savings
Community Beds
We have been working with other trusts, commissioners and the voluntary sector to provide an alternative for those patients that need care but don’t require an acute hospital admission. We have collectively agreed to open 100 additional community beds which will reduce bed occupancy at East Surrey Hospital, allow us to be better prepared for winter and improve the patient experience.
Sir David Nicholson, Chief Executive of NHS England has said that preventative care and improved services for people in the community were crucial to avoid a growing funding gap in the NHS. By working in partnership we are ensuring that the way in which services are organised is in the best interests of patients.
PACS/RIS System
The deployment of the new PACS and RIS systems at Surrey and Sussex Healthcare NHS Trust was successfully delivered and implementation has gone well despite having to work to some very demanding timescales.
As follows any major system deployment there are a number of issues that we are working hard to resolve. This issues are:
- Images not yet reported (June/July) – some reports, in particular plain film, are experiencing a delay in being reported, due to the volume and the images accessibility during the changeover. A plan has been implemented to clear the back log of reports, with additional reporting in house and increase in work load, to our third party reporting company, Medica.
- Typing backlog (for dictated images & reports) – Unfortunately, we are not currently able to make full use of our voice recognition system; therefore, due to the volume of images being reported to clear the backlog (in house), this has put additional pressure on our Medical Secretaries. Additional hours are being put into typing to ensure reports can be sent timely with the report being dictated.
- Patient waits for appointments – unfortunately, some of our patients, particularly in CT, MRI and US, have experienced a longer than normal wait for the appointment date. We have now resolved the back log and are rapidly booking patients; waiting times will be back to normal by mid-August.
- GPs receiving a high number of results and communications which although are related to the patient, the GP has not been involved in that part of the patients care, hence upon the patient’s report being completed, the protocol in Cerner then reads the ‘direct referral’ status and automatically sends the results to the referring clinician AND GP. This has been escalated to our Cerner Back Office team are working on a resolution for it and we will update on progress as soon as possible.
If you have a report that you urgently require and hasn’t yet been reported, please kindly bleep the X-Ray Coordinator at East Surrey Hospital on bleep 600 and they will immediately arrange for the report to be dictated and typed; we can facilitate an urgent report to be sent electronically or faxed to the practice where possible.
The X-Ray Coordinator can be contacted Monday to Friday 08.30 to 17.00.
Again, please accept our apologies for any delay caused to you and your patients, but we are working hard to remove any excess waiting times, with additional resource in the department and hope to be in a stronger position within four weeks.
Should you wish to speak to someone in regards to this, but not in request of results, please kindly contact:
Victoria Bailey, Interim Radiology Business Manager on ext.1602 or Victoria.bailey@sash.nhs.uk; she will be happy to talk through your concerns with you.
Outpatient Referral Letters
All GP Referral Letters, except those referred through the Choose & Book or Two Week Rule method, should be sent to direct to the Outpatient Booking Office, East Surrey Hospital, Canada Avenue, Redhill, RH1 5RH.
Please do not send these direct to a consultant, a medical secretary or any other department. You can, of course, make the actual outpatient referral letter out to a specific consultant.
The Outpatient Booking Office is responsible for processing ALL referrals for outpatient appointments which then initiates the patient’s 18 week RTT status. Outpatient Referrals made under the TWO WEEK RULE method should be faxed immediately to 01737 231733.
To make this system as easy and cost-effective as possible we would like to introduce an online system for outpatient referral letters. Please could you let us know whether you would prefer an online template to download, complete and email to a dedicated address or whether you would prefer a form you complete online and then press a submit button to send.
Please send all comments or queries to:
Jackie Brown, Head of Outpatient Services on 01737-768511 ext.2824 or email Jackie.Brown2@sash.nhs.uk
Mortality Data
Our local newspapers recently published a story on the fact that data obtained under a Freedom of Information request showed that more people died on a Monday in our hospital compared to other days of the week. In the articles I said that we would look into this and I now understand that this is a data glitch, with some deaths which occur at the weekend not being entered onto our patient management system until Monday. Adjusting for this we have very similar deaths each day, with no significant over-representation on any day of the week. We are working with our trainers both in data quality and on the wards to ensure that how we record this vital information is as accurate as possible and I’d like to apologise to patients and staff for any distress these articles may have caused. Mortality, or death rates, in hospitals are closely scrutinised and the NHS uses a system called Dr Foster which publishes hospital mortality rates on a regular basis. If the number of patients who die in hospital is the same as the number expected to die then the hospital gets a score of 100. Dr Foster’s most recent data records our mortality rate as 90.1, meaning patients are approximately 10% less likely to die with us. This is one of the most widely accepted quality measures and agrees well with the CQC inspection we had across all our services in February which passed us on all standards. We know that we have an average of 3.5 deaths every day across our 655 beds but that nationally it has been reported that more people die at the weekend. This has prompted Sir Bruce Keogh to look to all hospitals and health care to be available 7 days per week and from September we will be one of the first hospitals to have consultants working seven days a week in key specialties.
Friends and Family Test
On July 30 the results of the Friends and Family Test are being released for all Trusts. This will be the first opportunity we will have to see how we are doing compared to other hospitals in England. I welcome the publication of the Friends and Family Test data. Over the last two years we have moved from delivering very few of the national quality and safety standards to delivering them all and as part of our journey of improvement we have ensured that we use patient feedback to improve services.
We have a live feed from Patient Opinion (an independent internet feedback site) on the homepage of our website from patients talking about their care. We also introduced the Friends and Family Test months before the Government’s deadline through our ‘Your care matters’ survey. Our survey asks more than just ‘would you recommend’ it asks detailed questions on a wide-range of areas including cleanliness, pain control, privacy, emotional support and confidence in doctors and nurses. It allows us to monitor and make improvements based on real-time feedback from patients. In June 2013, 90% of inpatients and 87% of Emergency Department patients who answered our ‘Your care matters’ survey were likely or extremely likely to recommend the Trust.
As well as the Friends and Family Test, the annual national inpatient survey will also be carried out. All inpatients who are in the hospital during the month of August will be asked to complete a survey and posters will be put up in the wards to inform patients.