Open and Honest Tameside

'Open and Honest Care' at Tameside and Glossop Integrated Care NHS Foundation Trust

NHS England

This report is based on information from May 2017. The information is presented in three key categories: safety, experience and improvement. This report will also signpost you towards additional information about Tameside and Glossop Integrated Care NHS Foundation Trust's performance..

1. SAFETY

Safety thermometer

On one day each month we check to see how many of our patients suffered certain types of harm whilst in our care. We call this the Safety Thermometer. The Safety Thermometer looks at four harms: pressure ulcers, falls, blood clots and urine infections for those patients who have a urinary catheter in place. This helps us to understand where we need to make improvements. The score below shows the percentage of patients who did not experience any new harms.

98.0% of patients did not experience any of the four harms whilst an inpatient in our hospital

97.9% of patients did not experience any of the four harms whilst we were providing their care in the community

98.9% of patients did not experience any of the four harms in the Trust

 

For more information, including a breakdown by category, please visit:
http://www.safetythermometer.nhs.uk/

Health care associated infections (HCAIs)

HCAIs are infections acquired as a result of healthcare interventions. Clostridium difficile (C.difficile) and methicillin-resistant staphylococcus aureus (MRSA) bacteremia are the most common. C.difficile is a type of bacterial infection that can affect the digestive system, causing diarrhoea, fever and painful abdominal cramps - and sometimes more serious complications. The bacteria does not normally affect healthy people, but because some antibiotics remove the 'good bacteria' in the gut that protect against C.difficile, people on these antibiotics are at greater risk.

The MRSA bacteria is often carried on the skin and inside the nose and throat. It is a particular problem in hospitals because if it gets into a break in the skin it can cause serious infections and blood poisoning. It is also more difficult to treat than other bacterial infections as it is resistant to a number of widely-used antibiotics.

We have a zero tolerance policy to infections and are working towards eradicating them. If the number of actual cases is greater than the target then we have not improved enough. The table below shows the number of infections we have had this month and results for the year to date.

The rigorous Root Cause Analysis is in place to determine whether a ‘ lapse in care’ occurred for the 7 C.difficile cases during the month of April  2017 and as a result this number may be subject to change.

 Total CasesC.difficileMRSA
This month 4 2
Improvement target (year to date) 97 0
Actual to date 13 2

 

Avoidable CasesC.difficileMRSA
This month 0 0

 

For more information please visit: https://www.england.nhs.uk/patientsafety/associated-infections/

 

Pressure ulcers

Pressure ulcers are localised injuries to the skin and/or underlying tissue as a result of pressure. They are sometimes known as bedsores. They can be classified into four grades, with one being the least severe and four being the most severe.

This month 11 pressure ulcers were acquired during hospital stays.

SeverityNumber of pressure ulcers
Grade 2 1
Grade 3 0
Grade 4 0

 

The pressure ulcer numbers include all pressure ulcers that occurred from 72 hours after admission to this Trust

So we can know if we are improving even if the number of patients we are caring for goes up or down, we also calculate an average called 'rate per 1,000 occupied bed days'. This allows us to compare our improvement over time, but cannot be used to compare us with other hospitals, as their staff may report pressure ulcers in different ways, and their patients may be more or less vulnerable to developing pressure ulcers than our patients. For example, other hospitals may have younger or older patient populations, who are more or less mobile, or are undergoing treatment for different illnesses.

Rate per 1000 bed days: 0.04

Falls

This measure includes all falls in the hospital that resulted in injury, categorised as moderate, severe or death, regardless of cause. This includes avoidable and unavoidable falls sustained at any time during the hospital admission.

This month we reported 4 falls that caused at least 'moderate' harm.

SeverityNumber of falls
Moderate 4
Severe 0
Death 0

 

So we can know if we are improving even if the number of patients we are caring for goes up or down, we also calculate an average called 'rate per 1,000 occupied bed days'. This allows us to compare our improvement over time, but cannot be used to compare us with other hospitals, as their staff may report falls in different ways, and their patients may be more or less vulnerable to falling than our patients. For example, other hospitals may have younger or older patient populations, who are more or less mobile, or are undergoing treatment for different illnesses.

Rate per 1,000 bed days: 0.34

2. EXPERIENCE

To measure patient and staff experience we ask a number of questions.The idea is simple: if you like using a certain product or doing business with a particular company you like to share this experience with others.

The answers given are used to give a score which is the percentage of patients who responded that they would recommend our service to their friends and family.

Patient experience

The Friends and Family Test

The Friends and Family Test requires all patients, after discharge, to be asked: How likely are you to recommend our ward to friends and family if they needed similar care or treatment? We ask this question to patients who have been an in-patient or attended A&E (if applicable) in our Trust.

The In-patient FFT score: 97.7% for the Friends and Family test*. This is based on 854 responses

A&E FFT score: 81.0%for the Friends and Family test*. This is based on 1087 responses

Community FFT score: 92.0%for the Friends and Family test*. This is based on 1087 responses

*This result may have changed since publication, for the latest score please visit:

http://www.england.nhs.uk/statistics/statistical-work-areas/friends-and-family-test/friends-and-family-test-data/

 

We also asked 9 patients the following questions about their care:

 Percentage recommended
Were you involved as much as you wanted to be in the decisions about your care and treatment?  89
If you were concerned or anxious about anything while you were in hospital, did you find a member of staff to talk to?  78
Were you given enough privacy when discussing your condition or treatment?  89
During your stay were you treated with compassion by hospital staff?  89
Did you always have access to the call bell when you needed it?  100
Did you get the care you felt you required when you needed it most?  100
How likely are you to recommend our ward/unit to friends and family if they needed similar care or treatment?  89

A patient's story

Our patient stories are important to us and we believe that feedback - both positive and negative - is essential to improving the care received by the patients and their families.

Cora Dawsons Story

Tameside Family Support Nurse

 

 

 

Staff experience

We asked 22 staff the following questions:

 Net Promoter Scores
I would recommend this ward/unit as a place to work 93
I would recommend the standard of care on this ward/unit to a friend or relative if they needed treatment 55
I am satisfied with the quality of care I give to the patients, carers and their families 87

 

Guidelines produced by the National Institute for Health & Care Excellence (NICE) make recommendations to ensure safe staffing levels on adult wards in acute hospitals and maternity settings. In-line with this guidance we are required to publish monthly reports showing the number of Registered Nurses/Midwives and Health Care Assistants (Care Staff) working on our in- patient wards.

Each month the data compares the number of staff hours ‘Planned’ against the number of staff hours used ‘Actual’. This is collected by ward, by shift, and is reported by calendar month as a % fill rate by day and by night.

An overview of Tameside hospitals current position is given below:

 

To view our detailed reports, which provide a breakdown by ward and to access the monthly Trust Board Reports relating to Safer Staffing information at Tameside, please use the link below:

Safer Staffing

3. IMPROVEMENT

Improvement story: We are listening to our patients and making changes

 

Extensive Care service

 

New Pioneering Care Service has launched in Tameside and Glossop

 

The frail elderly, care home residents and people over 18 with complex medical conditions living in Tameside and Glossop have been chosen as the first in Greater Manchester to benefit from a pioneering new approach to healthcare, which is proving successful in America and Sweden.

The new Extensive Care Service brings everyone together under one roof as part of an integrated team. This means all the doctors, nurses, care co-ordinators and other health professionals will all be in the same place, meaning less time for people having to travel from appointment to appointment between different organisations within the local healthcare system.

The hope is that this unique trial - a partnership between the local integrated care organisation (ICO), Council, GPs, social health professionals and the voluntary sector - will improve the general health and wellbeing of patients, and reduce the need for hospital admissions.

This service is for people who are registered with a GP within Tameside and Glossop, have multiple long-term conditions and who have had regular unplanned visits or admissions to A&E within the last three months. Initially, the pilot study will focus on about 150 patients, who will be treated at home and at a clinic. Most will stay under Extensive Care for three to six months, “graduating” when their conditions are optimally controlled.

It is being led by Dr Helen Bain. She is a senior neighbourhood-based doctor, who is supported by a team of experts. Patients will remain registered with their own GP and have to volunteer to take part.

Dr Bain explains: “Our vision is that once the service is fully operational it will provide co-ordinated 24/7 care that is wrapped around the patient with a single point of access. We believe this approach will feel very different. It will help give people more confidence and knowledge to help them make informed decisions on how best to manage their conditions. And it should mean fewer planned and unplanned hospital admissions.”

 

Karen James, Chief Executive of Tameside and Glossop Integrated Care NHS Foundation Trust, which runs Tameside Hospital, believes the Extensive Care approach could help in the vision to raise healthy life expectancy in Tameside and Glossop within the next five years.

 “Our five neighbourhoods cover a registered population of 244,771 across 41 GP practices. Together they have been telling us of the need for improved support for the ‘at risk’ frail elderly, care home residents and people with complex needs. This pioneering approach is designed to provide personalised care to patients who are at highest risk of relapse and hospital readmission. Once we are sure the service works we hope to extend it to about 400 patients across all neighbourhoods.” she adds.