SASH meeting clinical standards
Latest performance data (August 2012) from the Department of Health (DH) shows that Surrey and Sussex Healthcare NHS Trust is meeting all the nationally set clinical standards:
• ED 95% in 4 hours – 99%
• MRSA – 0
• CDiff – 1
• 18 Weeks admitted – 91.4%
• 18 Weeks non-admitted – 95.8%
• Cancer TWR – 93%
• Mixed Sex Breaches – 0
• VTE risk assessment on admission – 91.2%
Patient experience
We agreed with the DH that we would undertake a local survey to see if our patient experience score had improved since our last inpatient survey from July last year. We therefore surveyed 2,800 patients who were discharged in January and June 2012. This survey was undertaken through August and I am pleased to be able to say that the Patient Experience scores in June were sufficiently higher than January such that the DOH have agreed that the User Experience scores on our Performance Framework should be changed to ‘Performance under Review’.
This leaves an overall Trust Quality score of ‘Performing’. This is a considerable achievement for the Trust and reflects well on the journey we have made over the last couple of years.
Our monthly patient survey scores show that for August, 96% of medical patients and 97% of surgical patients would recommend our services to a friend.
Paediatric pathways
Our new paediatric ED area adjoining our main ED at East Surrey Hospital opened last month. The new area is brighter and better laid out and includes its own isolation and resuscitation rooms. It has areas for seeing both major illness/ injury and minor injuries, allowing complete separation of paediatric patients from the main ED.
Paediatric patients arriving in ED are seen by the dedicated ED staff, including paediatric trained nurses. The vast majority of patients are treated and discharged, however a small number of patients are referred to our Child Assessment Unit for ongoing investigation, treatment and observation under our Paediatric Consultants and/or the surgical specialities. When needed some patients are admitted directly to Outwood Ward, our inpatient children’s ward. Our Child Assessment Unit (CAU) remains located on the first floor next to Outwood. If parents or carers bring children to the East Surrey Emergency Department, they will be seen in the paediatric emergency department and then triaged to the appropriate service from there.
Child Assessment Unit
The Child Assessment Unit is part of the paediatric emergency service for the Trust. Young patients are referred either from East Surrey Hospital’s Paediatric Emergency Department, Horsham Hospital walk-in centre, Crawley urgent treatment centre or via their GP. Passport patients can self refer – these are children with chronic illnesses who are well know to the paediatric department and need specialist emergency treatment, allowing them to by-pass the Emergency Department and come straight to the CAU when it is open.
Many children referred by their GP will need to be seen acutely, but for others who need an urgent but not immediate review, it may be appropriate for the child to come the next day or be seen in the Rapid Access Clinic. This can be discussed with the doctor taking the referral. During Mon-Fri 9-5pm GPs can speak to the CAU consultant for advice by calling 01737 768511 and asking for bleep 807. Out of hours the paediatric middle grade will advise. Phone 01737 768511 and ask for the on-call paediatric registrar.
If when making an acute referral a child sounds unstable, the paediatrician will ask the GP to call an ambulance and the paediatric team will see the child on their arrival in the Emergency Department. Referrals deemed stable by the GP can be sent directly to CAU.
CAU is open every day, with referrals accepted between 9am-10pm on weekdays, and 10am-6pm on weekends and bank holidays.
Children are referred to the CAU with acute medical conditions, such as asthma and diabetes, where they can be assessed in a child-friendly environment by paediatric nurses and doctors. The unit allows investigation, treatment and observation for up to 12 hours. The aim, where possible, is to prevent overnight admission to the children’s ward. When the CAU is not open the paediatricians commence treatment in ED and then transfer the patients to Outwood ward.
The paediatric team work alongside the ED team for any child requiring resuscitation in ED. Patients are stabilised in ED before transferring them to the CAU or Outwood ward.
Crawley Hospital Fire Incident: Update on Jumbo and Comet Wards
A fire incident happened at Crawley Hospital on 28th August. Although this was a relatively small fire, it caused an extensive amount of damage and disrupted all of the services that run out of Comet ward, which include the hospital’s medical day unit and some outpatient chemotherapy. The fire damage had a ripple effect throughout the whole hospital, and beyond, because displaced services had to be relocated to other wards and up to East Surrey Hospital. Work is now nearing completion – there is a new entrance and waiting area for Comet ward and it has been deep cleaned and the smell of smoke removed. Once the infection control procedures are complete the move back can begin.
We are working closely with West Sussex PCT to move back in a safe and planned way, but until then the majority of medical day unit and chemotherapy services are now being provided on Jumbo, although maximum numbers that can be treated are more limited due to space constraints.
We prioritise cancer and supportive therapies and do our best to treat all our non-urgent patients without delay. The new patients with suspected DVT’s continue to be assessed by AMU at ESH and this arrangement will continue at present. The haematology clinic has been moved until 26 October to Outpatients 2 at Crawley hospital for September. SASH paediatric outpatient services which have clinics on Thursdays and Fridays have temporarily relocated until 26 October to the paediatric outpatients department at East Surrey Hospital.
New Main Entrance Open
As part of our redevelopment programme, East Surrey Hospital has recently opened its new Main Entrance. The Main Entrance houses a new reception desk which is manned from 8am to 8pm weekdays, and 11am till 7pm at weekends, and a retail outlet which is home to WHSmith Shop and Café. As well as the usual WH Smith range there are products such as toothpaste and slippers for the convenience of patients who have forgotten these small but essential items. In October the new Boots pharmacy will also open providing a wide range of useful products for patients and visitors.
Extended Visiting Hours
With a view to further improving patient experience, East Surrey Hospital is also trialling new visiting hours. Historically visiting times for most wards were set at between 3pm and 5pm and 7pm to 8pm. As of now these have been extended from 2pm – 8pm for the majority of ward areas. Some areas such as Paediatrics, Intensive Care and Maternity have their own hours so will not be affected by this.