For April 2013 the Trust is rated as “Performing” for its Quality of Services.
Significant points of note regarding performance include:
- There were no incidences of MRSA and three incidences of C-Diff during April
- RTT performance continued as expected with the 90% Admitted, 95% non-admitted and 92% incompletes measures all being achieved in aggregate
- Delayed Transfers of Care was below the 3.5% standard
- Following abnormally high levels of adult ED attendances for three continuous weeks, the Trust underperformed on the 4hr ED standard
Direct access non-obstetric ultrasound
The Trust has invested in new equipment, staff training and the image technology, and is proud to offer a consultant led, robust, safe, high quality direct access non-obstetric ultrasound service under the current contract we have with Commissioners in 2013/14, including thyroid, MSK, vascular, hernias/lipomas and under 18s.
We are pleased to report diagnostic waits are currently well under the six week target, in fact our latest data shows 89 per cent of patients have been seen in less than three weeks.
As a service we get positive feedback from our service users, and receive relatively few complaints in relation to numbers of exams we undertake. We put the success down to the fact that the service is delivered by highly skilled staff that undergo yearly appraisals and undertake continual professional development. We also constantly reinforce our work practices by reviewing and updating our local policies, and we hold regular ‘discrepancy’ meetings to promote shared learning and improvement with regards to how images are interpreted by our consultants. We audit and re-audit our performance on scanning patients for Trauma and Stroke, and we audit the percentage of images that are reported in a ‘timely way’ irrespective of department activity in order to achieve a high standard.
We encourage GPs to make contact with us to discuss the most appropriate test and the test results, and our radiologists contact GPs with any results they are concerned about. Recently we have been gathering hotline numbers for the GP surgeries to help with this flow of information.
Going forward we have been investigating: how GPs can access the iRefer booklet that guides them to refer the correct test for their patients; how to offer flexible appointments to suit our service users’ lifestyles for Ultrasound and plain film; and how we can offer a new range of services that GPs can have direct access to, for example, Nuclear medicine, to enhance what we can offer our local population.
For more information about direct access non-obstetric ultrasound service, contact:
Michelle van Zyl, Radiology Ultrasound Manager, Extension 2731
The Trust’s Endoscopy department has dedicated facilities at ESH and Crawley. Both are purpose built units that meet the highest environmental standards using state of the art equipment and delivering a comprehensive range of diagnostic and therapeutic services. In March the department opened its doors for an Open Day where the public was invited on a tour of the unit at ESH, which was very well received.
The JAG Team (Joint Advisory Group for GI Endoscopy) visited the department on 30 April for a pre-accreditation visit. The visit went well and they were very positive in their feedback. We have since received confirmation from the JAG that they will conduct the formal accreditation visit on 1 October 2013.
Accreditation will pave the way for the Trust to carry out bowel and flexi-sigmoid screening for patients who currently have to travel to Guildford or Frimley.
For more information about the Trust’s Endoscopy department contact:
Rosemary Goodchild, Endoscopy Unit Manager: 01737 768511 ext 8340
For more information about The JAG see: www.thejag.org.uk
Pathology Results available via ICE
Just a reminder to all GP colleagues that the ICE desktop program which you use for ordering pathology tests can also be used to view results on your patients ordered during a hospital episode.
If you are unsure how to use this facility and would like to do so, please contact :-
Martin Stone, Pathology IT Manager on 01737 768511 Ext 6467 email firstname.lastname@example.org
Concerns have been raised by GPs in Surrey about the validity and accuracy of the INR assay at the East Surrey Hospital laboratory. The issue concerned three patients who, in late April (two in one week from the same practice), had blood collected for INR from a primary care setting. The samples were analysed at the East Surrey Hospital laboratory and were found to be high (>20 in most cases) but on repeat testing of a fresh sample taken at a later time were found to be within therapeutic limits.
The Haematology department has conducted a thorough investigation into the performance and accuracy of the analysers and methodology. In all three cases, the initial high result was confirmed by repeat testing before being reported (this is our Standard Operating Procedure). The reproducibility of the results indicates that the readings were not due to a processing error. Both analysers are functioning correctly and performance on Internal Quality Control is within stated tolerances showing no significant bias or random error. External Quality Assurance data demonstrates good correlation of results with similar models of analyser in other laboratories. Resulting from this investigation the Trust wishes to reassure all GP colleagues that there is no systemic problem with INR analysis at the East Surrey laboratory.
A data search of the pathology computer system for the six months to end of April 2013 identified eight patients with INR results >20 out of 66,246 tests carried out. Four samples were from within the hospital and four from primary care, of which three from primary care were within two weeks of each other. This is an incidence of approximately 1 in 8,300. The fact that these unexpectedly high results are so rare means that they should be interpreted with caution and in the light of the clinical picture. If the result does not correlate with the clinical findings, repeat sampling is advised before deciding the patient management.
Whilst it is impossible to be completely certain, it is well known that INR analysis is very susceptible to poor sampling technique and order of draw (the INR sample should be drawn first). This is the most likely cause of repeatable but erroneous results on the same sample, and is the most likely explanation for the cases in question.
In future, and after discussion with the Consultant Haematologists, all results where the INR is >20 will be phoned in accordance with current laboratory practice but additionally reports will contain the following comment:
“INR result on this sample confirmed. However, please treat this result with caution and in the light of other clinical findings. If in any doubt please repeat.”
We hope that this has provided reassurance about the safety and quality of our INR service. As always, we are happy to discuss any further concerns you may have.
Dr Bruce Stewart
Chief of Service for Clinical Support Services
Tel: 01737 231904
New Birthing Unit Open
The brand new Birthing Unit at East Surrey Hospital welcomed its first arrival this month. Following a £400,000 investment, the Birthing Unit now has three en-suite rooms with birthing pools. The midwifery led unit offers a comfortable and private environment for women who might opt for a home birth but who also want the comfort of having expert medical staff on hand.
A fourth room with a pool is available for high risk patients who would still like the option of a water birth.
The money awarded to Surrey & Sussex Healthcare NHS Trust was part of a £25 million investment programme by the Department of Health in maternity facilities and was the largest amount given to a hospital in this area.
At the beginning of May work commenced on the first phase of a £14.5m theatre refurbishment programme on the East Surrey site. Once completed in the 4th Quarter of 2014/15 the Trust will have four new and six fully refurbished theatres, with an up to date post-anaesthetic recovery area.
Phase 1 is a modular building containing a suite of four theatres, two of which will have ultra clean air ventilation for trauma and orthopaedics. This is scheduled to be handed over to the Trust in October this year. These four theatres will then allow the decant of the existing theatres that are 30 years old, for Phase 2, which is a major refurbishment of the existing theatres, post anaesthetic recovery and staff changing facilities.
BoC Respiratory Unit at East Surrey Hospital
This month the Trust was granted planning permission with overwhelming support for a new respiratory unit, which will be built on-site at East Surrey Hospital. The new facility will offer a unique level of care to patients recovering from critical illness who remain ventilator dependent. It is an extension of the facility currently provided at St Thomas’ Hospital, London, and will provide a more local centre for those patients from parts of south London, Kent, Surrey and Sussex.
The intention is that work will start on-site in August this year and receive the first patient in May next year. BoC will be responsible for appointing the contractor and overseeing the works.
Academic Health Science Networks
NHS England has confirmed the designation of 15 new Academic Health Science Networks (AHSNs), including one for Kent, Surrey and Sussex for which the Medical Director will be our own Chief Medical Officer, Dr Des Holden.
AHSNs have the potential to transform health and healthcare by putting innovation at the heart of the NHS. This will improve patient outcomes as well as contributing to economic growth. AHSNs present a unique opportunity to pull together the adoption and spread of innovation with clinical research and trials, informatics, education, and healthcare delivery. They will develop solutions to healthcare problems and get existing solutions spread more quickly by building strong relationships with their regional scientific and academic communities and industry. The 15 AHSNs will now be given license to operate and will cover the whole of England.
The Trust has a new website. To help GPs we have created a GP Centre where you will find a Consultant Directory, an A-Z of services, and the Formulary.
We are currently developing the GP Centre and would like to hear from GPs about what you would find useful and interesting. If you have suggestions or comments for how we can further improve the GP Centre, please contact Bethan at Bethan.Borrett@sash.nhs.uk or call 01737 768511 ext 2976
You can view the website here
Spread the word, not the germs – a film to promote correct hand washing technique
Children from the hospital’s Sunshine Day Nursery scrubbed-up to make a short film about the correct hand washing technique. The film, made by the Trust is part of the induction training and is available to view on the Trust’s website and reminds staff and shows visitors it’s as easy as 1-2-3 to wash your hands properly to prevent the spread of infection. You can watch the film (2 minutes) here: http://youtu.be/lTWiWRZ4PV4
If you would like to show the film on your website or in your surgery, please contact Eloise for a copy at Eloise.email@example.com or call 01737 768511 ext 6844
Our commitment to safety, quality and the patient experience
‘Your Care First’, the Nursing and Midwifery Strategy for 2013-2016, was launched in May. The strategy will play a key role in shaping nursing and midwifery practice over the next three years, enabling staff to continue to deliver world-class patient care. It is the culmination of the hard work of many nurses and midwives across the trust over the last three months and is underpinned by three key objectives:
- providing safe and effective patient care
- developing skills, behaviours and competence to deliver quality nursing and midwifery care
- building up the potential of our nursing and midwifery workforce
At the centre of the strategy is the commitment to our patients, their families and carers that we deliver quality care with compassion and in which our patients can always have confidence.
The strategy is available here: SASH Nursing and Midwifery Strategy