We are looking at different ways to indicate the outcomes of our monitoring in the future. In the community CAMHS service, young people had access to the staff kitchen at Monks Park House, which contained knives and hazardous cleaning products. Standards of infection control varied across the trust and results of the mandatory reporting were variable. Tier 3 CAMHS were provided by a wide range of professionals, were effective and there was evidence of mutually supportive, multidisciplinary working across all of the CAMHS teams. Good A childrens and young persons participation strategy (20142016) had been developed. Records were clear, up-to-date, and available to staff providing care. The group listening events provided refreshments as an extra incentive to attend. The BBC is not responsible for the content of external sites. The specialist palliative care team had worked with the acute medical unit with complex end of life patients to improve patient outcomes. One quick win from the Perform process was instigating huddles, which took place on the wards, focused on key data, with actions as a result. The trust had a deficit of 20.1million at the end of August, 6.7M worse than planned. hbbd``b` @QH0 kWGA@:L %@ HVDA(fym %@vlD # One patient had their operation cancelled on the day of operation for the second time. Of the other services four were rated as good and the remaining seven as requiring improvement. North Bristol NHS Trust owns the hospital but the adjacent health centre is owned by NHS Property Services. The impact of the programme included releasing 50 beds, reducing length of stay by 13 per cent and enabling a 10.2 per cent increase in the four-hour performance. Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. Caring remained outstanding and effective, responsive and well-led all improved to outstanding. Staff supported patients to make informed decisions about their care and treatment. The trust needed to maintain focus on culture, particularly in maternity, facilities management and the BME population and continue to promote freedom to speak up. 404 0 obj <> endobj In the 2019 staff survey, NBT improved its wellbeing score from 5.7 to 5.9 and staff engagement from 6.9 to 7.1. If this service has not had a CQC inspection since it registered with us, our judgement may be based on our assessment of declarations and evidence supplied by the service. We respect each other, acknowledge everyone's strengths and communicate effectively in an open and trusting environment. Governance systems had developed since our last inspection. University Hospitals Bristol and Weston NHS Foundation Trust (UHBW) was formed on 1 April 2020 following the merger of University Hospitals Bristol NHS Foundation Trust and Weston Area Health NHS Trust. All the hospitals were clean. [16] An unnamed whistleblower claimed a lack of beds was putting patient safety at risk because small rooms designed for minor procedures, such as injections, were being used to keep patients in overnight. Following our inspection the trust had updated the standard operating procedure to address concerns about the safety of placing patients in escalation areas. Only 71 per cent of patients in A&E received the care they needed within four hours. M+q}#c{Bo iJ We are OneNBT. Children and young people were involved in developing information leaflets and media applications, and the recruitment and training of staff, and have created artwork to make the service environments feel more welcoming. Staffs self-reported happiness scores, using Happy App, improved from 46 per cent (rated a neutral result) in 2017 to 59 per cent (rated a positive result) in 2018. and our acute colleagues in Weston Area Health NHS Trust and North Bristol NHS Trust, It takes a progressive approach to staff wellbeing. There are over 8,000 reasons why North Bristol NHS Trust is a place to be #NBTProud of. jobs@uhbw.nhs.uk On staff engagement there was an improvement in questions on staff feeling their feedback was acted on. As part of each inspection, we look at the way health services provide care and treatment to people. Infection control processes were not always followed. ?CI ( patients in the emergency department must be assessed in a timely manner and cared for in a suitable environment. Hundreds of staff from all parts of the trust participated, and more than 750 comments were collected, analysed, and fed back to staff. [22] . This was an improvement from our last inspection in 2018. Patients should not have to share sleeping accommodation with others of the opposite sex and should have access to segregated bathroom and toilet facilities.. It comes as the Government is poised to rewrite equality law to protect women by making it easier to bar trans people from single-sex spaces such as wards. The trust had a clear structure for overseeing performance, quality and risk, with board members represented across the divisions. This was the same as our last inspection at Southmead hospital in 2016. However, some staff felt unsupported by operational management arrangements and undervalued, and that both service management and the trust did not listen to them. The overall rating took into account the previous good ratings in the effective, caring and well led domains. Governance arrangements were in place, with clear lines of reporting from clinical hubs through to the trust board. In addition, the lack of individual risk assessments and clearly documented care plans had the potential to put children and young people at risk of receiving unsafe or inappropriate care and treatment. Discussions could be about the number of beds, outlier patients, anyone whos in the wrong place, or any other metrics that are decided by the team as being crucial to understanding how an area was performing and identifying how to keep it functioning properly. Some aspects of safety required improvement in relation to infection control, security and medicines management. Translate this page. The service was able to respond to urgent referrals. People could not consistently access the service in a timely way and this was a continuing problem since our last inspection. Plans were in place to review staffing and caseloads to manage this increase. Campaigners on Wednesday welcomed Lord Markhams comments, but cautioned that the British public has been fooled into thinking the NHS is trying to eliminate mixed-sex accommodation when in reality any male can self-identify onto a womens ward. Not all areas were following best practice and we were not assured the trust had full oversight of cleaning regimes in some areas. Due to the demands on the emergency department patients were not being cared for in the most appropriate place to manage their needs with a corridor often being used inappropriately. ensure that actions planned to reduce the backlog ofimages to be reported and appointments requested are effective and that systems are in pace to prevent such a backlog occurring in the future. We observed collaborative working from all staff contributing to patient care. Lord Markham added: Patients can request same-sex intimate care, and it will be up to the care provider or clinician to respond based on the patients needs and staff availability. If this service has not had a CQC inspection since it registered with us, our judgement may be based on our assessment of declarations and evidence supplied by the service. Some examples include the use of deep brain stimulation techniques for the treatment of functional disorders such as Parkinsons disease, led by Professor Gill, and developing the use of robotic surgery to deliver drugs directly into the brain.[4]. It produced an operational resilience and capacity plan, envisaging the trust would achieve performance of 92 per cent against the A&E four-hour standard by April which was rejected. We saw good evidence of collaborative working across the system. Most populous nation: Should India rejoice or panic? lhV qe+ bEpdc6hv4Y0{B nh5NfePhyMasS%_D%`& There were backlogs in unreportedimages (4,642) and in appointment requests (49,000). Families were involved in the referral and assessment process. endstream endobj 405 0 obj <>>> endobj 406 0 obj <> endobj 407 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text]/XObject<>>>/Rotate 0/TrimBox[0.0 0.0 595.276 841.89]/Type/Page>> endobj 408 0 obj <>stream End of life care: was rated outstanding overall. Bed occupancy within the hospital was consistently high at 96% and within critical care was above 80%. Although the NHS may claim to be committed to providing single-sex services, the reality is that both accommodation and care are mixed sex because NHS policies allow transgender people to be included as the sex with which they identify, according to the way they dress, and the name and pronouns they currently use. NBT saw a demand increase of 12.2 per cent, with bed occupancy regularly running at 102 per cent, meaning patients waiting in corridors. The trust's treatments and advances in care have won national and international recognition. Staff we spoke with were enthusiastic about their work and it was evident they were committed to providing the best service they could. Involvement of woman and their partners in their maternity care at Cossham Hospital. In the 2019 staff survey, NBT improved its wellbeing score from 5.7 to 5.9 and staff engagement from 6.9 to 7.1. The move to the Brunel building had been managed well and the trust was aware that work was now required to further develop new ways of working and a clear strategy for the future of the whole trust. Effective, responsive and caring ratings remained good. Although we rated safety as requires improvement in the trust, improvements had been made. Staff assessed risks to patients, acted on them and kept good care records. Our rating of well-led at the trust improved. Following the implementation of Perform, NBTs performance improved massively. Research North Bristol NHS Trust . the service is performing exceptionally well. We aim to be an anti-discriminatory organisation and are committed to building a team that represents a variety of backgrounds,. Although there was a trust wide focus on patient flow within the hospital and improvements had been made this still required improvement. Governance processes were innovative, and focused on improving safety, quality, and patient experience specifically for outpatients. Safe improved to good. In January 2018 NBT instigated a new staff wellbeing programme, which was shaped through staff feedback as the year went on. This was an improvement from our last inspection in 2018. His comments came after a Policy Exchange report warned that NHS trusts were compromising womens rights by providing same-sex intimate care based not on a staff members biological sex, but their self-declared gender identity. We saw evidence of challenge in the board minutes. PWC consultants initially trained 15 per cent of NBTs workforce, holding bootcamps with staff from all 26 wards, sites and discharge teams, supporting them through a 10-step process. +6]`.12UNjxt^aS/7GoXRF[@; ~Y^TC+[AjdX"XVB2E,Ky z7'gP "9$pmt5XW)RvMsM~ 0 However, improvements were required in end of life care . Research has shown that bed occupancy of both 85% (and above 70% within critical care services) could start to affect the quality of care provided to patients. Bristol, We rated outpatient services as good overall. David was previously director of operational finance at North Bristol NHS Trust from June 2014. In 2016 it had launched a new strategy, which for the first time focused on the workforce as the key to improvement, but it had not made enough progress before the trials of winter 2017/18, and it needed to shift up a gear. However this had deteriorated from September 2015 and in November 2015 only 82% of patients met this standard. North Bristol NHS Trust values all people as individuals. Nurse staffing levels were meeting national guidelines. The trust ran inpatient geriatric services at Blackberry Hill Hospital until 2005, when it closed activities at the site transferring most services to Frenchay and Southmead, and eventually selling the trust's part of the site. A culture of wellbeing was encouraged, with organised lunchtime walks to wellbeing from the site twice a week and an emphasis on the importance of taking breaks. Staff treated patients with compassion and kindness and took account of their individual needs. improve feedback to staff following incident reporting. Clinical psychologists have been seconded into staff support roles, taking the team working on staff wellbeing from two full-time equivalent to 10. Staff were reaching out to promote the use of the unit and natural births not excluding woman who traditionally may have not been thought suitable to have their birth in a midwifery led unit. [14], The hospital recruited a group of volunteers, known as 'Move Makers', to aid the transition from the Frenchay site. There was excellent partnership working with Barnardos Helping Young People (Children and Families) Engage (HYPE) service and a clear ethos of engagement with and involvement of children, young people and their families in developing and delivering the services. NBT engaged professional services firm PWC to help develop an approach to improving patient flow, using a staff coaching and empowerment methodology called Perform. ensure that all patients medical records are available when the patient is being seen and that the reliance on temporary records is reduced to a minimum. Patients length of stays decreased by 13 per cent. Lord Blencathra told the Telegraph: The response from Lord Markham is 100 miles away from the replies that we were receiving from the Department of Health on these issues a year ago and shows that ministers are moving in the direction of offering proper protection to biological women. Isobel is a fellow member of the . Staff at all levels were very committed to providing good patient care and frustrated when they felt they could not achieve this. The bereavement midwife visited women in the CDS and also followed women up at home at any time, even beyond the normal time limit for postnatal midwifery care. There were however some concerns that hand washing audits were not meeting the compliance target of 95% and some staff were seen not to be bare below the elbow. North Bristol NHS trust is a centre of excellence for health care in the South West in a number of fields, as well as one of the largest hospital trusts in the UK. In the community services for children and young people such working was excellent, with work with Barnardos Child Sexual Exploitation (BASE) project which focused on young people who were at risk of exploitation being recognised nationally as an area of outstanding practice. Improve patient flow within the hospital and ensure that there is a robust hospital-wide system of bed management so as to: significantly reduce delays in patient flow through the emergency department; reduce occupancy to recommended levels within medical services; and, ensure that there is capacity within the hospital so that patients can be admitted to and discharged from critical care at the optimal time for their health and well-being. We aim to be an anti-discriminatory organisation and are committed to building a team that represents a variety of backgrounds, perspectives, and skills. Our values are how we work towards achieving our vision to provide an outstanding experience for our patients, their families and the people who work for and with us. usGJQB4\%WdQ A new employee assistance programme was instigated, giving staff access to free financial and legal support, relationship advice and counselling 24/7. One of the messages to come from the listening events was that the health and wellbeing of staff should be a trust priority. Overall, there was a 6 per cent increase in patients cared for, handled with 38 fewer beds. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. Inadequate A development plan had been initiated and coaching was ongoing. [26], In September 2019, the trust was rated by the Care Quality Commission (CQC) as outstanding for caring, and good overall. Control of Substances Harmful to Health (COSHH) Policy. The huddles also demonstrated to staff that they were empowered to fix problems in their areas and were supported to do so through a coaching approach. The secret mine that hid the Nazis' stolen treasure. He said that the Government noted the Policy Exchange report on gender identity ideology in the NHS and is considering whether trusts need guidance on the importance of same-sex care. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. [18] It spent 20.8M, 7.1% of its total turnover, on agency staff in 20142015. Our decisions on overall ratings take into account, for example, the relative size of services and we use our professional judgement to reach a fair and balanced rating. On this inspection we did not inspect critical care, children and young peoples services, outpatients, diagnostic imaging. We rated it as good because: Caring and Well led at core service level were rated outstanding. Your information helps us decide when, where and what to inspect. We rated well-led as good because: Urgent and Emergency services: (also known as accident and emergency services or A&E) were rated good overall. As much emphasis was placed in the caring for and about those close to patients as patients themselves. The site is to be redeveloped for the first time in 30 years.
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