NHS Blackpool
Community Health Services
Quality Account
1st April 2011 to 31st March 2012
Contents
Section 1 - Chief Executive’s Statement of Quality
5
Section 2 - Looking Forward - Priorities and Proposed initiatives for 2012 / 2013
6
Section 3 - Looking Backwards - Review of 2011 / 2012:
8
The effectiveness of services
Participation in Clinical Audit
10
Participation in Clinical Research
10
Goals agreed with commissioners - use of the CQUIN payment framework
11
Productive Community Services Showcase Event
12
Data Quality
15
Sexual Health Services Award
16
Non Medical Prescribing Award
16
Gold Accreditation for looking after our staff
16
The experience of people who use the services
Patient Experience Events 2011 / 2012
19
Compliments and Complaints 19
The safety of services
Incident Reporting
21
Introduction of lessons learned
22
Infection Prevention 23
What others say about NHS Blackpool Community Health Services
Care Quality Commission 23
2011 National NHS Staff Survey
24
Statements from the Local Involvement Network, NHS Blackpool Commissioners and
the Blackpool Council Health Overview and Scrutiny Committee
3
Section 1
Chief Executive’s
Statement of Quality
We are delighted to present
the NHS Blackpool Community
Health Services second annual
Quality Account outlining our
performance for 2011/12 and our
quality priorities for 2012/13.
Community Health Services strive
to ensure that the quality of
healthcare is at the very centre
of everything we do and aim to
exceed the expectations of our
service users by learning and
improving on our performance.
The Quality Account is written for
members of the public, patients and
staff so that they can share in our
service experiences over the last 12
months and know our plans for the
forthcoming year. Quality accounts
are annual reports to the public from
providers of NHS healthcare about the
quality of services they deliver.
We have established great
foundations to build upon and in this
document outline our achievements
against the priority areas identified
in last year’s Quality Account. NHS
Blackpool Community Health Services
have had an exciting year with many
quality initiatives being delivered.
4
This Quality Account
meets the requirements of
the NHS (Quality Account)
Regulation 2010 as set out
in the NHS Action 2009
models of services which support
the provision of care closer to home,
reduce the need for hospital visits and
improve continuity of care for people
with long term conditions.
During 2011 / 2012 NHS Blackpool
Community Health Services was
the provider arm of NHS Blackpool
Primary Care Trust and delivered
community health services to the
population of Blackpool and some
surrounding areas.
We hope you find this Quality
Account useful and easy to read. If
you have any feedback or suggestions
on how we might improve our quality
account, please do let us know by
emailing chsfeedback@blackpool.
nhs.uk or writing to Community
Health Services, Mezzanine Floor, The
Stadium, Seasiders Way, FY1 6JX.
From April 2012 NHS Blackpool
Community Health Services
transferred along with NHS North
Lancashire Provider Services to
Blackpool Teaching Hospitals NHS
Foundation Trust, as a part of the
Transforming Community Services
Programme.
We readily acknowledge that our
ability to deliver the quality and safety
agenda rests on the co-operation and
commitment of our staff, patients,
and other stakeholders and would like
to say “thank you” to all those who
have worked with us so far.
Looking back at our statement on
quality in last year’s document, we
talked about the exciting opportunity
that the integration of acute and
community health services would
present. Our integration became
reality on the 1st April 2012 and
we are now in a unique position
to improve the quality of care and
quality of life for our patients through
the development of integrated care
pathways.
Integrated care has collaboration at its
heart and our clinicians are working
with GPs, commissioners, colleagues
within the hospital setting, patients
and carers to further develop new
Wendy Swift
Liz Holt
Chief Executive NHS
Blackpool
Director of Community
Health Services
5
Section 2
Looking Forward
Priorities and Proposed Initiatives
for 2012 / 2013
In selecting our priorities for
quality improvement for the
forthcoming year, we have
concentrated on areas where the
organisations performance could
be improved.
6
Quality
Improvement
Area
Quality
Improvement
Target
Quality Improvement Measure
Patient
Experience
Ensuring that people
have a positive
experience of care.
Percentage of
staff who would
recommend the
provider to friends or
family needing care.
The NHS staff survey includes the following statement: “if a
friend or relative needed treatment, I would be happy with the
standard of care provided by this Trust” and asks staff whether
they strongly agree, agree, neither agree nor disagree, disagree,
or strongly disagree. Community Health Services will monitor
the percentage of staff that responded to the NHS staff survey
and agree or strongly agree that if a friend or relative needed
treatment, they would be happy with the standard of care
provided by the Trust, and compare the results with the national
average.
Community Health Services will continue to monitor patient
experience using real time patient experience questionnaires.
Patient Safety
Surveillance of
treating Clostridium
difficile.
Clostridium difficile can cause symptoms including mild to severe
diarrhoea and sometimes severe inflammation of the bowel, but
hospital-associated Clostridium difficile can be preventable.
Domain 5 of the NHS Outcomes Framework for 2012/13 includes
incidences of Clostridium difficile as an important indicator of
improvement in protecting patients from avoidable harm, as does
the NHS Operating Framework for 2012/13, which sets out a “zero
tolerance” approach to infections acquired in healthcare settings.
Community Health Services will continue to investigate all
outbreaks of Clostridium difficile and will undertake a clinical
audit of non-medical prescribing and the use of anti-biotics. The
clinical audit will include levels of antibiotic prescribing and the
reasons for prescribing.
Patient Safety
Treating and caring
for people in a safe
environment and
protecting them
from avoidable
harm. Proactively
monitoring patient
safety incidents and
percentage resulting
in severe harm or
death.
An open reporting and learning culture is important to
enable the NHS to identify trends in incidents and implement
preventative action. As part of Community Health Services
transition to Blackpool Teaching Hospitals NHS Foundation Trust
in April 2012 we will develop an integrated incident reporting
system. Community Health Services will also introduce root cause
analysis as a method of investigating incidents graded at level 3
or above.
Patient Quality
End of Life Care and
the choice of where
to die.
Community Health Services will monitor all patients on the
Liverpool End of Life pathway and the number who died in their
preferred place.
The Liverpool Care Pathway for the Dying Patient (LCP) is a care
pathway which a patient can expect in the final days and hours
of life, which also becomes a structured record of the actions and
outcomes that develop.
It is a means to transfer the best quality of care of the dying from
the hospice movement into other clinical areas, so that wherever
the person is dying there can be an equitable model of care.
Patient Safety
National Patient
Safety Thermometer
data collection.
The NHS Safety Thermometer is a local improvement tool
for measuring, monitoring and analysing patient harms and
harm free care. We collect information monthly on pressure
ulcers, falls, catheters with urinary tract infections and Venous
Thromboembolism (VTE).
7
Section 3
Looking Backwards
Review of 2011 / 2012:
Strong leadership is essential
within a successful organisation
and as reflected in our strategic
objectives, our Board is committed
to ensuring that we provide safe
quality care to the people who
use our services.
NHS Blackpool Community Health
Services has reviewed all the data
available to them on the quality of
care in 17 of these NHS Services.
The quality targets selected for 2011
/ 12, as outlined below comprised the
three areas identified by Community
Health Services and those identified
by our commissioners which are
specified in the community contractrelated Commissioning for Quality
and Innovation Scheme (CQUIN).
• 48 hour target to access sexual
health services - (This target refers
only to Genito-Urinary Medicine
services for screening)
• Reduction in pressure ulcers
8
grades 3 & 4 - (Pressure ulcers
occur when the skin or underlying
tissue becomes damaged. Health
professionals use a recognised
grading system to describe the
condition of pressure ulcers. Grades
range from 1 to 4 with 1 being at
a superficial stage and 4 being the
most severe)
• Reduction in Urinary Tract Infections
• Reduction in Methicillin-resistant
Staphylococcus aureus (MRSA)
& Clostridium difficile - (MRSA Staphylococcus aureus is a normal
bacteria found in healthy people.
Most bacteria are sensitive to
antibiotics. Staphylococcus aureus
that are resistant to an antibiotic
called methicillin are referred to as
methicillin resistant Staphylococcus
aureus or MRSA. MRSA is rarely
dangerous to healthy people)
(Clostridium difficile (or c difficile)
is a bacterium that normally lives in
the large intestine (or bowel) It may
cause inflammation of the intestine
when there is an over growth of
the bacteria. This overgrowth
may take place after a person has
taken antibiotics that have killed
the helpful bacteria that live in the
intestine and which normally keep
the balance of clostridium difficile)
• Continue to implement the
Productive Community Service
Programme (See page 12 for full
description)
• Choice of where to die for patients
who are at the end of their lives
(Preferred place of death)
Quality
Improvement
Area
Quality
Improvement
Target
Quality Improvement
Measure
Target Achievement
Clinical
Effectiveness
48 hour target
to access sexual
health
All first attendances at the Genitourinary medicine (GUM) service to be
seen within 48 hours of contacting
the service.
We offered a GUM appointment within
48 hours 100% of the time.
However due to patient choice the
number actually seen in 48 hour is just
under 100%.
Clinical
Effectiveness
Productive
Community
Services
Implementation
Each service to complete at least
one Productive Community Services
module and provide evidence that
they are working towards another
during 2011/12. This will ensure
our services are implementing
LEAN techniques to improve service
delivery.
All services completed one module in
the Productive Community Services
Series and had started a second project.
Patient
Experience
Choice of where
to die
Preferred place
of death
Community nursing will record the
number of patients on their caseload
who die and the proportion of these
who have been facilitated to die in
their preferred place of death.
Within community nursing
quality metrics for end of life care have
been developed which prompt staff to
ensure patients are on the Liverpool
Care Pathway and offered a choice of
where to die.
Patient
Experience
Introduce real
time patient
experience
questionnaires
Within a number of our services
we will introduce real time patient
experience questionnaires to ensure
we capture more accurately the views
of our service users.
Clinic based services within the
organisation have introduced a real
time patient experience questionnaire
and all the services have at least 200
questionnaires returned.
Child and Adolescent Mental Health
Services / Dental / Health Visitors /
Well Leg Clinic / Stop Smoking Service
/ Sexual Health Services / Primary
Intermediate Mental Health Team.
Patient Safety
Reduction in
grade 3 & 4
pressure ulcers
Increase the number of patients
with a waterlow score of 15 or
above to have a Malnutrition
Universal Screening Tool (MUST
Tool) completed. This is important
to ensure our patients are not
malnourished which can affect
wound healing.
Increase the number of patients with
a grade 2 pressure ulcer to have had
a Malnutrition Universal Screening
Tool (MUST Tool) completed.
80% of community nursing staff to
complete pressure ulcer training.
Collect baseline data on hospital
admissions / hospital attendances
for patients requiring tissue viability
care.
42% increase in patients with a
waterlow score of 15 or above having
a Malnutrition Universal Screening Tool
(MUST Tool) completed.
Baseline = 50% compliance
Reaudit = 92% compliance
48% increase in patients with a
grade 2 pressure ulcer to have had a
Malnutrition Universal Screening Tool
(MUST Tool) completed
Baseline = 41% compliance
Reaudit = 89% compliance
86% of staff have been trained
Baseline data for admissions has been
collected through-out the year.
Patient Safety
Methicillinresistant
Staphylococcus
aureus (MRSA)
& Clostridium
Difficile (c
difficile)
All confirmed cases of Methicillinresistant Staphylococcus Aureus
(MRSA) & Clostridium Difficile are
reported and investigated. Trajectory
for 2011 / 2012 is less than 2 MRSA
reported incidents.
There were no outbreaks of MRSA
during 2011 / 2012.
Patient
Safety, Clinical
Effectiveness
and Patient
Experience
Reducing Urinary
Tract Infections
Increase the number of staff trained
to carry out male and female
catheterisation. The target is that
16 staff have to attend training in
2011/12
Develop a catheter care leaflet in line
with National Institute for Health and
Clinical Excellence (NICE) guidance
(2006) for patients / carers.
8 staff trained in quarter 1
9 staff trained in quarter 2
1 staff trained in quarter 3
A patient information leaflet has been
developed.
9
Goals agreed with commissioners - Use of CQUIN payment framework
Commissioning for Quality and Innovation (CQUIN)
aims to embed quality as the ongoing principle for
NHS services and place quality at the heart of every
organisation.
The Effectiveness of Services
Participation in
Clinical Audit
Clinical audit is used as a driver
for improvements in quality
and we aim to ensure that all
clinical professional groups
participate in clinical audit.
We recognise that clinical audit
is a key component in the NHS
Blackpool Community Health
Services quality assurance system
and have invested in providing
clinicians with sufficient support
to enable them to participate in
both national and local audits.
The clinical audit team provides
assistance throughout the
organisation by co-ordinating the
annual clinical audit programme
and maintaining a database of the
national and local audit projects
undertaken by NHS Blackpool
Community Health Services.
During 2011 / 2012 there were
no national clinical audits and no
confidential enquiries covering
the NHS services provided by
NHS Blackpool Community Health
Services. (Appendix 1 - List of
National Clinical Audits).
The reports of 82 local clinical
audits were reviewed by the
provider in 2011 / 2012 and NHS
Blackpool Community Health
Services intends to take the
following actions to improve the
quality of healthcare provided as a
result of the findings.
The following table illustrates some of the improvements we have
made through audit projects:
Audit title
Improvements made
Practice
Nurse Relief
Team record
keeping and
documentation
audit
The results show a high standard of record keeping
within the Practice Nurse Relief Team with 100%
compliance being achieved in all areas apart from one
(one follow up date was not documented).
Dental Services
Record Keeping
Audit
Documenting GP details, documenting child’s
ethnicity, recording consent for procedure.
Hand Hygiene
Audit
Safeguarding Team demonstrated 100% compliance
with hand hygiene practices and following protocol.
Decontamination
Audit
Dental Services demonstrated 100% compliance with
decontamination techniques.
End of life
referral timeline
project
100% of patients were seen by a community nurse
within the expected response for end of life care.
-7 patients contacted on the day visit requested or
sooner than requested.
-1 patient was contacted within 2.5 hours following
receipt of the referral.
-0 patients were contacted after the requested date
of referral.
Audit of ADHD –
NICE guideline
Audit indicated that a full sleep history is undertaken
before prescribing medication for children with ADHD
(Attention Deficit Hyperactivity Disorder)
Community
Nursing
NHS Blackpool Community Health Services considers
the appearance of its employees to be of significant
importance in promoting health and safety and
in portraying a positive and professional image to
all users of services – patients, visitors, clients or
colleagues. An audit undertaken within nursing
indicated compliance with the uniform policy. A
re-audit will be undertaken to ensure standards are
maintained.
Participation in Clinical Research
The number of patients receiving NHS services provided or sub-contracted by
NHS Blackpool Community Health Services in 2011 / 2012 that were recruited
during that period to participate in research approved by a research ethics
committee was zero.
10
contract, agreement or arrangement with for the provision
of NHS services, through the Commissioning for Quality
and Innovation payment framework.
Further details of the agreed goals for 2011 / 2012
and the following 12 month period are available
electronically at
www.institute.nhs.uk/world_class_commissioning/pct_
portal/cquin.html
A proportion (1.5%) of NHS Blackpool Community
Health Services income in 2011 / 2012 was conditional
on achieving quality improvement and innovation goals
agreed between NHS Blackpool Community Health
Services and any person or body they entered into a
CQUIN Goals for 2011 / 2012
CQUIN 1 was a regionally mandated goal and the others were agreed locally.
Goal
Goal description
CQUIN 1
All services to have completed 1 module of the productive community services series and be
working to complete a second one.
CQUIN 2
High Impact Actions to improve Pressure Ulcer and Catheter Care.
CQUIN 3
Introduce Real Time Patient Experience questionnaires within clinic settings.
In 2011 / 2012 NHS Blackpool Community Health Services CQUIN was worth £321,452. The majority of its CQUIN
targets were achieved, which resulted in a payment of £321, 240.
CQUIN Scheme
CQUIN Total
Payment Achieved
CQUIN Scheme 1 (0.50%)
£107,151
Full Payment Achieved
CQUIN Scheme 2 (0.50%)
£107,151
CQUIN Scheme 3 (0.50%)
£107,151
Full Payment Achieved
106, 938 Achieved *
*£213 was deducted as the organisation achieved 92% compliance against a target of 99%.
Improvement made in pressure ulcer care through CQUIN
Pressure ulcers are a type of injury that affects areas
of the skin and underlying tissue. They are caused
when the affected area of skin is placed under
too much pressure. There has been a lot of work
undertaken nationally to improve the care patients
receive for pressure ulcers.
The Waterlow Risk Assessment is a risk scale with gradings
ranging from 1-4 to categorise pressure ulcers and the
MUST is a five-step screening tool to identify adults, who
are malnourished, at risk of malnutrition (under nutrition),
or obese. It also includes management guidelines which
can be used to develop a care plan.
The CQUIN initiatives focused around completing a
Waterlow Risk Assessment and a Malnutrition Universal
Screening Tool (MUST) for patients receiving treatment for
a pressure ulcer.
Within NHS Blackpool Community Health Services our
CQUIN targets were to increase the use of Waterlow and
MUST tools within our patients with pressure ulcers.
Number
of Pressure
Ulcers
Number with
a completed
waterlow score
Number with
a waterlow of 15
and above
Number
with a completed
MUST tool
Baseline Audit
55
36 (66%)
24 (67%)
12 (50%)
Re-Audit
46
44 (96%)
Goal
During 2011 / 2012 we have:
• Increased the recording of Waterlow for all patients with a pressure ulcer by 30%
• Increased the recording of MUST for patients with a Waterlow of 15 and above by 42%
• Increased the recording of MUST for patients with a grade 2 or above pressure ulcer by 46%
36 (92%)
11
Productive Community Services
Productive Community Services (PCS) is an
organisation-wide change programme which aims to
help systematic engagement of all front line teams
in improving quality and productivity. It is a practical
application of lean based techniques that aims to
increase the organisation’s capacity and capability
for continuous improvement. The modules are list
below:
Health Visiting and School Nurses
• Well Organised Working Environment
• Knowing How We are Doing
• Patient Status at a Glance
• Managing Caseload & Staffing
• Planning our Workload
• Working Better With Our Key Care Partners
• Agreeing the Care Plan with the Patient
• Standard Care Procedures
• Perfect Intervention
• Patient Perspective
With community services playing a crucial role in the
shape of the new NHS, and care shifting away from acute
services, the new PCS programme from the NHS Institute
for Innovation and Improvement has been seen as a timely
opportunity to revitalise the workforce and increase NHS
capacity to care for patients in community settings.
In 2011 / 2012 we have continued to focus on embedding
PCS methodology within our teams. Our CQUIN target
was to ensure each team complete one PCS project and
had started another one. A total of 20 projects were
completed during 2011 / 2012.
All our teams achieved this target and to celebrate and
share our projects we held 2 showcase events.
Community Nursing
PCS Module
Project Title
Improvements / Changes
Knowing how
we are doing
Being the Best. A district nursing team
have developed quality metrics for end of
life care.
Standardising of care for patients. Gold
standard practice which will be rolled out
to all district nursing teams.
Well organised
working
environment
Four district nursing teams have recently
moved into South Primary Care Centre.
Working space for four teams is now
organised. More efficient working now
in place. Developing clear processes and
create a more efficient way of working.
Patient status
at a glance
Introducing a patient status board.
Fewer interruptions for staff when other
team members require information
relating to a patient. Will allow the nurses
to see at glance information about the
patient.
Sexual Health Services & Young Peoples Sexual Health Services
12
PCS Module
Project Title
Improvements / Changes
Knowing how
we are doing
Reviewed the work undertaken last year
around changing clinic opening times
and found the clinic times requested have
poor attendance.
Clinic times have been reviewed and
clients were audited again to ask what
times they would prefer the service to be
opened. From the results the clinic times
were altered to meet the needs of the
service users.
Well organised
working
environment
The aim of the project was to arrange
all the trolleys in the clinical rooms in
Connect and label all the equipment.
This would enable staff attending from
outlying clinics to find all the equipment
required when working in Connect, the
young people’s sexual health service.
This would save time when looking for
equipment.
Enables staff attending from outlying
clinics to find all the equipment required
when working in Connect. Now that
Connect has been integrated into Sexual
Health Services all staff work across
all areas of the service. Therefore the
whole service is in the process of rolling
out standardised trolley contents and
labelling of trolleys across all clinics.
PCS Module
Project Title
Improvements / Changes
Knowing how
we are doing
Introduction of the Universal Pathway.
The new Universal pathway for health
visiting has been established along with
a revision of health visiting records to
support it, which will enable us to audit
universal provision to all families.
Managing
caseload and
staffing
Caseload analysis/paperwork for Child
Protection for the Health Visitors and
School Nurses.
Evenly distributed workload between all
teams.
Organised
working
environment
Implementation of electronic resource
system.
Immediate access to electronic copies of
paperwork /forms/resources required.
Reduce storage space required.
Reduce amount of paper wasted due to
updated versions of referral forms etc.
Everything is stored in one location and
limiting the amount of duplication of
resources.
PCS Module
Project Title
Improvements / Changes
Working better
with our key
care partners
(Patient
perspective)
Dental Education and joint working with
Park School.
Reduced anxiety in pupils attending for
dental treatment. The School nurses from
Park School were concerned that some of
their pupils were scared of attending the
dentist. Joint working with parents and
children to explain services and treatment
available.
Working Better
with our key
care partners
Implement joint working with Children’s
services at Blackpool Teaching Hospitals
NHS Foundation Trust (BTH) and dentistry
to improve dental care for children
undergoing surgery. Initial pilot assessed
and currently being reviewed with BTH.
During the pilot project, children were
having their teeth removed secondary to
recieving surgery for other main reasons.
As a result they were not receiving extra
general anasthetic to have their teeth
removed and there was a cost saving as
anaesthetist costs were reduced.
Dental
Allied Health Professionals
PCS Module
Project Title
Improvements / Changes
Managing
caseload and
staffing
To develop and adopt guidance for
safe and appropriate working, when
conducting home visits on the way into
work and on the way home from work.
Flow chart of safe working practice
developed, agreed and adopted. Staff
are now clear about when and who to
contact in an emergency situation.
Well organised
working
environment
To plan organise and implement the
smooth transition of therapy services
which allows the integration of nursing ,
Occupational Therapy and physiotherapy
within Intermediate Care. Utilising
existing resources and maximising
available space to ensure a more efficient
working environment.
In liaison with Social Services plans
have been drawn up for the layout
of the proposed new office and a list
of requirements collated. Awaiting
commencement of works.
Well Organised
working
environment
Review of current filing system with the
aim of being able to retrieve case notes
efficiently.
We have reviewed filing systems used
by other similar departments and have
moved towards a single open case filing
system.
13
Child and Adolescent Mental Health Services
PCS Module
Project Title
Improvements / Changes
Patient
perspective
Patient experience event held on the 1st
February with local young people asking
them their views of the service and how
to make improvements.
The service now has patient views to
adapt the service to meet the needs of its
service users. Extended opening times on
a Thursday to offer choice to clients and
will continue to pilot this for a further 6
months.
Well organised
working
environment
Telephone Messages - Consistency in
message taking.
Checklist developed to assist taking
telephone messages.
Primary Intermediate Mental Health Services
PCS Module
Project Title
Improvements / Changes
Knowing how
we are doing
Developing an electronic record keeping
system (SystmOne) to monitor waiting
times and activity.
An improvement in waiting times for
patients, therefore providing them with
a better quality service as having to wait
less for appointments.
Working better
with our key
partners
Closer working with Blackpool GP’s.
Clarification for GP practices as to how
PIMHT allocate referrals to specific
disciplines within the team.
Enhance the communication with
referring GP regarding the allocation,
treatment given and outcomes.
We will provide clarification for GP’s
regarding accessing support in a crisis
both in and out of hours.
Smoking Cessation Services
PCS Module
Project Title
Improvements / Changes
Agreeing the
care plan with
the patient
The agreeing the care plan with the
patient module helps teams create
patient-led, goal driven plans.
Motivational texting has been introduced
for clients and text reminder to clinics as
one of the PCS projects.
Texts are sent automatically to clients to
keep them motivated in their attempt
to stop smoking. This service is in
conjunction with the normal text service
we run from the advisers and it helps in
keeping the clients motivated to continue
to be smoke free.
Patient
Perspective
Invited patients along to an event where
they could share their experiences of
smoking cessation services and discuss
areas they would like to see improved.
The event provided extremely useful
information about the service for a
difficult to reach client group.
Started a monthly weight management
clinic with the health trainers which runs
on a Wednesday at Whitegate Health
Centre in the afternoon til early evening,
as requested by participants who were
worried about weight gain due to
stopping smoking.
Data Quality
Good quality data underpins the
effective delivery of patient care
and is essential if improvements
in quality of care are to be made.
Improving data quality and hence
the information available to our
services, will improve patient care
by helping to improve efficiency
and value for money.
In order to promote and facilitate the
improvement in the quality of data
Community Health Services have
developed a Data Quality and Better
Information Strategy. The strategy
sets out the high level objectives of
improving data quality and producing
better information. Throughout the
next 12-18 months the strategy will
be implemented across Community
Health Services.
NHS Blackpool Community Health
Services was not subject to the
payment by results clinical coding
audit during 2011 / 2012 by the Audit
Commission.
Our score for information quality and
records management as assessed
using the information governance
toolkit was 67%. Trusts are rated
red, amber, green denoting level
of concern. This organisation is
compliant with the standard and
rated green.
NHS Blackpool Community Health
Services did not submit records during
2011 / 2012 to the Secondary Uses
Service for inclusion in the Hospitals
Episode Statistics which are included
in the latest published data.
Priority Data Items
100
% Valid NHS Numbers
50
99.8%
0
100
% Valid Referral Dates
50
100%
0
100
% Valid Contact Methods
50
99.6%
0
100
% Valid Discharge Dates
50
100%
0
Also introduced new posters to
demonstrate the variety of venues
available which have been delivered to
community pharmacies, Dentists and
Children’s centres.
14
15
National Awards
Sexual Health Services Award
Sexual Health Services and the Public
Health Team were shortlisted in the
Managing Long Term Conditions
category as recognition for the
ongoing work around improving
patient pathways for patients with
HIV.
Their project entitled: HIV – No longer a
death sentence but a long term condition
– Transforming treatment services
involved undertaking a service redesign in
collaboration with heath, social care, the
voluntary sector and MedicX pharmacy
based in Whitegate Health Centre.
prevalence of HIV in the UK. Each year
between 19 and 42 people are diagnosed
locally, with a total of 372 people now
living in or attending services in Blackpool
with HIV. Since the introduction of new
therapies, HIV if managed well has
become a long term but as yet incurable
condition. A major part of this work has
been developing the work between the
HIV Team and MedicX pharmacy where
patients can now access their medications
7 days a week from the community
pharmacy on site with longer opening
hours and patients now also have access
to a specialist pharmacist on site.
Blackpool has one of the highest
Non Medical Prescribing Award
NHS Blackpool Community Health
Services were shortlisted as finalist
for the Health Service Journal –
Efficiency in Medicines Management
award. Within NHS Blackpool,
Community Health Services there
has been an initiative to develop a
wound care formulary for community
nursing. The work was undertaken
because within community nursing,
wound care accounts for the highest
volume activity of district nursing
teams. There is also disparity
between individual teams, uncertain
evidence base for practice, open to
individual interpretation, lack of
availability of independent guidance
and encourage standardisation of
practice.
The formulary was developed by front
line clinicians from Community Health
Services in conjunction with our nonmedical prescribing lead. The project also
involved partnership working with the
pharmaceutical industry to print the final
wound care formulary booklet. Many
wound care tools are copyrighted and
require license fees to be paid to utilise
them. To save money for the NHS a
wound care company agreed to publish
the formulary at no cost to ourselves
as they already license these tools. The
content of the wound care formulary
was finalised before entering into any
negotiations with the pharmaceutical
organisations and partner pharmaceutical
organisation had to agree to produce a
non promotional handbook without any
logos. Community Health Services were
incentivised through a CQUIN target to
adopt and comply with formulary.
The quality of patient care has improved
because practice has been standardised
across the whole of Blackpool
Community Health Services. The wound
care formulary is A5 size and fits into the
district nurses diaries so they always have
validated wound care tools at the
The experience of people who use our services
point of care. The formulary encourages
evidence based practice and is a decision
making tool for staff to use. There is a
clear pictorial guide to aid recognition of
wounds and severity easily.
Gold Accreditation for looking After Our Staff
16
Within NHS Blackpool Community
Health Services we appreciate the
importance of ensuring our staff are
healthy to deliver high quality care.
To obtain these awards we have offered
staff an opportunity to participate in a
number of different exercises including,
golf, netball, football and walking.
Throughout 2011 / 2012 we have been
part of the NHS 2012 Sport and Physical
Activity Challenge to encourage more
staff to take part in exercise.
The London 2012 Inspire programme
enables NHS organisations across the UK
to link their events and projects to the
London 2012 Games in an official scope.
We have been recognised nationally
by the department of health and have
achieved Gold Accreditation presented by
Sir David Nicolson and been awarded the
London 2012 inspire mark for the work
we have undertaken to encourage staff
to participate in exercise.
NHS Blackpool Community Health
Services is committed to involving
our patients with improving
services and during 2011 / 2012
we introduced real time patient
experience feedback.
Real time patient feedback is
concerned with the ongoing
collection of feedback from patients
following a recent experience of using
health care services.
• Child and Adolescent Mental
Health Services
• Sexual Health Services
• Dental Services
• Health Visiting
• Well Leg Clinic
• Smoking Cessation Service
• Primary Intermediate Mental
Health Team
The questionnaires were completed
by our service users, immediately after
they received their treatment in the
clinic before leaving the premises.
Reports were then produced every 2
weeks detailing the findings, which
allowed managers to respond and to
make immediate changes to services.
All our services that provide care from
a clinic base were involved in the
project where patients were asked to
complete a questionnaire each time
they visited the services.
17
As well as organising patient satisfaction surveys we also organised patient experience events for our services. This was
to give service users the opportunity to speak face to face with a health professional and share their experience. Each
service organised an event, giving service users the opportunity to tell us their story and provide suggestions about how
we could improve the service we offer.
Date of Event
Dental
11th July 2011
Smoking Cessation
17th October 2011
Connect (Sexual Health Services)
24th / 27th October 2011
Community Nursing / AHP
16th November 2011
Health Visiting
November 2011
CAMHS / School Nursing
1st February 2012
Primary Intermediate Mental Health Team
10th Feb 2012
Learning Disabilities
20th Feb 2012
A full report is available detailing all our patient experience work undertaken throughout 2011 / 2012 by contacting
chsfeedback@blackpool.nhs.uk
Comments, Compliments and Complaints
Q1.On reflection did you get the care
that mattered to you?
Service
Yes
208/ 225
CAMHS
92%
214 / 228
Dental
94%
186 / 202
Health Visitors
92%
219 / 235
Mental Health Team
93%
764 / 802
Sexual Health / Connect
95%
201 / 204
Stop Smoking
99%
232 / 236
98%
Well Leg
Sexual Health / Connect
Mental Health Team
Health Visitors
Dental
CAMHS
11
11
114
15
20
26
23
Service
CAMHS
Dental
Health Visitors
Mental Health Team
Sexual Health / Connect
Stop Smoking
Well Leg
0
0
1
0
2
2
0
0
164
153
157
194
633
190
204
NHS Blackpool Community Health Services encourages people to tell us about their experience of
using our service.
CAMHS
12
37
9
13
23
3
9
41
23
24
30
4
17
13
0
0
294
11
0
0
0
1
4
41
25
8
7
12
16
22
17
32
64
10
2
2009 / 2010
2010 / 2011
2011 / 2012
Adult Mental Health
27
28
44
CAMHS
Child & Adolescent Mental Health Services
0
6
3
Community Nursing
239
192
70
Connect
1
11
18
Dental
0
35
13
Health Visiting
22
15
15
Community Occupational and Physiotherapy
8
18
55
Governance and Quality
0
0
2
School Nursing
11
9
27
Sexual Health
3
67
28
Smoking Cessation
0
0
16
TOTAL
358
381
309
2
1
0
0
1
0
0
0
3
2
0
0
0
0
0
1
4
5
1
0
4
13
0
0
5
3
0
1
3
7
1
2
6
24
5
5
20
29
2
2
7
34
3
15
43
87
1
5
8
48
31
33
44
125
28
27
9
103
180
138
111
519
172
195
10
168
190
180
193
755
200
228
Blank
5
7
10
6
20
0
4
158
176
153
137
399
173
220
2
1
0
2
2
0
Always
211 / 225
94%
213 / 228
93%
193 / 202
95%
223 / 235
95 %
784 / 802
98%
203 / 204
99%
231 / 236
98%
Q3. Did staff listen to your worries?
Service
CAMHS
Dental
Health Visitors
Mental Health Team
29
19
9
7
15
1
4
Well Leg
Stop Smoking
Sexual Health / Connect
Mental Health Team
Health Visitors
Dental
CAMHS
Q4. Did you feel that staff treated
you as an individual?
Service
Always
CAMHS
200 / 225
88%
Dental
211 / 228
92%
Health Visitors
184 / 202
91%
Mental Health Team
222 / 235
94%
Sexual Health / Connect
770 / 802
96%
Stop Smoking
203 / 204
99%
225 / 236
95%
Well Leg
69
74
231
51
132
65
144
0
2
0
3
1
2
3
2
1
0
0
1
0
0
0
8
10
7
109
182
9
6
51
24
5
22
9
4
18
3
3
6
2
147
8
1
137
3
0
25
0
0
37
1
18
9
24
0
3
7
10
0
604
0
180
0
96
2
14
2
11
8
6
54
0
0
0
2
13
0
211
0
16
2
0
0
1
0
5
0
14
7
8
6
6
Blank
5
2
10
8
6
8
21
48
119
156
58
17
126
114
441
36
12
120
5
34
9
Q7. Did your relatives / carers / friends get the answers to their questions at
the time they needed them, and in a way that they could understand?
Service
Always
Never
Sometimes
Blank
N/A
Sexual Health / Connect
Stop Smoking
Well Leg
26
18
13
33
30
3
4
0
1
1
0
1
2
0
0
1
Q9. Using the scale below where 0 is least likely and 10 is most likely, how likely
would you be to recommend this service to others?
Well Leg
Stop Smoking
Sexual Health / Connect
Mental Health Team
Health Visitors
CAMHS
Dental
Service
0
202
225
235
Service
Q6. Did you get the answers to your questions at the time you needed
them, and in a way that you could understand?
Always
Never
Sometimes
Blank
Well Leg
Stop Smoking
Sexual Health / Connect
Mental Health Team
Health Visitors
Dental
CAMHS
Service
Compliments received by services
Overall questionnaires received from June 2011
Connect/Sexual Health:
802
Health Visitors:
Dental:
228
CAMHS:
Stop Smoking:
204
Mental Health Team :
Well Leg Clinic:
236
Comments, compliments as well as complaints help us in making decisions about the services we provide and how
we can improve them. Compliments can be given either verbally or written if a person has received a particularly good
service from NHS Blackpool Community Health Services.
Q2. When you arrived at the service did you feel that the staff knew
about you and any previous care you had received?
Blank
N/A
No
Not Sure
Yes
Service
Dental
Health Visitors
Mental Health Team
Well Leg
Stop Smoking
Sexual Health / Connect
26
12
16
13
32
0
12
0
0
0
1
0
0
0
Q8. Using the scale below where 0 is the worst and 10 is the best, how would you rate this Service
during your visit today?
Stop Smoking
Q5. Patients have said that " Sometimes in services, Members of staff
may say one thing but then do another “Did this happen to you?
Service
Always
Never
Sometimes
Blank
Well Leg
Time period included in the report: 3rd June 2011 – 6th April 2012
Number of questionnaires returned: 2132
Final Overall Report Project 128 – Real Time Patient Experience Questionnaire
Service
19
18
Patient Experience Events Held in 2011 / 2012
Complaints
All staff work hard to get things right, but sometimes things do go wrong and if people are not happy with
the level of service received they are encouraged to let us know in order that we can better understand and
improve our services.
Complaints by service
2009 / 2010
2010 / 2011
2011 / 2012
Service
Resolved
within 24
hrs
Formal
Complaint
(more
than 24hrs
to resolve)
Resolved
within 24
hrs
Formal
Complaint
(more
than 24hrs
to resolve)
Resolved
within 24
hrs
Formal
Complaint
(more
than 24hrs
to resolve)
Adult Mental
Health
0
0
0
0
0
6
CAMHS
5
4
9
6
4
2
CHS Admin
0
0
0
1
-
1
Community
Nursing
1
7
5
5
7
11
Connect
1
0
2
1
1
-
Dental
0
2
0
1
3
4
Health Visiting
3
1
1
5
4
-
Community
Occupational
and
Physiotherapy
or Allied
Health
Professional
for consistency
Within 2011 / 2012 we have introduced an electronic method of reporting incidents which has resulted in a more
efficient process, allowing managers to action incidents quicker. The introduction of the electronic incident reporting
system has had a positive impact on staff.
0
1
0
0
1
4
Staff incidents
reported
School Nursing
2
3
2
0
0
0
Sexual Health
9
3
10
3
13
3
Reasons for complaints
20
Within NHS Blackpool we
appreciate the importance
of staff attitude and
communication therefore during
2011 / 2012 have been running
customer care training for all
our staff. A total of 149 staff
attended the training which
focused on communication
styles and how important verbal
and non-verbal communication
can be.
The safety of services
Incident Reporting
Blackpool Community Health Services reports all patient safety incidents to the National Reporting and
Learning System (NRLS) which is organised by the National Patient Safety Agency (NPSA).
Non-Patient Safety incidents reported
(not reportable to the NPSA)
Grade of incident
Number Reported
Grade of incident
Number Reported
1 (very low)
118
1 (very low)
27
2 (minor)
193
2 (minor)
36
3 (moderate)
36
3 (moderate)
14
4 (major)
2
4 (major)
0
5 (catastrophic)
0
5 (catastrophic)
0
6 (near miss)
7
6 (near miss)
2
Total
356
Total
79
Category of Complaint
Number in 2011 / 2012
Attitude of Staff
11
Clinical Treatment
10
Grade of incident
Number Reported
Appointments
2
1 (very low)
39
Aid / Appliance
2
2 (minor)
182
Building Access
1
3 (moderate)
94
Failure to visit
1
4 (major)
8
Personal Records
1
5 (catastrophic)
0
Assessment Procedure
1
6 (near miss)
7
Administration
1
Total
330
Patient Safety incidents reported
21
Infection Prevention
250
200
150
100
50
Sa
f
eg
ua
r
di
ng
iss
ea
in
es
ed
ic
All patient safety incidents are investigated to ensure that lessons are learned within Community Health Services.
NHS organisations are required to report their most serious incidents (SUI’s) to The Strategic Executive Information
System (StEIS). The shared reported encourages national learning from very serious incidents.
Within NHS Blackpool Community Health Services we reported 3 incidents to StEIS and 2 of these have now been
closed. One investigation is still ongoing.
Lessons learned bulletin
Blackpool Community Health Services continues to produce a monthly lessons
learned bulletin where national and local learning issues are shared, during
2011 / 2012 the bulletin has included:
• Learning from Blackpool Safeguarding Children Board
• Learning from an incident involving MRSA
bacteraemia
• Learning from serious case reviews children, young people and adults
• Security risk to elderly and vulnerable
patients caused by recording door entry
codes on national demographic spine
• Quarterly Complaints Report
• Practical advice for students, nurses and
midwives using social networking sites from
the NMC (Nursing and Midwifery Council)
• Ages of concern: learning lessons from serious
case reviews - Ofsted’s evaluation of serious
case reviews from 1 April 2007 to 31 March
2011
• Lapsed Health Professional Registration – Is
your registration up to date?
• Have you had your Personal Development
Review?
• Top 10 mistakes when completing an electronic
incident reporting form
22
Clostridium difficile (CDiff) and Methicillin-resistant
Staphylococcus aureus (MRSA) are two common
bacterium that can cause problems for our patients,
and as a result patients may develop a healthcare
associated infection; ( HCAI’s).
As an organisation we look at each case of MRSA
bloodstream infection and Clostridium difficile infections
to understand how this occurred and to identify any
learning in order to prevent a similar infection in other
patients.
These can cause significant harm and in the worst
cases cause pain, anxiety and suffering. NHS Blackpool
Community Health Services are committed to delivering
high standards of care and patient safety through the
delivery of high standards of infection control in all our
services. This is achieved through ensuring that appropriate
management arrangements are in place in relation to HCAI
and that effective prevention and control is embedded into
everyday practice and applied consistently by everyone. It
is important that good standards of infection control and
careful antibiotic prescribing are adhered to at all times to
prevent MRSA and C.difficile infections being spread to
patients.
Information on infection control, audit and outbreaks
and incidents reported to the Trust Board at its monthly
meetings.
We are proud of the way our staff have worked hard to
reduce healthcare acquired infection.
There were no outbreaks of Clostridium difficile or MRSA
during 2011 / 2012.
There were 2 incidents where Community Health
Services were involved in Root Cause Analysis for MRSA
bacteraemia.
M
N
re
la
rM
te
d
es
D
al
ed
ic
M
ov
er
G
io
n
In
fo
rm
at
ev
ic
na
nc
e
ls
Fa
l
s
ic
gn
os
t
ia
D
Pa
tie
nt
A
cc
Cl
in
ic
id
en
t
0
al
Number of incidents reported
Patient Safety Incidents and category reported
What others say about NHS Blackpool
Community Health Services
The Care Quality Commission (CQC) is the
independent regulator of all health and adult social
care in England. Their aim is to ensure better care is
provided for everyone, whether in hospital, in care
homes, in people’s own homes, or elsewhere. NHS
Blackpool is committed to delivering high quality
healthcare, and works closely with
NHS Blackpool is required to register with the CQC and
its current registration status is ‘fully registered without
conditions’. The CQC has not taken enforcement action
against NHS Blackpool during 2011 / 2012.
NHS Blackpool has not participated in any special reviews
or investigations by the CQC during the reporting period.
In March 2012 Blackpool Community Health Services was
part of a review of compliance to assure that the service
has quality checking systems to manage risks and assure
the health, welfare and safety of people who receive care,
Outcome 16.
Review of compliance
Blackpool Community Health Services was
meeting all the essential standards of quality
and safety.
Appropriate systems were in place for
monitoring the quality of service people
receive.
The outcome of the compliance review reported that the CQC felt that the organisation was meeting all the essential
standards of quality and safety and appropriate systems were in place for monitoring the quality of service people
receive.
As an organisation we continually monitor each service we provide to ensure that these CQC standards are being met
and maintain our registration status.
23
2011 National NHS Staff Survey
The annual staff survey now forms part of the organisation’s assessment by the Care Quality Commission
(CQC) on the premise that staff feedback and experience from the national NHS staff survey can have an
impact on patient experience and service delivery. NHS Blackpool Community Health Services participated in
the national staff survey carried out by the Care Quality Commission.
In the 2011 Survey 63.2% of staff took part compared with 62.9% in 2010. This includes staff from the commissioning
part of NHS Blackpool.
Detailed below are the four key findings in which Blackpool Community Health
Services compares most favourably with other Community Health Services in England:
Percentage of staff feeling there are
good opportunities to develop their
potential at work
50
Effective
/fair
procedure
40
30
%
20
Fairness & effectiveness of incident
reporting procedures
5
4
3
50
38
10
2
1
Blackpool
National Average
Blackpool
Percentage of staff appraised with
personal development plans in last 12
months
5
80
4
60
3
0
1
20
2
2.9
3.1
1
0
0
Blackpool
National Average
Statements from the Local
Involvement Network, NHS
Blackpool Commissioners and
the Blackpool Council Health
Overview & Scrutiny Committee
24
National Average
Work pressure felt by staff
(Lower scores are better)
100
40
3.5
Ineffective
/unfair
procedure 0
0
%
3.6
Blackpool
National Average
Blackpool Local Involvement
Network (LINK)
The report was discussed with a working group
in LINK and comments were suggested by
members to ensure the report was easy to read
for people not working in the NHS. Blackpool
LINK commented they look forward to working
with the Community Health Services team in
the future.
Blackpool Council Health Overview NHS Blackpool Commissioning
& Scrutiny Committee
Comments
This report was presented to the Blackpool Council
Health Overview and Scrutiny Committee on the
24th May 2012 and they provided a response letter:
‘Blackpool Council’s Health Scrutiny Committee was
pleased to be given the opportunity to review and
comment upon the Quality Account for 2011 / 12, which
was formally considered at the Health Scrutiny Committee
meeting on 24th May. Representatives from Community
Services presented the Committee with an explanation of
the key issues that were contained within the Account,
together with a summary of what the Account was
designed to provide in terms of information.
A number of questions and comments from the
Committee were addressed in connection with certain
elements of the Account. With regard to Child and
Adolescent Mental Health Services (CAMHS), waiting times
and staffing levels, members were informed that following
a review of the staffing structure, that changes had been
made and consistent staffing arrangements were now in
place.
The Committee commented on the generally positive
nature of the Quality Account and questioned whether
that was in fact a true reflection of the situation in
relation to actual patient services and outcomes. The Trust
representatives responded by explaining that Community
Services had undergone a period of significant change,
during which time complaints were treated seriously and
were in fact encouraged to be made. At the same time,
the service had continued to receive a much greater
number of positive comments than complaints and that
different ways of capturing those were being looked
at. It was further explained that the Patient Experience
Annual Report was a different type of report to the Quality
Account which gave more in depth details of complaints
and that copies of that report would be provided to the
Committee.
Responding to questions about improvements to the
service, the Committee was informed about an issue that
had been raised in connection with the opening times
of the Blackpool Connect service, which provided sexual
health services for young people. It was explained that the
service had extended its opening times four months after
the issue had been raised.
The Committee has enjoyed a high level of cooperation
with NHS Blackpool, together with good communication
links during the period in question. Officers from the Trust
have attended Committee meetings on a regular basis,
whenever requested, in order to present items and to be
held to account by the Committee. Now that Community
Health Services has transferred to Blackpool Teaching
Hospitals NHS Trust, the Committee looks forward to a
similar level of cooperation in order for it to carry out its
scrutiny role in relation to the service during the next 12
months.
NHS Blackpool welcomes the publication of this
quality account. We can confirm that the account is
an accurate reflection of the work undertaken by
NHS Blackpool Community Health Services (CHS)
to improve quality during 2011 / 12 and outlines
relevant priorities for continued quality improvement
in 2012 -13.
It is clear from the account that quality is at the very heart
of provision and CHS continue to seek ways to improve
their services. The patient experience work provides
evidence of an organisation that listens to patients views
and acts on them to improve services. Commissioners will
continue to work with the provider on the actions taken to
improve quality as a result of complaints.
During 2011/12 CHS successfully implemented a
Commissioning for Quality and Innovation (CQUIN)
scheme which aimed to improve patient care. For
example the service improved the care for patients who
were at the end of their lives and for those patients who
developed pressure ulcers and urinary tract infections. The
undertaking of additional clinical training for staff and
ensuring that best practice National Institute for Health
and Clinical Excellence (NICE) guidance was followed were
pivotal in this achievement. The CQUIN also supported
the introduction of a real time patient experience
questionnaire within clinic environments, resulting in
the capture of views of service users that were acted on
promptly.
The safety of care culture is evident within CHS as a
monthly Staff Lessons Learned Bulletin is published which
demonstrates its commitment to learning from both staff
and patient incidents so that services can be improved
and the quality of care maintained. Commissioners will
continue to monitor the incidents reported by the service
to promote risk reduction.
Commissioners are also pleased to report that the
service achieved a non medical prescribing award for
developing a Wound Care Formulary; which means
that all patients are receiving quality dressings in line
with best practice.
This year has seen the service starting to integrate with
the local Hospital (Blackpool Teaching Hospitals NHS
Foundation Trust) and community services in Fylde and
Wyre in preparation for the integration which took place
on 1st April 2012. We look forward to our future working
with CHS as part of the Blackpool Teaching Hospitals NHS
Foundation Trust, and building upon the already excellent
care being delivered.
25
Appendix 1 – List of National Clinical Audits
Glossary
Peri-and Neo-natal
Cardiovascular disease
Perinatal mortality (MBRRACE-UK)
Acute Myocardial Infarction & other ACS (MINAP)
Neonatal intensive and special care (NNAP)
Heart failure (Heart Failure Audit)
Attention Deficit Hyperactivity Disorder - is a
developmental disorder. It is characterised primarily by
“the co-existence of attention problems and hyperactivity,
with each behaviour occurring infrequently alone” and
symptoms starting before seven years of age.
Clostridium difficile - also known as “CDF/cdf”, or
“C. diff”, is a species of Gram-positive bacteria of the
genus Clostridium that causes severe diarrhoea and other
intestinal disease when competing bacteria in the gut flora
have been wiped out by antibiotics.
Care Quality Commission - The Care Quality
Commission (CQC) regulates all health and adult social
care services in England, including those provided by the
NHS, local authorities, private companies or voluntary
organisations. It also protects the interests of people
detained under the Mental Health Act.
LINKs - Local Involvement Networks (LINks) are made up
of individuals and community groups, such as faith groups
and residents’ associations, working together to improve
health and social care services.
Acute stroke (SINAP)
Children
Cardiac arrhythmia (Cardiac Rhythm Management Audit)
Paediatric pneumonia (British Thoracic Society)
Paediatric asthma (British Thoracic Society)
Renal disease
Pain management (College of Emergency Medicine)
Renal replacement therapy (Renal Registry)
Childhood epilepsy (RCPH National Childhood Epilepsy
Audit)
Renal transplantation (NHSBT UK Transplant Registry)
Paediatric intensive care (PICANet)
Cancer
Paediatric cardiac surgery (NICOR Congenital Heart Disease
Audit)
Lung cancer (National Lung Cancer Audit)
Diabetes (RCPH National Paediatric Diabetes Audit)
Head & neck cancer (DAHNO)
Acute care
Bowel cancer (National Bowel Cancer Audit Programme)
Oesophago-gastric cancer (National O-G Cancer Audit)
Emergency use of oxygen (British Thoracic Society)
Trauma
Adult community acquired pneumonia (British Thoracic
Society)
Hip fracture (National Hip Fracture Database)
Non invasive ventilation -adults (British Thoracic Society)
Severe trauma (Trauma Audit & Research Network)
Pleural procedures (British Thoracic Society)
Psychological conditions
Cardiac arrest (National Cardiac Arrest Audit)
Prescribing in mental health services (POMH)
Severe sepsis & septic shock (College of Emergency
Medicine)
Schizophrenia (National Schizophrenia Audit)
Adult critical care (ICNARC CMPD)
Blood transfusion
Potential donor audit (NHS Blood & Transplant)
Seizure management (National Audit of Seizure
Management)
Long term conditions
Bedside transfusion (National Comparative Audit of Blood
Transfusion)
Medical use of blood (National Comparative Audit of
Blood Transfusion)
Diabetes (National Adult Diabetes Audit)
Health promotion
Heavy menstrual bleeding (RCOG National Audit of HMB)
Risk factors (National Health Promotion in Hospitals Audit)
Chronic pain (National Pain Audit)
Ulcerative colitis & Crohn’s disease (UK IBD Audit)
End of life
Parkinson’s disease (National Parkinson’s Audit)
Care of dying in hospital (NCDAH)
Adult asthma (British Thoracic Society)
Bronchiectasis (British Thoracic Society)
Elective procedures
Hip, knee and ankle replacements (National Joint Registry)
Elective surgery (National PROMs Programme)
Intra-thoracic transplantation (NHSBT UK Transplant
Registry)
Liver transplantation (NHSBT UK Transplant Registry)
Coronary angioplasty (NICOR Adult Cardiac Interventions
Audit)
Peripheral vascular surgery (VSGBI Vascular Surgery
Database)
Carotid interventions (Carotid Intervention Audit)
CABG and valvular surgery (Adult Cardiac Surgery Audit)
26
The CQC makes sure that essential standards of quality
and safety are being met where care is provided, from
hospitals to private care homes. It has a wide range of
enforcement powers to take action on behalf of people
who use services if services are unacceptably poor.
Clinical Audit - Clinical audit is a process that has
been defined as a quality improvement process that
seeks to improve patient care and outcomes through
systematic review of care against explicit criteria and the
implementation of change.
The key component of clinical audit is that performance is
reviewed (or audited) to ensure that what should be done
is being done, and if not it provides a framework to enable
improvements to be made.
Clinical Research - is a branch of medical science
that determines the safety and effectiveness of
medications, devices, diagnostic products and treatment
regimens intended for human use. These may be used
for prevention, treatment, diagnosis or for relieving
symptoms of a disease. Clinical Research is different than
clinical practice. In clinical practice, one used established
treatments while in clinical research evidence is collected
to establish a treatment
CQUIN – Commissioning for Quality and Innovation.
The CQUIN payment framework enables commissioners
to reward excellence, by linking a proportion of English
healthcare providers’ income to the achievement of local
quality improvement goals.
Methicillin-Resistant Staphylococcus Aureus
- Methicillin-resistant Staphylococcus aureus (MRSA)
is a bacterium responsible for several difficult-totreat infections in humans. It is also called multidrugresistant Staphylococcus aureus and oxacillin-resistant
Staphylococcus aureus (ORSA). MRSA is any strain of
Staphylococcus aureus that has developed resistance
to beta-lactam antibiotics, which include the penicillins
(methicillin, dicloxacillin, nafcillin, oxacillin, etc.) and the
cephalosporin’s. Strains unable to resist these antibiotics
are classified as methicillin-sensitive Staphylococcus aureus,
or MSSA. The development of such resistance does not
cause the organism to be more intrinsically virulent than
strains of Staphylococcus aureus that have no antibiotic
resistance, but resistance does make MRSA infection more
difficult to treat with standard types of antibiotics and thus
more dangerous.
NRLS - The National Reporting and Learning System
(NRLS) is a central database of patient safety incident
reports. Since the NRLS was set up in 2003, over four
million incident reports have been submitted.
NPSA - The National Patient Safety Agency (NPSA)
leads and contributes to improved, safe patient care by
informing, supporting and influencing the health sector.
NHS 2012 Sport and Physical Activity Challenge
- The NHS (2012) Challenge aims to inspire NHS staff
to set up and take part in sports & physical activity
challenges.
Health Service Journal – Is a weekly magazine
published to discuss issues within the NHS.
Non Medical Prescribing - Non Medical Prescribing
is the prescribing of medicines, dressings and appliances
by health professionals who are not doctors. There are 3
models of Non Medical Prescribing.
Health Overview & Scrutiny Committee – The
council health overview and scrutiny committee looks
at the work of the local NHS and acts as a critical friend
by suggesting ways that health related services might
be improved. It also looks at the way the health service
interacts with social care services, the voluntary sector,
independent providers and other council services to jointly
provide better health services.
Genito-Urinary Medicine - It is primarily related to
medicine dealing with sexually transmitted diseases.
Pressure Ulcers - also known as ulcers or bedsores,
are lesions caused by unrelieved pressure on soft tissues
overlying a bony prominence which reduces or completely
obstructs the blood flow to the superficial tissues. Most
commonly this will be the sacrum or the hips, but other
sites such as the elbows, knees, ankles or the back of the
cranium can be affected.
27
How to Provide Feedback on
the Quality Account
We welcome any comments you may
have on this, our Quality Account and ask
you to become involved in next year’s
Quality Account by sharing your views and
experiences of using our services.
This can be done by contacting Blackpool
Community Health Services on 01253 651200.
Alternatively, you may choose to write to the
Director of Community Health Services, The
Stadium, Seasiders Way, Blackpool, FY1 6JX.
Health... at the heart of life in Blackpool
NHS Blackpool Believes in Access for All
To ensure services provided by NHS Blackpool are accessible
information is available upon request in a variety of formats including
large print, Braille, on audio cassette or computer disk. We can also
provide help for British Sign Language users and provide information in
languages other than English. Please ask for details from the addresses
or numbers listed.
Published by
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NHS Blackpool
Blackpool Stadium
Seasiders Way
Blackpool
Lancashire
FY1 6JX
Tel: 01253 651200
Fax: 01253 651210
IWL PRACTICE plus STANDARD