Open and Honest Care in your Local NHS Trust
Norfolk Community Health &
Care NHS Trust
Report for: November 15
The Open and Honest Care: Driving Improvement
Programme aims to support organisations to become
more transparent and consistent in publishing safety,
experience and improvement data; with the overall
aim of improving care, practice and culture.
1. SAFETY
Safety Thermometer
On one day each month we check to see how many of our patients suffered certain types of harm whilst in our care. We call this the NHS Safety
Thermometer. The safety thermometer looks at four harms: pressure ulcers, falls, blood clots and urine infections for those patients who
have a urinary catheter in place. This helps us to understand where we need to make improvements. The score below shows the percentage
of patients who did not experience any harm within our care. The target The Trust is expected to meet is set for 90%;
92.1%
of patients did not experience any of the four harms in this community trust
Pressure Ulcers contribute to those patients who were identified as having harm caused to them.
Health care associated infections (HCAIs)
HCAIs are infections acquired as a result of healthcare interventions. Clostridium difficile (C.difficile) and methicillin-resistant staphylococcus
aureus (MRSA) bacteraemia are nationally monitored and our staff work hard to try and reduce the incidence of these infections.
Clostridium difficile is a type of bacterial infection that can affect the digestive system, causing diarrhoea, fever and painful abdominal cramps and sometimes more serious complications. The bacterium does not normally affect healthy people, but because some antibiotics remove the
'good bacteria' in the gut that protect against Clostridium difficile , people on these antibiotics are at greater risk.
The MRSA bacteria are often carried on the skin and inside the nose and throat. It is a particular problem in hospitals because if it gets into a
break in the skin it can cause serious infections and blood poisoning. It is also more difficult to treat than other bacterial infections as it is
resistant to a number of widely-used antibiotics.
In November NCH&C have no reported MRSA patients reported and no Clostridium difficile (C.difficile).
Norovirus (Winter Vomiting Bug)
There have been very low levels of Norovirus across the Norfolk, NCH&C has had no cases of Norovirus in November within our Inpatient
Hospitals.
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Norfolk Community Health and Care - Open and Honest Report November 2015.
Flu Campaign
We are pleased to confirm that we have had a higher than normal response for our clinical staff receiving the Flu vaccine. This is good news for
our patients and our staff.
Pressure ulcers
Pressure ulcers are localised injuries to the skin and/or underlying tissue as a result of pressure. They are sometimes known as bedsores. They
can be classified into four categories, with one being the least severe and four being the most severe.
NCH&C investigate all of the pressure ulcers patients acquire in our care and assess if they are:
1. Avoidable - having reviewed our patients care we identified we could have undertaken further assessment or provided equipment more
quickly, which may or may not have prevented the pressure ulcer occurring. We apologise to our patients informing them this has
occurred.
2. Unavoidable – having reviewed the care provided to our patients we conclude nothing more could have been done to prevent the
pressure ulcer occurring.
Oct
2015
Sept
2015
August
20-15
July
2015
Figures
Validated
Some figures not yet validated
All Figures not validated
June
2015
Key
May
2015
Apr
2015
The following table shows the total number of avoidable ulcers, Grade 3 & 4 acquired within the care of NCH&C;
Inpatient
0
0
0
1
0
1
0
Community - Patients Home
12
8
14
9
19
10
5
Community - Residential Home
4
4
5
6
10
9
2
16
12
19
16
29
20
7
Total
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Norfolk Community Health and Care - Open and Honest Report November 2015.
Key
2015 10
2015 09
2015 08
2015 07
2015 06
2015 05
2015 04
The following table shows the number of unavoidable pressure ulcers, Grade 2, 3 & 4 acquired within the care of NCH&C;
Grade Two
81
95
78
95
90
88
81
Grade Three
20
15
17
21
10
18
32
Grade Four
1
3
2
3
1
2
8
102
113
97
119
101
108
121
Totals:
Figures
Validated
Some figures not yet validated
All Figures not validated
2. EXPERIENCE
To measure patient and staff experience we ask a number of questions. The idea is simple: if you like using certain
products or doing business with a particular company you like to share this experience with others.
The answers given are used to give a score which is the percentage of patients who responded that they would
recommend our service to their friends and family.
Patient experience
The Friends and Family Test
The Friends and Family Test (FFT) requires all patients to be asked;
‘How likely are you to recommend our service to friends and family if they needed similar care or treatment?’
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Trust Recommend % for October
Trust 2015/16 Year Total
A patient's story
As well as the wealth of feedback received from patients, carers and families in the Friends and Family Test and other surveys, the trust has
many other sources of patient feedback:
The Patient Advice and Liaison Service (PALS) is part of our overall commitment to provide high standards of care and to support patients,
carers and the public who use NCH&C services. PALS provides an informal and impartial way to resolve the concerns of patients, carers,
relatives and the public. PALS aims to manage concerns, comments and enquiries effectively, promote service user satisfaction, reduce the
number of issues that may escalate to a complaint where appropriate and ensure that the patient’s voice is at the heart of the service.
PALS works closely with patients, carers and NCH&C staff to resolve concerns and where required, provides advice and guidance to enquirers
to access NCH&C Complaints procedure. PALS ensure lessons are learnt from specific concerns and feedback leading to continuous
improvement of services to patients, carers and relatives, members of the public, key stakeholders and commissioners.
For example, this month PALS received an enquiry from a daughter concerned about her father who had been in an inpatient hospital for
rehabilitation. The daughter felt her father had deteriorated rapidly physically, emotionally and mentally. The daughter also had concerns about
inconsistencies in communication and record management when a care review meeting had not taken place. With consent of the daughter, and
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acting on behalf of the daughter, PALS liaised with the Ward staff who confirmed that a family meeting was arranged for the following day to talk
through concerns. The daughter was informed of this meeting and given the option that if she felt she was unsatisfied with the outcome of the
meeting, PALS would continue to seek further resolution. No further contact was received.
NCH&C PALS is available Mon – Fri 9am – 5pm. Contact PALS pals@nchc.nhs.uk Free phone tel 0800 0884449.
Staff experience - The Friends and Family Test
The Friends and Family Test (FFT) requires staff to be asked, at periodic points;
How likely are you to recommend our organisation to friends and family if they needed care or treatment?’ and ‘How likely are you to
recommend our organisation to friends and family as a place to work?’
Number of Respondents
"How likely are you to
recommend this organisation to
friends and family if they needed
care or treatment"
"How likely are you to
recommend this organisation to
friends and family as a place to
work"
64
162
86
12
11
6
15
36
101
91
61
44
2
15
350
65.00%
350
40%
NCH&C are undergoing a period of change and transition which has impacted on our results. We are currently running a series of staff
engagement workshops to hear how we can improve our staff satisfaction.
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3. IMPROVEMENT
Improvement story: we are listening to our patients and making changes
Patient led service improvement example;
The Patient Environment group meets regularly to review feedback about and plan improvements related to, the Trust’s Community Inpatient
Rehabilitation Units and clinic environments. Through our internal and external assessments of these areas plus feedback through our patients
and the Friends and Family Test feedback, patients reported that they felt safe, secure and well looked after. Patient stated some areas for
improvement in respect of the lack of Wi-Fi connection, limited TV and other entertainment media options available. NCH&C have already
commenced a Project to instate WI-FI connection and this will be finished in June next year.
Further improvements following these inspections have resulted in colour coding ward walls and doors plus dining areas to support those
patients who have dementia. In addition more clocks have been put in key areas for all of our patients.
Supporting information – Contact us
Contact Norfolk Community Heath and Care with any comments about this report at;
Head Office: Woodlands House; Norwich Community Hospital,
Norwich, Norfolk, NR2 3TU
Online: http://www.norfolkcommunityhealthandcare.nhs.uk
Telephone: 01603 697300
www.facebook.com/nchandc
@NCHC_NHS
There will be no publication of this report in December due to internal verification of data
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Norfolk Community Health and Care - Open and Honest Report November 2015.