George Eliot Hospital, Nuneaton

General Services Information

Hospital Questions

• How many single rooms are available to NHS patients at this hospital: 60

• Of these how many have an ensuite toilet: 24

• Of these how many have an ensuite toilet and shower or bath: 14

• Does this hospital operate an accident and emergency unit:

• How many specialist palliative care beds are available at this hospital: 0

• Does this hospital have a named private unit/service:

Trust Questions

• Does the Trust treat private patients:

Patient Safety

Trust Questions

• Is there a system for recording operations that resulted in a foreign body being left post surgery:

• What is the reporting system for a foreign body being left post surgery: Trust Incident reporting system

• Is there a system for recording operations that were cancelled due to missing notes:

• What is the reporting system for operations that were cancelled due to missing notes: Trust Incident reporting system

• Is there a system for recording operations that resulted in wrong site surgery taking place:

• What is the reporting system for operations that resulted in wrong site surgery taking place: Trust Incident reporting system

• During the period 01 April 2010 - 31 March 2011, how many operations resulted in a foreign body being left post surgery: 0

• During the period 01 April 2010 - 31 March 2011, how many operations were cancelled due to missing notes: 1

• During the period 01 April 2010 - 31 March 2011, how many operations resulted in wrong site surgery taking place: 0

• How many incident investigations using a full Root Cause Analysis did were carried out in 2010/11: 99

• What percentage of patient safety incidents resulting in severe harm or death had a full RCA initiated/completed: 100%

• What percentage of acute inpatients have a track and trigger warning system in place for the duration of the admission: 100% All In-patients have MEWS undertaken

• What percentage of patients are risk assessed for venous thromboembolism on admission: 91-99%

• Compliant with all relevant NPSA safety alerts issues in 2010/11 (you can find a full list of alerts issued at http://www.nrls.npsa.nhs.uk/resources/?p=3). :

• Does the Trust have a policy for providing educational programmes on using and interpreting clinical indicators:

• Does the Trust have a designated member of staff who supports teams in locating and analysing safety and quality data? (support):

• Is safety and quality data available on a central platform and actively disseminated to users:

Infection Control

Trust Questions

• Does the Trust employ an antibiotic pharmacist:

• Does the Trust operate a pre-admission assessment clinic or equivalent system where patients are screened and results returned in advance of the day of admission:

• Elective patient groups screened at the pre-op assessment clinic: All elective surgical Apart from the DH exclusions ie dental, endoscopy patients etc.

• Are all oncology patients screened at the pre-op assessment clinic: NO Do not routinely attend pre-op assessment clinic unless having surgery, and all surgical admissions are screened. All patients attending Breast Unit prior to surgery, prior to admission to tertiary hospital. Known history of MRSA.

• Are all chemotherapy patients screened at the pre-op assessment clinic: NO Do not routinely attend pre-op assessment clinic unless having surgery, and all surgical admissions are screened. All patients attending Breast Unit prior to surgery, prior to admission to tertiary hospital. Known history of MRSA.

• Are all elective neurosurgery patients screened at the pre-op assessment clinic: Not Applicable

• Are all patients with past history of MRSA screened at the pre-op assessment clinic:

• What method of MRSA screening is used when screening at admission: Culture based in 24-48hrs

• On admission, does topical suppression take place immediately:

• Does the Trust have at least one accident and emergency unit:

• Are all patients admitted through A&E screened: When the decision to admit is made, the patient is screened either in Clinical Decisions Unit or the admitting ward.

• Is screening done according to individual risk assessment:

• Does the Trust have a dedicated isolation ward:

• Protocol for isolating patients with infections: Risk assessment/review of patients in siderooms is done daily by the Infection Prevention Team and out of hours by onsite team. The siderooms are colour coded to denote reason for use. Red circle shape indicates patient needs isolation from an infection point of view. Blue Square shape is for clinical purposes (eg neutrooaenia). Purple crescent shape is for privacy and dignity issues and Green triangle shape means the patient does not require to be in a sideroom. Risk assessment/review of patients in siderooms is done daily by the Infection Prevention Team and out of hours by onsite team. The siderooms are colour coded to denote reason for use. Red circle shape indicates patient needs isolation from an infection point of view. Blue Square shape is for clinical purposes (eg neutrooaenia). Purple crescent shape is for privacy and dignity issues and Green triangle shape means the patient does not require to be in a sideroom.

• Does the Trust have an isolation policy:

• Where medically appropriate, are patients with C Diff isolated in single rooms as a matter of priority:

• Does the Trust have a policy to guide the use of metronidazole and vancomycin for C.difficile infected patients:

• Does the Trust routinely isolate all patients with diarrhoea:

Stroke Medicine

Hospital Questions

• Does the hsopital have a specialist stroke unit:

• What type of stroke unit does the hospital have: combined acute and rehabilitation stroke unit Also has outreach team to support discharges

• Number of beds in the unit: 18 plus 1 assessment bed

Trust Questions

• Does the Trust have a specialist stroke unit or units:

• Is the Trust part of a stroke care network:

• Details: Coventry and Warwickshire cardio vascular network

• How many emergency admissions with a primary diagnosis of stroke (ICD10 codes I60 - I64) did the Trust receive in the financial year (period 01 April 2010 - 31 March 2011): 223

• Of these, what was the number of patients given a Computerised Tomography (CT) scan within 24 hrs of admission: 195

• Is thrombolysis for stroke patients provided 24 hours per day and 7 days a week :

• Are there any formal arrangements with neighbouring hospitals for the emergency transfer of stroke patients who would benefit from thrombolytic treatment:

• These arrangements are with: University Hospitals Coventry & Warwickshire

Trauma & Orthopaedics

Trust Questions

• Does the Trust offer a trauma service:

• Does the Trust have a dedicated trauma list available 24 hours a day for the duration of the week, (Sunday to Sunday): Monday to Friday am dedicated trauma list is available. Pm and evenings share with other specialties. Saturday and Sunday shared with other specialties.

• Does the Trust offer an orthopaedics service:

• Do all the Trust's orthopaedic ward/team have a linked geriatric team with whom they have regular meetings at least once a week:

• Does the Trust run a pre-operative patient education session/class for patients to attend prior to Total Knee Replacement (TKR) and Total Hip Replacement (THR)? :

• What is the estimated percentage of all patients that attend the class prior to surgery: 70

• Does the Trust have a standardised anaesthetic protocol for Total Knee Replacement (TKR) and Total Hip Replacement (THR) patients: Enhanced recovery programme has been started. Will be audited.

• Not able to put a figure on the percentage compliance to this protocol:

• Estimated percentage of the Trusts total knee replacement (TKR) and total hip replacement (THR) patients walk within 24 hours of surgery: 90 Almost all the patients are being mobilised within 24 hours unless there is a medical reason. Physiotherapists form part of the enhanced recovery protocol.

• Does the Trust have a specialist orthopaedic physiotherapy service which is available 7 days a week:

• How many patients' discharge's delayed due to lack of physiotherapy services at weekends - estimated figure: 0

• Are patients for total knee replacement (TKR) and total hip replacement (THR) admitted prior to the day of surgery: All patients are seen in the pre-assessment clinic. They return on the day prior to their surgery to commence thrombopophylaxis. Final check is performed on this day. Patients are admitted on the day of surgery in the morning.

• Are patient records routinely recorded using a specific multi-disciplinary team THR/TKR pathway document: They form part of the enhanced recovery pathway.

• Is this data used to monitor compliance with the agreed pathway: Will be audited.

• Is criteria-based discharge used:

• Are patients routinely phoned in the first 48 hours after discharge to check on their progress: We provide contact telephone numbers to the ward and the physiotherapy service and advice them to contact if there is any concern.

Paediatrics

Hospital Questions

• Does the hospital have a paediatrics service:

Trust Questions

• Is the Trust's elective paediatric surgery carried out only by designated surgeons with at least six months training in a specialist unit: The Trust has an SLA with University Hospital of Leicester NHS Trust Childrens unit

• Do the Trust's anaesthetists with responsibility for paediatric anaesthesia participate in at least one paediatric list per week:

• Is a paediatrician on site (SpR or higher) 24 hours per day, 7 days per week:

• Are at least two registered children's nurses on duty 24hours per day in each children's ward:

• Is there a designated facility on site for parents or guardians to stay overnight:

Palliative Care

Trust Questions

• Does the Trust provide a palliative care service:

• How is specialist palliative care delivered at the hospital: Other (please specify) There are no SPC beds at GEH. Patients who require inpatient SPC will usually be transferred to one of the 5 local hospices

• Does the hospital's specialist palliative team includes: A consultant in palliative medicine,A palliative care nurse,Other (please specify) The Trust has a service covering the hospital & North Warwickshire community. It comprise 0.8 WTE consultant & 4.8 WTE Macmillan nurses.There are no junior doctors in the team although there is an Educational supervisor for a StR. The time at GEH is not ring-fenced in any way.

• Is the Trust's specialist palliative care team available 24 hrs a day seven days a week: The team works Monday to Friday 9-5 pm with out-of-hours SPC advice available from Warwick Myton Hospice. The consultants in palliative medicine for Coventry & Warwickshire provide telephone advice for professionals from Coventry & Warwickshire hospitals and community outside working hours.

• Are facilities provided to support relatives and carers who wish to stay with a patient in hospital: Facilities for relatives are basic, although there is capacity for relatives to stay for ITU patients.

• Does the Trust routinely survey and evaluate the views of patients and bereaved relatives and carers regarding the delivery of care on the end of life programme: Not aware that the Trust routinely survrys bereaved carers.

Maternity Care

Maternity Sites

• George Eliot Hospital - Consultant Led

• How many women gave birth in the unit during the year? (not including home births): 2398

• How many babies were born in the unit during the year? (not including home births): 2460

• How many women were booked for a home birth: 57

• How many women had a home birth? (not including births at home by accident): 38

• Number of antenatal rooms: 11 In-patient antenatal and postnatal housed on one combined ward area 23 bedded area. It has 4 bedded areas & 7 side rooms.

• Total antenatal beds: 23 see above

• Number of assessment area rooms (for monitoring and / or induction): 11 see above.Entered total number of rooms as application assumed incomplete if left blank. Low risk IOL performed on the ward and the high risk performed on delivery suite

• Total assessment area beds: 6

• Number of delivery rooms: 10

• Total delivery beds: 0

• Number of postnatal rooms: 11 see "Antenatal Rooms" comment above

• Total postnatal beds: 23 see "Antenatal Rooms" comment above

• Number of rooms in obstetric high dependency unit: 0

• Total obstetric high dependency beds: 0

• Number of single rooms used for both delivery and postnatal care (labour, delivery, recovery and postnatal, or LDRP, rooms): 6

• Amenity rooms; Are women able to book a single room in advance of their birth:

• If women can pay for a single room what is the average cost per night (GBP): 31

• Does the maternity unit have a neonatal intensive care unit:

• Does the maternity unit have a neonatal high dependency unit:

• Does the maternity unit have a special care baby unit:

• Security measures - ankle bands for the baby:

• Security measures - cot alarms:

• Security measures - CCTV:

• Security measures - restricted access:

• Pain relief available - bath or shower: Provided by unit

• Pain relief available - birthing pool: Provided by unit

• Pain relief available - birth ball: Provided by unit

• Pain relief available - Massage: Provided by women

• Pain relief available - Aromatherapy: Provided by unit

• Pain relief available - TENS: Provided by women

• Pain relief available - Epidural: Provided by unit

• Pain relief available - Mobile epidural: Not available

• Pain relief available - Entonox (gas and air): Provided by unit

• Pain relief available - Intramuscular injection: Provided by unit

• Other pain relief: oral analgesia

• Total number of WTE midwives at the unit in your funded establishment, including vacant posts: 67.56 All approved awaiting start dates from midwives

• Total number of WTE midwives at the unit as staff in post, including agency and bank staff: 66.1

• Does the unit have midwives available to provide one-to-one care available 24 hours a day, 7 days a week: On site and on call

• Does the unit have midwives available for home births available 24 hours a day, 7 days a week: On site and on call

• Does the unit have midwives trained and experienced in water birth available 24 hours a day, 7 days a week: On site and on call 1700 hrs to 0900 hrs

• Does the unit have a paediatrician available 24 hours a day, 7 days a week: On site and on call 1700 hrs to 0900 hrs

• Does the unit have an obstetrician available 24 hours a day, 7 days a week: On site and on call 1700 hrs to 0900 hrs

• Does the unit have an anaesthetist available 24 hours a day, 7 days a week: On site and on call 1700 hrs to 0900 hrs

• Does the unit have a dedicated obstetric anaesthetist available 24 hours a day, 7 days a week: On site and on call 1700 hrs to 0900 hrs

Trust Questions

• Do all women have a choice about where they receive their antenatal appointments (i.e. at hospital or local health centre):

• Are NHS antenatal classes available (e.g. Parentcraft): This resource is targeted at vulnerable client groups mainly teenagers. There are free sessions offered in the local chidren centres and subsidised classes held at the hospital.

• Available during the daytime (until 5pm):

• Available in the evenings (after 5pm):

• Available at weekends (Saturday and/or Sunday):

• Available for women only groups:

• Available for other groups:

• Also available for: Teenagers

• Are all women routinely offered ultrasound scans:

• Scan 1 available between: 11+2 & 14+1 weeks Later scans can be performed and second trimester screening offered.

• Scan 2 available between: 18 - 20 +6 weeks

Trust Statistics

Trust Questions

• You can view various measures relating to the Trust's performance by clicking the following link: George Eliot Hospital NHS Trust