Halton General Hospital, Runcorn

General Services Information

Hospital Questions

• How many single rooms are available to NHS patients at this hospital: 11

• Of these how many have an ensuite toilet: 5

• Of these how many have an ensuite toilet and shower or bath: 0

• Does this hospital operate an accident and emergency unit: There is a Minor Injuries Unit on the Halton site operating 9am to 10pm daily.

• 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: Incident reporting and immediate activation of the Incident and Investigations Policy as this would be classed as SUI automatically as it is an NPSA Never Event

• 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: Incident reporting category within the category of notes not available and the severity of the harm caused would be flagged if an operation was cancelled

• 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: Incident reporting and immediate activation of the Incident and Investigations Policy as this would be classed as SUI automatcially as it is an NPSA Never Event

• During the period 01 April 2010 - 31 March 2011, how many operations resulted in a foreign body being left post surgery: 2

• During the period 01 April 2010 - 31 March 2011, how many operations were cancelled due to missing notes: 0

• 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: 20

• 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: 91-99% Patients on end of life pathway are excluded when appropriate to do so.

• 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 and medical

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

• Are all chemotherapy patients screened at the pre-op assessment clinic: YES

• 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: Molecular or other method result in less than 24hrs The screening method is decided based on the reason for the emergency admission e.g. if a patient is admitted for certain types of emergency surgery a molecular MRSA screen is performed

• 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:

• Is screening done according to individual risk assessment:

• Does the Trust have a dedicated isolation ward: This is for patients identified with Clostridium difficile. Patients with other suspected or laboratory confirmed infections will be nursed in side rooms on general wards. Patients are risk assessed for signs and symptoms of infection. Patients are isolated on suspicion of infection. Categories of isolation differ (respiratory, contact, enteric). Patients will remain in isolation until they are no longer considered infectious.

• How many beds does it contain: 10

• 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: The Trust follows the DH guidelines (2008) and promotes the SIGHT mnemonic

Stroke Medicine

Hospital Questions

• Does the hsopital have a specialist stroke unit: All Halton residents needing stroke care are admitted to Warrington.

Trust Questions

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

• Is the Trust part of a stroke care network:

• Details: Cheshire and Mersey Cardiac and Stroke 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): 458 This figure does not include anyone who had stroke as an inpatient or transferred from another hospital after having a stroke.

• Of these, what was the number of patients given a Computerised Tomography (CT) scan within 24 hrs of admission: 436

• Is thrombolysis for stroke patients provided 24 hours per day and 7 days a week : This is provided on a shared service protocol basis with a neighbouring trust - see Question 36.

• Are there any formal arrangements with neighbouring hospitals for the emergency transfer of stroke patients who would benefit from thrombolytic treatment: The service is provided at Warrington Hospital 08.00 - 20.00. Our stroke consultants work with Whiston Hospital to provide cover at Whiston Hospital for Warrington and Halton patients between the hours of 20.00 - 08.00

• These arrangements are with: St Helens and Knowsley Teaching Hospitals NHS Trust

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): The Trust runs a dedicated trauma list from 8am-5pm, weekdays and 8am-12.30pm weekends.

• Does the Trust offer an orthopaedics service: The Trauma and Orthopaedic Service has the following Consultants: Six Consultant Orthopaedic Surgeons with an interest in lower limb + 1 Associate Specialist; Two Consultant Orthopaedic Surgeons with an interest in upper limb; Two Consultants Orthopaedic Surgeons with an interest in spines

• 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)? :

• Does the Trust have a standardised anaesthetic protocol for Total Knee Replacement (TKR) and Total Hip Replacement (THR) patients:

• 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: 80

• 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:

• What is the principle reason for patients not being admitted on the day of surgery: Some patients are admitted the day before surgery if they require optimisation for surgery or have conditions, such as diabetes, high blood pressure which require monitoring prior to surgery.

• Are patient records routinely recorded using a specific multi-disciplinary team THR/TKR pathway document:

• Is this data used to monitor compliance with the agreed pathway:

• Is criteria-based discharge used: We use a nurse led discharge pathway.

• Are patients routinely phoned in the first 48 hours after discharge to check on their progress: All patients are given clear contact details in case of any questions or concerns regarding post operative complications.

Paediatrics

Hospital Questions

• Does the hospital have a paediatrics service: Outpatient only

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:

• 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: This is on the Children's ward with fold down beds for parents/guardians.

Palliative Care

Trust Questions

• Does the Trust provide a palliative care service:

• How is specialist palliative care delivered at the hospital: A multi-disciplinary specialist palliative care team

• Does the hospital's specialist palliative team includes: A palliative care nurse,Counsellor(s),Other (please specify)

• Is the Trust's specialist palliative care team available 24 hrs a day seven days a week: A contract has been signed to provide 7 day per week cover by December 2011.

• Are facilities provided to support relatives and carers who wish to stay with a patient in hospital:

• 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: We participate in the VOICES questionnaire. 2nd round of VOICES questionnaire undertaken Dec 2010. 3rd round to be sent out at end July to next of kin of those who died in May 2011.

Maternity Care

Maternity Sites

• Warrington Hospital - Consultant Led

• How many women gave birth in the unit during the year? (not including home births): 3212

• How many babies were born in the unit during the year? (not including home births): 3229

• How many women were booked for a home birth: 40

• How many women had a home birth? (not including births at home by accident): 17

• Number of antenatal rooms: 10

• Total antenatal beds: 30

• Number of assessment area rooms (for monitoring and / or induction): 6

• Total assessment area beds: 6

• Number of delivery rooms: 12

• Total delivery beds: 12

• Number of postnatal rooms: 20

• Total postnatal beds: 30

• Number of rooms in obstetric high dependency unit: 1

• Total obstetric high dependency beds: 1

• Number of single rooms used for both delivery and postnatal care (labour, delivery, recovery and postnatal, or LDRP, rooms): 0

• 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): 59

• 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: Not available

• Pain relief available - Aromatherapy: Provided by unit

• Pain relief available - TENS: Provided by unit

• Pain relief available - Epidural: Provided by unit

• Pain relief available - Mobile epidural: Provided by unit

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

• Pain relief available - Intramuscular injection: Provided by unit

• Total number of WTE midwives at the unit in your funded establishment, including vacant posts: 97.4

• Total number of WTE midwives at the unit as staff in post, including agency and bank staff: 92.4

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

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

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

• Does the unit have a paediatrician available 24 hours a day, 7 days a week: On site

• Does the unit have an obstetrician available 24 hours a day, 7 days a week: On site

• Does the unit have an anaesthetist available 24 hours a day, 7 days a week: On site

• Does the unit have a dedicated obstetric anaesthetist available 24 hours a day, 7 days a week: On site

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):

• 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: Fathers

• Are all women routinely offered ultrasound scans:

• Scan 1 available between: 10 and 14 weeks

• Scan 2 available between: 18 and 20 weeks

Trust Statistics

Trust Questions

• You can view various measures relating to the Trust's performance by clicking the following link: Warrington and Halton Hospitals NHS Foundation Trust