Homerton University Hospital, London

General Services Information

Hospital Questions

• How many single rooms are available to NHS patients at this hospital: 56

• Of these how many have an ensuite toilet: 8

• Of these how many have an ensuite toilet and shower or bath: 26

• Does this hospital operate an accident and emergency unit: Homerton Hospital site only

• How many specialist palliative care beds are available at this hospital: 0 No dedicated beds are allocated but HUHFT has palliative care team in place to case manage patients wherever the need arises within the hospital; HUHFT also fully implements the Liverpool Care Pathway in the acute setting and is the process of rolling this out in the community

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

Trust Questions

• Does the Trust treat private patients: The Trust provides private fertility services

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 electonic incident reporting system and SI process (DATIX)

• 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 electronic 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 electonic incident reporting system and SI process

• 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: 1

• How many incident investigations using a full Root Cause Analysis did were carried out in 2010/11: 77

• 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%

• What percentage of patients are risk assessed for venous thromboembolism on admission: 31-60%

• 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: The Trust has a vital signs policy and training on vital signs and their interpretation is provided by the Critial Care Outreach Team.

• Does the Trust have a designated member of staff who supports teams in locating and analysing safety and quality data? (support): The Trust has an information department that can locate and analyse data as required. They produce safety and quality data for the Trust board which is disseminated to the Divisions each month for review and action where necessary

• Is safety and quality data available on a central platform and actively disseminated to users: The data is stored on a shared drive and disseminated to the Trust Board and the Divisions as a minimum on a monthly basis

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: Not Applicable

• 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:

• Is screening done according to individual risk assessment:

• Does the Trust have a dedicated isolation ward:

• Protocol for isolating patients with infections: All wards have single room accomodation and these are used for isolation purposes. We are also able on certain wards to isolate bays due to the upgrading of the estate. The Trust has in place an isolation policy for the management of infectious patients

• 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

• Number of beds in the unit: 20

Trust Questions

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

• Is the Trust part of a stroke care network:

• Details: Inner North East London

• 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): 49 These are defined as patients not repatriated via a HASU. Typically these patients presented to Homerton with Stroke not being the primary symptom

• Of these, what was the number of patients given a Computerised Tomography (CT) scan within 24 hrs of admission: 39 As per Q34, stroke was not the primary symptom on presentation to the hospital and hence a CT scan not done on all patients within 24 hours

• Is thrombolysis for stroke patients provided 24 hours per day and 7 days a week : This is now provided by the Hyper Acute Stroke Unit (HASU) at Barts and the London as part of a network arrangement

• 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: Royal London and University College London

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 has a dedicated list available for all emergency surgery including trauma.

• 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: 100 Patients don't proceed to surgery unless they have attended the education session

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

• Estimated percentage compliance to this protocol: 100

• Estimated percentage of the Trusts total knee replacement (TKR) and total hip replacement (THR) patients walk within 24 hours of surgery: 90 In the last EPR data submission report this figure was 92.3%

• Does the Trust have a specialist orthopaedic physiotherapy service which is available 7 days a week: HUHFT has a physiotherapy service 7 days a week but not specialist orthopaedic physiotherapy service.

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

• Not able to put a figure Patients' discharge delayed due to lack of physiotherapy services at weekends:

• Are patients for total knee replacement (TKR) and total hip replacement (THR) admitted prior to the day of 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:

• Are patients routinely phoned in the first 48 hours after discharge to check on their progress:

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:

• 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: A multi-disciplinary specialist palliative care team

• Does the hospital's specialist palliative team includes: A consultant in palliative medicine,A palliative care nurse,Counsellor(s)

• Is the Trust's specialist palliative care team available 24 hrs a day seven days a week: A nurse led on call team is available 24/7. This is part of a network arrangement with Newham and Whipps Cross

• 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:

Maternity Care

Maternity Sites

• Homerton University Hospital - Midwife Led

• How many women gave birth in the unit during the year? (not including home births): 695

• How many babies were born in the unit during the year? (not including home births): 695

• How many women were booked for a home birth: 114

• How many women had a home birth? (not including births at home by accident): 80

• Number of antenatal rooms: 0

• Total antenatal beds: 0

• Number of assessment area rooms (for monitoring and / or induction): 0

• Total assessment area beds: 0

• Number of delivery rooms: 4 all rooms on birthing centre are for midwifery led care and can be used for anteantal, intrpartum and postnatal care as required

• Total delivery beds: 4

• Number of postnatal rooms: 4 all rooms on birthing centre are for midwifery led care and can be used for anteantal, intrpartum and postnatal care as required

• Total postnatal beds: 4

• 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): 4

• 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): 0 Not applicable

• 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 women

• Pain relief available - TENS: Provided by women

• Pain relief available - Epidural: Not available

• 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

• Total number of WTE midwives at the unit in your funded establishment, including vacant posts: 10.5

• Total number of WTE midwives at the unit as staff in post, including agency and bank staff: 10.5

• 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

• Homerton University Hospital - Consultant Led

• How many women gave birth in the unit during the year? (not including home births): 4097

• How many babies were born in the unit during the year? (not including home births): 4209

• How many women were booked for a home birth: 0

• How many women had a home birth? (not including births at home by accident): 0

• Number of antenatal rooms: 5 one antenatal/postnatal ward with 5 side rooms which are used flexibly depending on needs

• Total antenatal beds: 9

• Number of assessment area rooms (for monitoring and / or induction): 1

• Total assessment area beds: 1 4 reclining chairs

• Number of delivery rooms: 14

• Total delivery beds: 14

• Number of postnatal rooms: 5 one antenatal/postnatal ward with 5 side rooms used flexibly depending on needs

• Total postnatal beds: 31

• Number of rooms in obstetric high dependency unit: 2

• Total obstetric high dependency beds: 3

• Number of single rooms used for both delivery and postnatal care (labour, delivery, recovery and postnatal, or LDRP, rooms): 14

• 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): 70 70 is the charge if the room is available

• 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 women

• Pain relief available - TENS: Provided by women

• 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: 145.5

• Total number of WTE midwives at the unit as staff in post, including agency and bank staff: 138.5

• 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: parent classes parent classes

• Are all women routinely offered ultrasound scans:

• Scan 1 available between: 11-14

• Scan 2 available between: 18-22

Trust Statistics

Trust Questions

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