North Devon District Hospital, Barnstaple

General Services Information

Hospital Questions

• How many single rooms are available to NHS patients at this hospital: 63

• Of these how many have an ensuite toilet: 31

• Of these how many have an ensuite toilet and shower or bath: 23

• Does this hospital operate an accident and emergency unit:

• How many specialist palliative care beds are available at this hospital: 1

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

• What is the name of the private unit/service: Roborough Suite

• How many beds are available within the private unit/service: 6

• How many single rooms are available within the private unit/service: 6

• Of these, how many have an ensuite toilet: 6

• Of these, how many have an ensuite toilet and shower or bath: 6

• Direct telephone number for the private unit: 01271 311 780

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: Staff will report via incident reporting system, and details are logged onto an electronic database. Incidents will be escalated to the relevant clinical and managerial staff, and an initial review of the incident will be undertaken. This report is reviewed by the Executive Director team, who will decide whether the incident needs to be escalated to a Serious Incident Requiring Investigation (SIRI). Incidents indentified as 'Never Events' (as per national guidance) are automatically escalated by the Executive Director team to SIRIs.

• 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: Staff will report via incident reporting system, and details are logged onto an electronic database. Incidents will be escalated to the relevant clinical and managerial staff, and an initial review of the incident will be undertaken. This report is reviewed by the Executive Director team, who will decide whether the incident needs to be escalated to a Serious Incident Requiring Investigation (SIRI). Incidents indentified as 'Never Events' (as per national guidance) are automatically escalated by the Executive Director team to SIRIs.

• 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: Staff will report via incident reporting system, and details are logged onto an electronic database. Incidents will be escalated to the relevant clinical and managerial staff, and an initial review of the incident will be undertaken. This report is reviewed by the Executive Director team, who will decide whether the incident needs to be escalated to a Serious Incident Requiring Investigation (SIRI). Incidents indentified as 'Never Events' (as per national guidance) are automatically escalated by the Executive Director team to SIRIs.

• 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: 35

• 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%

• 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): Head of Quality & Safety, Head of Performance

• Is safety and quality data available on a central platform and actively disseminated to users: Quality and Safety data is reported by a number of teams and is shared at a variety of committees and groups, consisting of staff from Ward Managers, Executive Directors, Trust Board, PCTs and SWSHA. Additionally, ward staff are able to access patient safety reports relating to a variety of interventions, such as the completion of risk assessments to hand hygiene. These are actively shared with relevant teams.

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 All over-night stays screened. All orthopaedic day cases screened. Medical patients may be screened in out-patients ie not dedicated pre-adm clinic

• Are all oncology patients screened at the pre-op assessment clinic: NO

• Are all chemotherapy patients screened at the pre-op assessment clinic: NO

• 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: If falls in to above category

• What method of MRSA screening is used when screening at admission: Culture based in 48-72hrs

• On admission, does topical suppression take place immediately: Only if known positive

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

• Are all patients admitted through A&E screened: except paediatrics

• Is screening done according to individual risk assessment:

• Does the Trust have a dedicated isolation ward:

• Protocol for isolating patients with infections: In order to prevent further spread of infection to others, Trust Policy requires isolation of patients in a single room who have a known or suspected communicable disease, or cohort nursing of patients with symptoms believed to be from the same source. In order to prevent further spread of infection to others, Trust Policy requires isolation of patients in a single room who have a known or suspected communicable disease, or cohort nursing of patients with symptoms believed to be from the same source.

• 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: Hyperacute stroke unit (HASU)

• Number of beds in the unit: 10

Trust Questions

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

• Is the Trust part of a stroke care network:

• Details: YES - Peninsula Heart 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): 351

• Of these, what was the number of patients given a Computerised Tomography (CT) scan within 24 hrs of admission: 250

• 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:

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 trauma list 5 days per week, and use of an emergency theatre list at all other times (24/7)

• 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: The Trust has some orthogeriatric support for the Trauma Ward

• 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 audited Percentage of all patients that attend the class prior to surgery: 57

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

• Audited percentage of the Trusts total knee replacement (TKR) and total hip replacement (THR) patients walk within 24 hours of surgery: 75

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

• 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:

• What is the principle reason for patients not being admitted on the day of surgery: In a very small proportion of cases, patients with specific pre-operative preparation requirements (as advised by the anaesthetist) are admitted the day before surgery

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

• 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: With the exception of emergency surgery

• 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: 24hr cover on site by 2x specialty doctors, 1x ST4, 3x ST3 plus attending Consultants

• 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: Parents or Guardians can be provided with 'put-up' beds if required

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 We can also refer to a community based Hospice as appropriate

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

• Is the Trust's specialist palliative care team available 24 hrs a day seven days a week:

• 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: Specialist palliative care team carry out a patient satisfaction survey as part of cancer peer review process

Maternity Care

Maternity Sites

• North Devon District Hospital - Consultant Led

• How many women gave birth in the unit during the year? (not including home births): 1616 Please note that Northern Devon Healthcare NHS Trust operates a 'shared care' service model with input from Midwives and Consultants as required.

• How many babies were born in the unit during the year? (not including home births): 1638

• How many women were booked for a home birth: 60

• How many women had a home birth? (not including births at home by accident): 27

• Number of antenatal rooms: 7 Used for antenatal or post natal

• Total antenatal beds: 18

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

• Total assessment area beds: 2

• Number of delivery rooms: 6

• Total delivery beds: 6

• Number of postnatal rooms: 7 Used for antenal or postnatal

• Total postnatal beds: 18

• 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): 52

• 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 2 available

• Pain relief available - birth ball: Provided by unit

• Pain relief available - Massage: Not available

• Pain relief available - Aromatherapy: Not available

• Pain relief available - TENS: Provided by unit

• 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

• Total number of WTE midwives at the unit in your funded establishment, including vacant posts: 60

• Total number of WTE midwives at the unit as staff in post, including agency and bank staff: 62.7

• 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: Available 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 During the day time. On-call outside of normal hours

• Does the unit have an anaesthetist available 24 hours a day, 7 days a week: On site During day time. On call outside normal hours

• Does the unit have a dedicated obstetric anaesthetist available 24 hours a day, 7 days a week: On site During day time. On call outside normal hours

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): Held inconjunction with Childrens Centres

• 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:

• Are all women routinely offered ultrasound scans:

• Scan 1 available between: 11-14

• Scan 2 available between: 18-21

Trust Statistics

Trust Questions

• You can view various measures relating to the Trust's performance by clicking the following link: Northern Devon Healthcare NHS Trust