Pembury Hospital, Pembury

General Services Information

Hospital Questions

• How many single rooms are available to NHS patients at this hospital: 405

• Of these how many have an ensuite toilet: 396

• Of these how many have an ensuite toilet and shower or bath: 396

• 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:

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

• How many beds are available within the private unit/service: 26

• How many single rooms are available within the private unit/service: 26

• Of these, how many have an ensuite toilet: 26

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

• Direct telephone number for the private unit: 01892 635842/635659

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: STEIS and Datix systems

• 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: THEATRE DATABASE

• 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: STEIS and Datix systems

• During the period 01 April 2010 - 31 March 2011, how many operations resulted in a foreign body being left post surgery: 1 Scalpel Tip

• During the period 01 April 2010 - 31 March 2011, how many operations were cancelled due to missing notes: 2 One in ophthalmology and one in ENT

• During the period 01 April 2010 - 31 March 2011, how many operations resulted in wrong site surgery taking place: 1 Wrong eye initially though both were to be operated on at different times.

• How many incident investigations using a full Root Cause Analysis did were carried out in 2010/11: 117

• What percentage of patient safety incidents resulting in severe harm or death had a full RCA initiated/completed: 91-99%

• What percentage of patients are risk assessed for venous thromboembolism on admission: 61-90%

• 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). : Complaince levels are reported bimonthly to Standards Committee and Quality and Safety Committee - the latter is a sub-committee of the Board.

• Alerts where not expected to be compliant by 1st December 2011 and when expected to be compliant. : NPSA/2011/PSA002 - Reducing the harm caused by misplaced nasogastric feeding tubes in adults, children and infants - Outstanding actions: e-learning package for training re NG tubes to be complete and procurement issues. NPSA 2010/RRR018 – Preventing fatalities from medication loading doses - outstanding issues: awaiting ratification of regional list of high risk medicines - will then procedd to taylor locally

• 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: Stored on Datix - disseminated via reports and committee papers

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: YES

• Are all chemotherapy patients screened at the pre-op assessment clinic: NO These patients are screened at the day chemo units – either on Maynard/Chartwell or Charles Dickens

• 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: Patients found to be MRSA positive are given topical suppression therapy prior to admission. Elective orthopaedic patients require 3 negative screens prior to surgery, if no negative achieved, topical suppression will be given commencing 5 days pre-admission and completing on the day of surgery. For all other patients topical suppression will be given commencing 5 days pre-admission and completing on the day of surgery

• 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: All patients screened

• Does the Trust have a dedicated isolation ward:

• Protocol for isolating patients with infections: Patients on surgical and orthopaedic wards are isolated in single rooms. Patients on medical rooms are isolated if room available, if not, nursed using barrier nursing precautions in a bay. From 21st September all patients in the new Tunbridge Wells Hospital will be isolated in a single room when required as all rooms are single rooms in the hospital.

• 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: Utilising a rapid risk assessment tool.

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) Rehabilitation will be carried out in stroke beds at Tonbridge Cottage Hospital

• Number of beds in the unit: 20 8 beds in the HASU at the Tunbridge Wells Hospital and 12 beds in the Stroke Rehabilitation Unit at Tonbridge Cottage Hospital

Trust Questions

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

• Is the Trust part of a stroke care network:

• Details: Kent & Medway 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): 654

• Of these, what was the number of patients given a Computerised Tomography (CT) scan within 24 hrs of admission: 482

• Is thrombolysis for stroke patients provided 24 hours per day and 7 days a week : Plan to commence thrombolysis 24/7 from October 2011

• 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: Medway Maritime Foundation Trust and Darenth Valley Hosptial

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):

• 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)? :

• Not able to put a figure on the percentage of all patients that attend the class prior to surgery: We have just started this attendence as a mandatory requirement prior to surgery

• 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: Again only just commenced- no data being collected

• Not able to put a figure on the percentage of the Trusts total knee replacement (TKR) and total hip replacement (THR) patients walk within 24 hours of surgery: Again only just commenced- no data being collected

• 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: Data not being collected

• 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: ICP being developed - currently in draft.

• 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: 24hr Consultant cover available for both sites

• 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 4 of each trustwide

• Is the Trust's specialist palliative care team available 24 hrs a day seven days a week: The team works Mon to Friday 9am to 5pm and has an on call Consultant led telephone advice service since Jan 2010.

• 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: The palliative care team complete a patient satisfaction survey annually but it is not specifically based on the end of life care programme. The team is planning to develop a survey to look at the views of caresand bereaved relatives in lisaion with the End of Life care CNS.

Maternity Care

Maternity Sites

• Maidstone Birth Centre - Midwife Led

• How many women gave birth in the unit during the year? (not including home births): 0 Birth Centre not open until September 2011

• How many babies were born in the unit during the year? (not including home births): 0 Birth Centre not open until September 2011

• How many women had a home birth? (not including births at home by accident): 0 Birth Centre not open until September 2011

• 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: 2

• Total delivery beds: 2

• Number of postnatal rooms: 4

• 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): 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): 0 N/A

• 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: Video entry system

• Security measures - restricted access:

• Other security measures: Swipe card entry for all

• 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 unit

• Pain relief available - Aromatherapy: Provided by unit

• Pain relief available - TENS: Provided by unit

• 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

• Other pain relief: Other forms of complimentary therapies may be available

• Total number of WTE midwives at the unit in your funded establishment, including vacant posts: 77.3

• Total number of WTE midwives at the unit as staff in post, including agency and bank staff: 77.3

• 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:

• Does the unit have an obstetrician available 24 hours a day, 7 days a week: On site Available during clinic times only

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

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

• Tunbridge Wells Hospital at Pembury - Consultant Led

• How many women gave birth in the unit during the year? (not including home births): 507 Hospital only opened on 26th January 2011

• How many babies were born in the unit during the year? (not including home births): 519 Hospital only opened on 26th January 2011

• How many women had a home birth? (not including births at home by accident): 20 Hospital only opened on 26th January 2011

• Number of antenatal rooms: 17

• Total antenatal beds: 17

• Number of assessment area rooms (for monitoring and / or induction): 4

• Total assessment area beds: 15 2 remaining rooms have couches

• Number of delivery rooms: 15

• Total delivery beds: 15

• Number of postnatal rooms: 31

• Total postnatal beds: 31

• Number of rooms in obstetric high dependency unit: 2

• Total obstetric high dependency beds: 2

• 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: All rooms are single rooms - there are no amenity rooms

• If women can pay for a single room what is the average cost per night (GBP): 0 All rooms at Tunbridge Wells are single rooms

• 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: All babies are tagged using the Baby Tagging security system

• Security measures - cot alarms:

• Security measures - CCTV: Video entry system on wards

• Security measures - restricted access:

• Other security measures: Swipe card entry for all

• 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 Women may also bring their own

• Pain relief available - Massage: Provided by unit

• 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: Not available

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

• Pain relief available - Intramuscular injection: Provided by unit

• Other pain relief: Other forms of complimentary therapies may be available

• Total number of WTE midwives at the unit in your funded establishment, including vacant posts: 79.86 Includes community midwives

• Total number of WTE midwives at the unit as staff in post, including agency and bank staff: 79.86

• 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): Generally women are not offered a choice but if a woman had a particular reason for wishing to choose this would be considered.

• 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: Teenagers

• Are all women routinely offered ultrasound scans:

• Scan 1 available between: 11+6 - 13+6 WEEKS

• Scan 2 available between: 20 Weeks

Trust Statistics

Trust Questions

• You can view various measures relating to the Trust's performance by clicking the following link: Maidstone and Tunbridge Wells NHS Trust