Royal Bournemouth Hospital, The, Bournemouth

General Services Information

Hospital Questions

• How many single rooms are available to NHS patients? 143

• Of these how many have an ensuite toilet? 79

• Of these how many have an ensuite toilet and shower or bath? 36

• Does this hospital site operate an accident and emergency unit?

• How many specialist palliative care beds do you have available at this site? 13

• Are staff scheduled to be on site for a rostered session or full shift every saturday to carry out: Imaging - Magnetic Resonance Imaging:

• If No, are staff scheduled to be on call at home available to come in and perform this test?

• Are staff scheduled to be on site for a rostered session or full shift every saturday to carry out: Imaging - Computed Tomography:

• If No, are staff scheduled to be on call at home available to come in and perform this test?

• Are staff scheduled to be on site for a rostered session or full shift every saturday to carry out: Imaging - Non-obstetric ultrasound:

• If No, are staff scheduled to be on call at home available to come in and perform this test?

• Are staff scheduled to be on site for a rostered session or full shift every saturday to carry out: Imaging - DEXA Scan:

• If No, are staff scheduled to be on call at home available to come in and perform this test?

• Are staff scheduled to be on site for a rostered session or full shift every sunday to carry out: Imaging - Magnetic Resonance Imaging:

• If No, are staff scheduled to be on call at home available to come in and perform this test?

• Are staff scheduled to be on site for a rostered session or full shift every sunday to carry out: Imaging - Computed Tomography:

• If No, are staff scheduled to be on call at home available to come in and perform this test?

• Are staff scheduled to be on site for a rostered session or full shift every sunday to carry out: Imaging - Non-obstetric ultrasound:

• If No, are staff scheduled to be on call at home available to come in and perform this test?

• Are staff scheduled to be on site for a rostered session or full shift every sunday to carry out: Imaging - DEXA Scan:

• If No, are staff scheduled to be on call at home available to come in and perform this test?

Trust Questions

• Do you have a process/policy for identifying patients for early supported discharge (ESD)?

• Is there currently an ESD programme for Trauma and Orthopaedics?

• Is there currently an ESD programme for Nose & Throat (ENT)? NA

• Is there currently an ESD programme for Paediatric Surgery? NA

• Is there currently an ESD programme for Urology?

• Is there currently an ESD programme for Plastic & Resconstructive? NA

• Is there currently an ESD programme for Neurosurgery? NA

• Is there currently an ESD programme for Cardiac surgery? NA

• Is there currently an ESD programme for Throacic surgery? NA

• Is there currently an ESD programme for Oral & Maxillofacial surgery? NA

• Is there currently an ESD programme for Cardiothoracic Surgery? NA

• Is there currently an ESD programme for GI surgery?

• Is there currently an ESD programme for Stroke Medicine?

• Is there currently an ESD programme for Care of the Elderly?

• During the period 01 April 2011 - 31 March 2012, the total number of patients within the trust who were eligible for an ESD programme? 681

• During the period 01 April 2011 - 31 March 2012, the total number of patients within the trust who were put on an ESD programme? 546 The difference is because our stroke ESD service only started in August 2011

• Does the trust treat private patients?

Patient Safety

Trust Questions

• Do you have 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? Adverse Incident Reporting System (AIRS)

• Do you have 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? Adverse Incident Reporting System (AIRS)

• Do you have 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? Adverse Incident Reporting System (AIRS)

• During the period 01 April 2011 - 31 March 2012, how many operations resulted in a foreign body being left post surgery: 0

• During the period 01 April 2011 - 31 March 2012, how many operations were cancelled due to missing notes? 0

• During the period 01 April 2011 - 31 March 2012, how many operations resulted in wrong site surgery taking place? 0

• How many incident investigations using a full Root Cause Analysis were carried out in 2011/12? 188

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

• What percent of acute inpatients have a track and trigger warning system in place for the duration of the admission? 100%

• During the period 01 April 2011 - 31 March 2012, the total number of patients who were transferred from a general ward to critical care because they had been coded to the 'high score group' according to the track and trigger system: 59

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

• Is the Trust compliant with all relevant NPSA safety alerts issues in 2011/12? (you can find a full list of alerts issued at http://www.nrls.npsa.nhs.uk/resources/?p=3).:

• Do the trust have a policy for providing educational programmes on using and interpreting clinical indicators? (training):

• 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?

Trust Board Activity and Patient Safety

Trust Questions

• How many board members are there in the trust? 15 8 non-executives including the chair, plus 7 executive directors.

• Over the course of the last year, what percentage of board meeting time has been devoted specifically to discussing patient safety issues? 31-60%

• Over the past year, have board members received formal training in relation to patient safety?

• What training and development programmes have been attended? All executive directors, the chairman and 2 non-executive directors have undertaken IOSH "Directing Safety" training and NHS Institute "Leading Improvement in Patient Safety - Exec Module", in the last year

• Have the board set explicit measurable goals for improving performance in relation to patient safety?

• Measurable goals: Reduction in patient falls; Reduction in SUIs; Reduction in avoidable hospital acquired category 3 and 4 pressure ulcers; Improvements in patient experience; 95% harm free care as measured by the Safety Express "Safety Thermometer"; Reduction in Hospital Acquired Infections, in line with national targets; Reduction in VTE as detailed in the Trust's Quality Account.

• Have strategic goals and objectives related to patient safety been distributed to staff groups within the last 12 months?

• Ambulance staff groups have received these goals and objectives:

• Allied Health Professionals staff groups have received these goals and objectives:

• Doctors staff groups have received these goals and objectives:

• Health Informatics staff groups have received these goals and objectives:

• Management staff groups have received these goals and objectives:

• Nursing staff groups have received these goals and objectives:

• Healthcare Science staff groups have received these goals and objectives:

• Wider Healthcare team staff groups have received these goals and objectives:

• Does the board have formal procedures for reporting inappropriate behaviours in relation to patient safety on a regular basis?

• What are these procedures? Our Adverse Incident Reporting System covers this and we also report all Serious Untoward Incidents via Root Cause Analysis.

• Are there procedures for proactively responding to the reporting of staff concerns (e.g. 'whistle blowing') about patient safety?

• What are these procedures? There is a Trust Public Interest Disclosure Policy

• Executive walk-arounds are reported at all board meetings:

• Patient stories are reported at all board meetings:

• Board members shadow clinicians to better understand patient safety issues are reported at all board meetings:

• Board members engaged clinicians to better understand patient safety issues are reported at all board meetings:

• Infection rates are reported at all board meetings:

• Mortality rates are reported at all board meetings:

• Morbidity rates are reported at all board meetings:

• Readmission rates are reported at all board meetings:

• Incident rates and levels of harm are reported at all board meetings:

• Patient Safety Surveys are reported at all board meetings:

• Formal Complaints processes are reported at all board meetings:

• Medication errors are reported at all board meetings:

• CQC Quality and Risk Profiles (QRPs) are reported at all board meetings:

• Staff safety (injuries and/or sickness) are reported at all board meetings:

• Implementation of safety alerts are reported at all board meetings:

• Formal written reports about safety performance are reported at all board meetings:

• How many members of the board have clinical backgrounds? 3

• Does the board have a formal subcommittee that discusses patient safety issues?

• How many times a year does this subcommittee meet? 12

• Are patient safety measures included in the Chief Executive Officer's performance review?

• Details: The CEO's performance measures include the implementation of the QUEST Program and its associated safety indicators, the use of the Safety Express Safety Thermometer, and Trust performance against HSMR and SHMI.

• Does the board use any national reporting measures of patient safety?

• Details: Patient safety incidents by 100 admissions; Inpatient falls by beds days; SUIS (STEIS); NRLS data; % harm free care; CQC patient survey; National clinical audits; NPSA never events;

• Financial performance: importance within the organistaion (with '1' being the most important and '6' being the least important): 5

• Clininical effectiveness: importance within the organistaion (with '1' being the most important and '6' being the least important): 3

• Patient Safety: importance within the organistaion (with '1' being the most important and '6' being the least important): 1

• Patient Experience: importance within the organistaion (with '1' being the most important and '6' being the least important): 2

• Achieving waiting time targets: importance within the organistaion (with '1' being the most important and '6' being the least important): 6

• Staff satisfaction: importance within the organistaion (with '1' being the most important and '6' being the least important): 4

Stroke Medicine

Hospital Questions

• Does this hospital have a specialist stroke unit?

• What type of unit does the hospital have? combined acute and rehabilitation stroke unit

• The number of beds in the Stroke unit: 32

• Is a trained thrombolysis stroke nurse available 24/7? No

• Is a consultant stroke physician/neurologist available 24/7? Yes on call and via telemedicine

• Is an ST3 physician with training in thrombolysis available 24/7? Yes on site

• Does the hospital have consultant led ward rounds for stroke wards seven days a week? Currently 5 days per week with proposal for 7

Trust Questions

• Does the trust have a specialist stroke unit or units?

• Is the Trust part of a stroke care network?

• Details: Dorset 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 2011 - 31 March 2012)? 705 Stroke Integrated Performance Monitoring Returns (Stroke Network) reporting codes I61, I63, I64 and includes elective admissions with Stroke as inpatient

• Of these, what is the number of patients given a Computerised Tomography (CT) scan within 24 hrs of admission? 540 Stroke Integrated Performance Monitoring Returns (Stroke Network) performance against the 24 hr target will differ as it is manually validated for patients with primary diagnosis of I61, I63, I64 only.

• Does the hospital have a team permanently onsite which is able to provide thrombolysis for stroke patients 24 hours per day and 7 days a week?

Trauma & Orthopaedics

Trust Questions

• Does the trust offer a trauma service?

• Does the trust offer an orthopaedics service?

• 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)?

• Percentage of all patients attend the class prior to surgery (estimate): 80

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

• percentage compliance to this protocol (estimate): 80

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

• Does the trust provide an equivalent physiotherapy service to both elective and trauma patients at the weekend? (i.e. is the service staffed on the weekend with the same skill mix, and numbers of staff): Not applicable - no trauma service. Service is available to elective patients.

• Does the Trust admit patients for total knee replacement (TKR) and total hip replacement (THR) prior to the day of surgery?

• Does the Trust routinely record patient records 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?

• Do 100% of hip and knee replacements follow an enhanced recovery pathway?

• Are there daily goals for hip and knee patients to achieve?

• What day does the Trust aim to have patients ready for home? i.e. what are patients told in their information booklets and at the pre-op class: Aim is for patients to go home on day 4.

• Apart from hip and knee replacement, what other procedures have enhanced recovery pathways? None

• For what percentage of hip fracture patients is the time to theatre within 36 hours of arrival to Emergency Department (or time of diagnosis (if an inpatient) to the start of anaesthesia)(%): N/A Elective service only

• What percentage of hip fracture patients are admitted under the joint care of a Consultant Geriatrician & a Consultant Orthopaedic Surgeon: N/A Elective service only.

• What percentage of hip fracture patients are admitted using an assessment tool agreed by geriatric medicine, orthopaedic surgery and anaesthesia: 100

• What percentage of hip fracture patients are assessed by a geriatrician in perioperative period (defined as 72hrs from admission) (Geriatrician defined as Consultant; SAS or ST3+): N/A Elective service only

• What percentage of hip fracture patients receive a postoperative Geriatrician-directed Multi-professional rehabilitation team: N/A Elective service only

• What percentage of hip fracture patients receive postoperative Geriatrician-directed Fracture prevention assessments (falls and bone health): N/A Elective service only

• What percentage of hip fracture patients have a Pre and post op abbreviated mental test score (AMTS): N/A Elective service only

Paediatrics

Trust Questions

• Does the trust provide a paediatrics service?

Palliative Care

Trust Questions

• Does the trust provide a palliative care service?

• How is specialist palliative care is delivered at this hospital? Adult inpatient specialist palliative care unit Adult inpatient specialist palliative care unit of 16 beds at Christchurch Hospital . In addition a Hospital Specialist Palliative Care Team is available on the main Royal Bournemouth hospital site for symptom control advice and psychological support.

• Does the hospital's specialist palliative team include: A consultant in palliative medicine,A palliative care nurse,Counsellor(s),Other (please specify) Others...Family Support team involving a social worker, counsellor and psychological support nurse; Rehabilitation team – physiotherapist, occupational therapist and rehabilitation assistants; Day Centre at the Macmillan Unit Christchurch which includes nursing, physiotherapy, occupational therapy, aromatherapy and reflexology

• 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?

Care of the Elderly

Trust Questions

• Does the trust have a named senior clinician who takes the lead for quality improvement in dementia in the trust?

• Name and job title: Dr Sue Hazel, Consultant Physician, Medicine for the Elderly

• Does the trust have an explicit care pathway for the management and care of people with dementia in hospital?

• Are all appropriate nurses trained to recognise the signs of dementia and identify patients for this care pathway?

• During the period 01 April 2011 - 31 March 2012, the total number of patients who were referred to this care pathway: 0 Data not collected in 2011/12. CQUIN data collected from 2012

• Is there a process for identifying patients who are at risk of dehydration an malnutrition?

• During the period 01 April 2011 - 31 March 2012, the total number of patients recorded as malnourished or dehydrated according to the trust's incident reporting system: 0

• Does the trust currently audit the number of "slips, trips and falls" using a risk management system?

• Is this information submitted to the NPSA's National Reporting and Learning System (NRLS) via the local risk management systems or e-forms?

• The total number of incidents during the period 01 April 2011 - 31 March 2012 for the category: No harm: 820

• The total number of incidents during the period 01 April 2011 - 31 March 2012 for the category: Low harm - harm requiring first-aid level treatment, or extra observation only (e.g. bruises, grazes): 645

• The total number of incidents during the period 01 April 2011 - 31 March 2012 for the category: Moderate harm - harm requiring hospital treatment or a prolonged length of stay but from which a full recovery is expected (e.g. fractured clavicle, laceration requiring suturing): 19

• The total number of incidents during the period 01 April 2011 - 31 March 2012 for the category: Severe harm - harm causing permanent disability (e.g. brain injury, hip fractures where the patient is unlikely to regain their former level of independence): 22

• The total number of incidents during the period 01 April 2011 - 31 March 2012 for the category: Death - where death is directly attributable to the fall: 0

Staffing

Hospital Questions

• Foundation Doctors, Year 1 & 2 Scheduled to be on site for rostered session or full shift on Sunday June 17th at 11:00am: 4

• Foundation Doctors, Year 1 & 2 On call, but physically on site either as a requirement of terms of on call or as routine practice, e.g. Ward round on Sunday June 17th at 11:00am: 0

• Foundation Doctors, Year 1 & 2 on call from home on Sunday June 17th at 11:00am: 0

• ST1/ST2 or CT1/CT2 (core training/specialist training ) or equivalent non-deanery post scheduled to be on site for rostered session or full shift on Sunday June 17th at 11:00am: 7

• ST1/ST2 or CT1/CT2 (core training/specialist training ) or equivalent non-deanery post on call, but physically on site either as a requirement of terms of on call or as routine practice, e.g. Ward round on Sunday June 17th at 11:00am: 1

• ST1/ST2 or CT1/CT2 (core training/specialist training ) or equivalent non-deanery post on call from home on Sunday June 17th at 11:00am: 0

• ST3 or higher (specialist training) scheduled to be on site for rostered session or full shift on Sunday June 17th at 11:00am: 3

• ST3 or higher (specialist training) on call, but physically on site either as a requirement of terms of on call or as routine practice, e.g. Ward round on Sunday June 17th at 11:00am: 4

• ST3 or higher (specialist training) on call from home on Sunday June 17th at 11:00am: 1

• Staff grade post equivalent to ST3 or higher scheduled to be on site for rostered session or full shift on Sunday June 17th at 11:00am: 2

• Staff grade post equivalent to ST3 or higher on call, but physically on site either as a requirement of terms of on call or as routine practice, e.g. Ward round on Sunday June 17th at 11:00am: 0

• Staff grade post equivalent to ST3 or higher on call from home on Sunday June 17th at 11:00am: 0

• Consultants scheduled to be on site for rostered session or full shift on Sunday June 17th at 11:00am: 0

• Consultants on call, but physically on site either as a requirement of terms of on call or as routine practice, e.g. Ward round on Sunday June 17th at 11:00am: 6

• Consultants on call from home on Sunday June 17th at 11:00am: 16

• Foundation Doctors, Year 1 & 2 responsible for current medical inpatients and new medical admissions scheduled to be on site for rostered session or full shift on Sunday June 17th at 11:00am: 1

• Foundation Doctors, Year 1 & 2 responsible for current medical inpatients and new medical admissions on call, but physically on site either as a requirement of terms of on call or as routine practice, e.g. Ward round, on Sunday June 17th at 11:00am: 0

• Foundation Doctors, Year 1 & 2 responsible for current medical inpatients and new medical admissions on call from home on Sunday June 17th at 11:00am: 0

• ST1/ST2 or CT1/CT2 (core training/specialist training ) or equivalent non-deanery post responsible for current medical inpatients and new medical admissions scheduled to be on site for rostered session or full shift on Sunday June 17th at 11:00am: 4

• ST1/ST2 or CT1/CT2 (core training/specialist training ) or equivalent non-deanery post responsible for current medical inpatients and new medical admissions on call, but physically on site either as a requirement of terms of on call or as routine practice: 0

• ST1/ST2 or CT1/CT2 (core training/specialist training ) or equivalent non-deanery post responsible for current medical inpatients and new medical admissions on call from home on Sunday June 17th at 11:00am: 0

• ST3 or higher (specialist training) responsible for current medical inpatients and new medical admissions scheduled to be on site for rostered session or full shift on Sunday June 17th at 11:00am: 1

• Staff grade post equivalent to ST3 or higher responsible for current medical inpatients and new medical admissions scheduled to be on site for rostered session or full shift on Sunday June 17th at 11:00am: 0

• Staff grade post equivalent to ST3 or higher responsible for current medical inpatients and new medical admissions on call, but physically on site either as a requirement of terms of on call or as routine practice, e.g. Ward round on Sunday June 17th at 1: 0

• Staff grade post equivalent to ST3 or higher responsible for current medical inpatients and new medical admissions on call from home on Sunday June 17th at 11:00am: 0

• Consultants responsible for current medical inpatients and new medical admissions scheduled to be on site for rostered session or full shift on Sunday June 17th at 11:00am: 0

• Consultants responsible for current medical inpatients and new medical admissions on call, but physically on site either as a requirement of terms of on call or as routine practice, e.g. Ward round on Sunday June 17th at 11:00am: 2

• Consultants responsible for current medical inpatients and new medical admissions on call from home on Sunday June 17th at 11:00am: 0

• Foundation Doctors, Year 1 & 2 scheduled to be on site for rostered session or full shift on Sunday June 17th at 11:00pm: 5

• Foundation Doctors, Year 1 & 2 on call, but physically on site either as a requirement of terms of on call or as routine practice, e.g. Ward round on Sunday June 17th at 11:00pm: 0

• Foundation Doctors, Year 1 & 2 on call from home on Sunday June 17th at 11:00pm: 0

• ST1/ST2 or CT1/CT2 (core training/specialist training ) or equivalent non-deanery post scheduled to be on site for rostered session or full shift on Sunday June 17th at 11:00pm: 6

• ST1/ST2 or CT1/CT2 (core training/specialist training ) or equivalent non-deanery post on call, but physically on site either as a requirement of terms of on call or as routine practice, e.g. Ward round on Sunday June 17th at 11:00pm: 0

• ST1/ST2 or CT1/CT2 (core training/specialist training ) or equivalent non-deanery post on call from home on Sunday June 17th at 11:00pm: 0

• ST3 or higher (specialist training) scheduled to be on site for rostered session or full shift on Sunday June 17th at 11:00pm: 3

• ST3 or higher (specialist training) on call, but physically on site either as a requirement of terms of on call or as routine practice, e.g. Ward round on Sunday June 17th at 11:00pm: 0

• ST3 or higher (specialist training) on call from home on Sunday June 17th at 11:00pm: 0

• Staff grade post equivalent to ST3 or higher scheduled to be on site for rostered session or full shift on Sunday June 17th at 11:00pm: 1

• Staff grade post equivalent to ST3 or higher on call, but physically on site either as a requirement of terms of on call or as routine practice, e.g. Ward round on Sunday June 17th at 11:00pm: 0

• Staff grade post equivalent to ST3 or higher on call from home on Sunday June 17th at 11:00pm: 0

• Consultants scheduled to be on site for rostered session or full shift on Sunday June 17th at 11:00pm: 0

• Consultants on call, but physically on site either as a requirement of terms of on call or as routine practice, e.g. Ward round on Sunday June 17th at 11:00pm: 0

• Consultants on call from home on Sunday June 17th at 11:00am: 22

• Foundation Doctors, Year 1 & 2 responsible for current medical inpatients and new medical admissions scheduled to be on site for rostered session or full shift on Sunday June 17th at 11:00pm: 2

• Foundation Doctors, Year 1 & 2 responsible for current medical inpatients and new medical admissions on call, but physically on site either as a requirement of terms of on call or as routine practice, e.g. Ward round on Sunday June 17th at 11:00pm: 0

• Foundation Doctors, Year 1 & 2 responsible for current medical inpatients and new medical admissions on call from home on Sunday June 17th at 11:00pm: 0

• ST1/ST2 or CT1/CT2 (core training/specialist training ) or equivalent non-deanery post responsible for current medical inpatients and new medical admissions scheduled to be on site for rostered session or full shift on Sunday June 17th at 11:00pm: 4

• ST1/ST2 or CT1/CT2 (core training/specialist training ) or equivalent non-deanery post responsible for current medical inpatients and new medical admissions on call, but physically on site either as a requirement of terms of on call or as routine practice: 0

• ST1/ST2 or CT1/CT2 (core training/specialist training ) or equivalent non-deanery post responsible for current medical inpatients and new medical admissions on call from home on Sunday June 17th at 11:00pm: 0

• ST3 or higher (specialist training) responsible for current medical inpatients and new medical admissions Scheduled to be on site for rostered session or full shift on Sunday June 17th at 11:00pm: 2

• ST3 or higher (specialist training) responsible for current medical inpatients and new medical admissions on call, but physically on site either as a requirement of terms of on call or as routine practice, e.g. Ward round on Sunday June 17th at 11:00pm: 0

• ST3 or higher (specialist training) responsible for current medical inpatients and new medical admissions on call from home on Sunday June 17th at 11:00pm: 0

• Staff grade post equivalent to ST3 or higher responsible for current medical inpatients and new medical admissions Scheduled to be on site for rostered session or full shift on Sunday June 17th at 11:00pm: 0

• Staff grade post equivalent to ST3 or higher responsible for current medical inpatients and new medical admissions on call, but physically on site either as a requirement of terms of on call or as routine practice, e.g. Ward round on Sunday June 17th at 1: 0

• Staff grade post equivalent to ST3 or higher responsible for current medical inpatients and new medical admissions on call from home on Sunday June 17th at 11:00pm: 0

• Consultants responsible for current medical inpatients and new medical admissions scheduled to be on site for rostered session or full shift on Sunday June 17th at 11:00pm: 0

• Consultants responsible for current medical inpatients and new medical admissions on call, but physically on site either as a requirement of terms of on call or as routine practice, e.g. Ward round on Sunday June 17th at 11:00pm: 0

• Consultants responsible for current medical inpatients and new medical admissions on call from home on Sunday June 17th at 11:00pm: 3

• Does the hospital have a formal "hospital at night" system?

• Night Nurse Practitioners in the "hospital at night" team: 4

• Other nursing staff in the "hospital at night" team: 0

• ST3 or higher (specialist training) in the "hospital at night" team: 1

• Staff grade post equivalent to ST3 or higher in the "hospital at night" team: 0

• Consultants in the "hospital at night" team: 1