Royal Devon& Exeter Hospital, Exeter

General Services Information

Hospital Questions

• How many single rooms are available to NHS patients at this hospital: 158

• Of these how many have an ensuite toilet: 88

• Of these how many have an ensuite toilet and shower or bath: 56

• Does this hospital operate an accident and emergency unit:

• How many specialist palliative care beds are available at this hospital: 0 No designated palliative beds but beds on oncology and haematology wards which are regularly used for palliative patients on a flexible basis and there is a hospice on site with an additional 12 beds.

• 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: Datix Web

• 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: Datix Web

• 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: Datix Web

• During the period 01 April 2010 - 31 March 2011, how many operations resulted in a foreign body being left post surgery: 1 Small piece of metal left in situ as deemed more of a risk to remove. Not a never event

• During the period 01 April 2010 - 31 March 2011, how many operations were cancelled due to missing notes: 0 Although there are incidents of notes missing there are no reported incidents of operations being cancelled

• During the period 01 April 2010 - 31 March 2011, how many operations resulted in wrong site surgery taking place: 1 Never event reported in November 2010

• How many incident investigations using a full Root Cause Analysis did were carried out in 2010/11: 26

• 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: 61-90% Taken from monthly Trustwide audit

• 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: Training is provided to any member of staff wishing to access Dr Foster Intelligence tools

• Does the Trust have a designated member of staff who supports teams in locating and analysing safety and quality data? (support): Operational Performance Manager, Performance Analyst and Patient Safety Analyst

• Is safety and quality data available on a central platform and actively disseminated to users: Integrated Board Performance Report and Adverse Events Forum Report

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 Inpatients for all Surgical Specialties (inc Gynaecology etc), Inpatients and Daycases for Orthopaedics

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

• 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: Culture based in 24-48hrs

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

• 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: N/A All Patients going through A&E are screened

• Does the Trust have a dedicated isolation ward:

• How many beds does it contain: 19

• 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: Other All of the listed types

• Number of beds in the unit: 28

Trust Questions

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

• Is the Trust part of a stroke care network:

• Details: Peninsula Stroke and Heart 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): 472

• Of these, what was the number of patients given a Computerised Tomography (CT) scan within 24 hrs of admission: 428

• 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): Lists routinely take place Sunday to Sunday between 8.00am and 6pm. Out of hours lists are available for emergency cases that cannot wait until the next daytime list.

• 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: 25

• 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: 75

• Estimated percentage of the Trusts total knee replacement (TKR) and total hip replacement (THR) patients walk within 24 hours of surgery: 95

• 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:

• 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: Not currently however this will begin in line with the ERP data collection which is due to commence in Sept 2011

• 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: The two lead anaesthetists for paediatrics do at least one list per week.

• Is a paediatrician on site (SpR or higher) 24 hours per day, 7 days per week: There is always an SpR on duty 24 hours a day. The Trust is also exploring the opportunity to increase the length of the day covered by a consultant paediatrician.

• Are at least two registered children's nurses on duty 24hours per day in each children's ward: There are approximately 50 wte RNs on the acute unit and only two of these are not registered children's nurses. There are normally a minimum of 6 children's registered nurses on duty 24 hours a day.

• Is there a designated facility on site for parents or guardians to stay overnight: There are designated parent's facilities and accommodation on both the acute unit and neonatal unit.

Palliative Care

Trust Questions

• Does the Trust provide a palliative care service:

• How is specialist palliative care delivered at the hospital: Other (please specify) 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) 3 CNS Consultant .6 wte. Dedicated counsellors for Child and Womens health Oncology and haematology

• 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: This is part of the End of Life care strategy

Maternity Care

Maternity Sites

• Tiverton Community Hospital - Midwife Led

• Honiton Community Hospital - Midwife Led

• Okehampton Community Hospital - Midwife Led

• Tiverton Community Hospital - Consultant Led

• Honiton Community Hospital - Consultant Led

• Okehampton Community Hospital - Consultant Led

• Royal Devon & Exeter Hospital - Consultant Led

• How many women gave birth in the unit during the year? (not including home births): 3992 Taken as 1st April 2010 to 31st March 2011

• How many babies were born in the unit during the year? (not including home births): 4067 Taken as 1st April 2010 to 31st March 2011

• How many women were booked for a home birth: 189 Taken as 1st April 2010 to 31st March 2011

• How many women had a home birth? (not including births at home by accident): 111 Taken as 1st April 2010 to 31st March 2011

• Number of antenatal rooms: 4

• Total antenatal beds: 12

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

• Total assessment area beds: 6

• Number of delivery rooms: 18 (inlcuding alongside and standalone units)

• Total delivery beds: 18

• Number of postnatal rooms: 19 (including birth units)

• Total postnatal beds: 39

• Number of rooms in obstetric high dependency unit: 10

• 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): 10 10 in consultant unit

• 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): 65

• 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: "Security swipe-access doors to both antenatal/ post natal wards, and labour wards/ theatre - staff controlled. 24/7 security guards on the security door to the Child and Women's Unit"

• 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: 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: 134.77 as at end of March 2011, month 12 position. Includes community midwives

• Total number of WTE midwives at the unit as staff in post, including agency and bank staff: 132.58 as at end of March 2011, month 12 position. Includes community midwives

• 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): All women who require an Obstetric appointments are seen at RDEFT Wonford site

• 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: 11-13 + 6 Including First trimester screening clinic appointments

• Scan 2 available between: 18-20 + 6

Trust Statistics

Trust Questions

• You can view various measures relating to the Trust's performance by clicking the following link: Royal Devon and Exeter NHS Foundation Trust