Salisbury District Hospital, Salisbury

General Services Information

Hospital Questions

• How many single rooms are available to NHS patients at this hospital: 92

• Of these how many have an ensuite toilet: 92

• Of these how many have an ensuite toilet and shower or bath: 73

• Does this hospital operate an accident and emergency unit:

• How many specialist palliative care beds are available at this hospital: 10 Salisbury Hospice is co located on the Salisbury District Hospital site

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

• What is the name of the private unit/service: The Clarendon Suite The Clarendon Suite opened in February 2011

• How many beds are available within the private unit/service: 4 In addition to the Clarendon Suite, private patients are also treated and cared for in other parts of Salisbury District Hospital as this may be clinically more appropriate

• How many single rooms are available within the private unit/service: 4

• Of these, how many have an ensuite toilet: 4

• Of these, how many have an ensuite toilet and shower or bath: 4 All bedrooms in the Clarendon Suite have en suite wet rooms

• Direct telephone number for the private unit: 01722 425281

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: Incident reporting as per the Trust's Adverse Events Reporting Policy

• 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: Incident reporting as per the Trust's Adverse Events Reporting Policy

• 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: Incident reporting as per the Trust's Adverse Events Reporting Policy

• During the period 01 April 2010 - 31 March 2011, how many operations resulted in a foreign body being left post surgery: 1 Retained swab - the patient came to no harm as a direct result as the swab was removed at further semi planned surgery within the same admission (on the next day). Full external reporting requirements met as per national standards. Serious Incident investigation was concluded and recommendations are currently being progressed to mitigate future risk. Patient and family fully aware

• During the period 01 April 2010 - 31 March 2011, how many operations were cancelled due to missing notes: 0

• During the period 01 April 2010 - 31 March 2011, how many operations resulted in wrong site surgery taking place: 1 Exploratory incision made on wrong digit. Error acknowledged and corrected. No permanent harm resulted. Full external reporting requirements met as per national standards. Serious Incident investigation was concluded and recommendations are currently being progressed to mitigate future risk. Patient and family fully aware

• How many incident investigations using a full Root Cause Analysis did were carried out in 2010/11: 26 26 investigations were subject to full root cause analysis techniques. 21 cases were subject to root cause analysis for investigation (for example, using a timeline of events)

• What percentage of patient safety incidents resulting in severe harm or death had a full RCA initiated/completed: 100% All patient safety incidents directly resulting in major harm or death are subject to RCA review

• What percentage of acute inpatients have a track and trigger warning system in place for the duration of the admission: 100% EWSS is in place across all inpatient ward areas and this is incorporated into the Trusts observation chart excluding maternity who use a MEOWS system for high risk mothers. EWSS score is calculated on every set of cardiovascular observations

• What percentage of patients are risk assessed for venous thromboembolism on admission: 91-99% Submitted monthly and audit data covers all areas.

• 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). : No outstanding alerts

• Does the Trust have a policy for providing educational programmes on using and interpreting clinical indicators: The Trust has an Education Strategy which references EWSS and escalation procedures. Link Nurses from the Critical Care Outreach team regularly audit compliance with EWSS

• Does the Trust have a designated member of staff who supports teams in locating and analysing safety and quality data? (support): This is not one designated member of staff there are several leads within the Quality Directorate (such as Risk and Complaints) who facilitate this in conjunction with the Senior Information Analyst for the Trust.

• Is safety and quality data available on a central platform and actively disseminated to users: Key Quality Indicator reports are held and coordinated on a shared drive between Risk and Information Departments. Reports are disseminated monthly to all departments and Directorate Management Teams/Executive Directors. Patient Real Time Feedback is disseminated in a robust manner and coordinated through the Quality Directorate. There is also a clinical dasboard programme in development and currently piloting with specific teams to enable access to real time quality and safety data.

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 orthopaedics and all elective surgical

• 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: All patients admitted through A&E are screened for MRSA

• Does the Trust have a dedicated isolation ward:

• Protocol for isolating patients with infections: According to Trust Isolation Policy, which includes an individual risk assessment score.

• 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: following individual risk assessment

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: 30

Trust Questions

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

• Is the Trust part of a stroke care network:

• Details: Avon, Gloucester, Wiltshire and Somerset 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): 329

• Of these, what was the number of patients given a Computerised Tomography (CT) scan within 24 hrs of admission: 297

• 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: Patients can always receive thrombolytic treatment at Salisbury District Hospital

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: An orthogeriatrician is based on the orthopadic ward, reviewing patients on a daily basis

• 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)? : All patients are invited to Hip and Knee school and strongly encouraged to attend. This is an integral part of the enhanced recovery programme

• What is the estimated percentage of all patients that attend the class prior to surgery: 75

• 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: 80 There are occasions where spinal anaesthetic (which is in the protocol) is contra indicated

• Estimated percentage of the Trusts total knee replacement (TKR) and total hip replacement (THR) patients walk within 24 hours of surgery: 70 All patients (unless medically unfit) get out of bed and are helped to walk to a chair within 24 hours of surgery. Some patients are not well enough to walk and attempts are made to mobilise 95% of patients

• 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: 93% of elective orthopaedic patients were admitted on the day of surgery in the past year

• 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: Compliance is monitored as part of the routine audit programme

• 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: Adult inpatient specialist palliative care unit The Trust has an onsite hospice providing adult inpatient beds and a co located day care support centre

• Does the hospital's specialist palliative team includes: A consultant in palliative medicine,A palliative care nurse,Counsellor(s),Other (please specify) Specialist Nurses, Therapists, Clinical Psychologist, Bereavement Support

• 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: Surveys, focus groups and other patient and public involvement activities are undertaken

Maternity Care

Maternity Sites

• Salisbury District Hospital - Consultant Led

• How many women gave birth in the unit during the year? (not including home births): 2317

• How many babies were born in the unit during the year? (not including home births): 2339 This is the number of registerable births

• How many women were booked for a home birth: 160

• How many women had a home birth? (not including births at home by accident): 112 A further 24 women had unplanned home births

• Number of antenatal rooms: 1

• Total antenatal beds: 4

• Number of assessment area rooms (for monitoring and / or induction): 3

• Total assessment area beds: 3

• Number of delivery rooms: 10

• Total delivery beds: 10

• Number of postnatal rooms: 3

• Total postnatal beds: 14

• 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): 0

• Amenity rooms; Are women able to book a single room in advance of their birth: Planned from September 2011

• If women can pay for a single room what is the average cost per night (GBP): 100 Planned from September 2011

• 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 The unit has 2 permanent birthing pools

• 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 Machines are available for hire from the 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: 74

• Total number of WTE midwives at the unit as staff in post, including agency and bank staff: 74

• 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 and on call

• 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): Most women choose to have antenatal care provided in the community

• 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: Special ante natal classes are provided for young parents

• Are all women routinely offered ultrasound scans:

• Scan 1 available between: 11 to 13

• Scan 2 available between: 20

Trust Statistics

Trust Questions

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