St Helens Hospital (Merseyside), St Helens

General Services Information

Hospital Questions

• How many single rooms are available to NHS patients at this hospital: 20 20 out of 32 beds on the St Helens Site

• Of these how many have an ensuite toilet: 20

• Of these how many have an ensuite toilet and shower or bath: 20

• Does this hospital operate an accident and emergency unit: Accident and Emergency Unit is available at our sister hospital at Whiston

• How many specialist palliative care beds are available at this hospital: 0

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

Trust Questions

• Does the Trust treat private patients: Private patients are cared for within our general bed stock and separate clinics are available at St Helens Hospital

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: Hospital Incident reporting system Hospital Incident reporting system

• 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: Hospital incident reporting system

• 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: Hospital incident reporting system

• 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: 0

• During the period 01 April 2010 - 31 March 2011, how many operations resulted in wrong site surgery taking place: 0

• How many incident investigations using a full Root Cause Analysis did were carried out in 2010/11: 16

• 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% Just below 90% of patients are risk assessed. The trust has plans in place to increase this during 2011-12

• 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):

• Is safety and quality data available on a central platform and actively disseminated to users:

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

• 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: Only if known to be MRSA positive

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

• Are all patients admitted through A&E screened: In accordance with best practice, only if patients are admitted for >12 hours

• Is screening done according to individual risk assessment:

• Does the Trust have a dedicated isolation ward:

• Protocol for isolating patients with infections: All patients are isolated in single rooms All patients are isolated in single rooms. Every ward has at leat one specialist isolation room.

• 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: This is available at our sister hospital Whiston

Trust Questions

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

• Is the Trust part of a stroke care network:

• Details: The trust is part of the Cheshire and Merseyside 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): 473

• Of these, what was the number of patients given a Computerised Tomography (CT) scan within 24 hrs of admission: 393 392 Patients has CT within 24hrs (22 did not have any CT, 6 patients either had them at another Trust or did not initially meet the clinical criteria).

• 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:

• These arrangements are with: Warrington and Halton Foundation Hospital Trust Warrington & Halton Foundation Trust 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): There is a dedicated list each day and access to dedicated theatre for life and limb threatening cases out of hours.

• 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: 95 95%

• 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: 95 95%

• Estimated percentage of the Trusts total knee replacement (TKR) and total hip replacement (THR) patients walk within 24 hours of surgery: 100 100%

• Does the Trust have a specialist orthopaedic physiotherapy service which is available 7 days a week: There is a specialist physiotherapy team available 6 days per week and general physiotherapy service available on call Sundays

• 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:

• 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:

• 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: Paediatric outpatient service only

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: The Trust has a clear children's surgical policy which identifies the surgeons who undertake elective surgical procedures and defines the appropriate age limit.

• Do the Trust's anaesthetists with responsibility for paediatric anaesthesia participate in at least one paediatric list per week: However, the trust is compliant with best practice issued by the Royal College.

• Is a paediatrician on site (SpR or higher) 24 hours per day, 7 days per week: There is an spR on site 24 hours a day seven days a week. Consultant paediatrician's are available 8 a.m.-6 p.m. out of hours can attend within 30 minutes.

• Are at least two registered children's nurses on duty 24hours per day in each children's ward: 70% ward staff are registered children's nurses. 80:20 trained to untrained staff ratio. 6 trained and 1 untrained at night. Usually 4 or 5 registered children's nurses on duty 24 hours a day.

• Is there a designated facility on site for parents or guardians to stay overnight: 75% of Inpatient beds are cubicles with ensuite facilities in which parents can stay with their child.

Palliative Care

Trust Questions

• Does the Trust provide a palliative care service: Yes we 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 The hospital has general counsellors and psycholgists available for all patients.

• Is the Trust's specialist palliative care team available 24 hrs a day seven days a week: 24hr access to Specialist advice is available via Helpline

• Are facilities provided to support relatives and carers who wish to stay with a patient in hospital: Yes relatives accommodation is available.

• 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:

Maternity Care

Maternity Sites

• Whiston Hospital - Midwife Led

• How many women gave birth in the unit during the year? (not including home births): 0

• How many babies were born in the unit during the year? (not including home births): 0

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

• How many women had a home birth? (not including births at home by accident): 23

• 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: 0

• Total delivery beds: 0

• Number of postnatal rooms: 0

• Total postnatal beds: 0

• 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:

• If women can pay for a single room what is the average cost per night (GBP): 0 Not applicable

• 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:

• Other security measures: 0

• 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: Not available

• Pain relief available - Aromatherapy: Not available

• 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

• Other pain relief: 0

• Total number of WTE midwives at the unit in your funded establishment, including vacant posts: 0

• Total number of WTE midwives at the unit as staff in post, including agency and bank staff: 0

• 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

• Whiston Hospital - Consultant Led

• How many women gave birth in the unit during the year? (not including home births): 3439

• How many babies were born in the unit during the year? (not including home births): 3447

• How many women were booked for a home birth: 0

• How many women had a home birth? (not including births at home by accident): 0

• Number of antenatal rooms: 37 The service has 1 Obstetric Ward which provides care to all women requiring antenatal hospital based care and postnatal care. In total the ward comprises of 37 beds. These beds can be 'flexed' to accomodate increased demands for antenatal ladies or postnatal women and their babies. The 37 bed ward comprises of four x4 bedded bays (16 beds) and 21 ensuite side rooms

• Total antenatal beds: 37

• Number of assessment area rooms (for monitoring and / or induction): 14 The purpose build modern Delivery Suite is made up of 14 delivery rooms, and 2 admission/assessment rooms. The 14 rooms include a large pool room, a high dependency room and bereavement suites

• Total assessment area beds: 14

• Number of delivery rooms: 14 The purpose build modern Delivery Suite is made up of 14 delivery rooms, and 2 admission/assessment rooms. The 14 rooms include a large pool room, a high dependency room and bereavement suites

• Total delivery beds: 14

• Number of postnatal rooms: 37 The service has 1 Obstetric Ward which provides care to all women requiring antenatal hospital based care and postnatal care. In total the ward comprises of 37 beds. These beds can be 'flexed' to accomodate increased demands for antenatal ladies or postnatal women and their babies. The 37 bed ward comprises of four x4 bedded bays (16 beds) and 21 ensuite side rooms

• Total postnatal beds: 37

• 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): 14 Each room has been designed for use as an LDRP room as required

• 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 Not applicable

• 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: Level 2 facility

• Security measures - ankle bands for the baby: The ankle band electronic security system is a new modern system that provides security from within the Delivery Suite to all parts of the maternity service including Special Care Baby Unit

• Security measures - cot alarms:

• Security measures - CCTV:

• Security measures - restricted access:

• Other security measures: 0

• 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: Not available We do not provide a formal massage service however the benefits of massage supported by the birth partner are advised and promoted within Parent Education Programmes

• Pain relief available - Aromatherapy: Not available

• 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

• Other pain relief: 0

• Total number of WTE midwives at the unit in your funded establishment, including vacant posts: 111.65WTE

• Total number of WTE midwives at the unit as staff in post, including agency and bank staff: 137 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 During 'office hours' the appropirate team midwife will attend the lady at home. Out of hours the service is provided via an on call system

• 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): Women choosing to have their babies at Whiston can be booked and recieve antenatal care at a variety of community settings as well as the Whiston and St Helens hospital. The service has satellite clinics with access to a consultant obstetrician at Haydock Health Centre, St Helens Hospital, Widnes Health Resource Centre and Runcorn.

• 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:

• Are all women routinely offered ultrasound scans:

• Scan 1 available between: 12 national recommendations is to scan betwen 11-13+6. We aim to undertake all booking scans at 12 weeks

• Scan 2 available between: 20-21 national recommendation is to scan between 18-21+6. We aim to undertake anomoly scans between 20-21 weeks

Trust Statistics

Trust Questions

• You can view various measures relating to the Trust's performance by clicking the following link: St Helens and Knowsley Hospitals NHS Trust