Wrightington Hospital, Wigan

General Services Information

Hospital Questions

• How many single rooms are available to NHS patients at this hospital: 24

• Of these how many have an ensuite toilet: 16

• Of these how many have an ensuite toilet and shower or bath: 16

• Does this hospital operate an accident and emergency unit:

• How many specialist palliative care beds are available at this hospital: 0 WWL is not a specialist palliative service

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

• What is the name of the private unit/service: John Charnley Wing

• How many beds are available within the private unit/service: 16

• How many single rooms are available within the private unit/service: 16

• Of these, how many have an ensuite toilet: 16

• Of these, how many have an ensuite toilet and shower or bath: 16

• Direct telephone number for the private unit: 01257 256265

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: Issues may also be identified as part of complaint investigations

• 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: 7 Reported via Datix Web. Five of the seven incidents relate to drill bit shavings being left in situ because, for patient safety reasons it was deemed more appropriate to not disturb the shaving

• During the period 01 April 2010 - 31 March 2011, how many operations were cancelled due to missing notes: 2 Reported via Datix Web

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

• How many incident investigations using a full Root Cause Analysis did were carried out in 2010/11: 11 11 for confirmed StEIs SUI's plus 25 divisional RCA's for division specific incidents requiring detaield investigation but not SUI's

• What percentage of patient safety incidents resulting in severe harm or death had a full RCA initiated/completed: 100% Reported and escalated

• What percentage of acute inpatients have a track and trigger warning system in place for the duration of the admission: 91-99% The Trust employs MEWS (Modified Early Warning Score) for the majority of patients

• What percentage of patients are risk assessed for venous thromboembolism on admission: 61-90% Compliance levels subject to divsional and corporate validation to be strengthened by an enhanced electronic recording system.

• 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). : Work remains ongoing on a number of alerts isued in 2010/11, these are within the specified 'action completed' deadlines and will be completed ahead or within deadline. There are a number of alerts which are not due for closure until 2012 or 2013 and work is underway, ongoing and on schedule with these alerts. Progress against all NPSA alerts is monitored and reviewed by QIC on a monthly basis.

• 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): Quality & Safety - Head of Quality & Safety, Patient & Staff Safety Team, Patient Safety and Health & Safety Manager

• Is safety and quality data available on a central platform and actively disseminated to users: Examples include, Quality & Safety Intranet Page, Global emails, Datixweb, Bi-monthly Feedback Newsletter, CAS leads, Internal Patient Safety Alerts

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: YES

• Are all elective neurosurgery patients screened at the pre-op assessment clinic: YES The Trust would screen this patient group, however neurosurgery patients are not seen at WWL and instead receive care at Salford Royal NHS Foundation Trust

• 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:

• Does the Trust have a dedicated isolation ward:

• How many beds does it contain: 12

• 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:

Trust Questions

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

• Is the Trust part of a stroke care network:

• Details: Greater Manchester

• 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): 494 Coded from I61-I64 (excludes I60 coded episodes)

• Of these, what was the number of patients given a Computerised Tomography (CT) scan within 24 hrs of admission: 405 based on latest available information from SINAP

• 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: Salford Royal NHS Foundation Trust

Trauma & Orthopaedics

Trust Questions

• Does the Trust offer a trauma service: A Trauma service is provided on the RAEI site. In addition, semi-elective trauma is undertaken on the Wrightington site and dedicated theatre sessions are provided to facilitate this service. In addition the Trust provides the regional pelvic trauma service and is contracted to 70 cases/year. Trauma services are provided to adults and children on the site. There are 28 Trauma beds within the 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 trauma list available 7 days/week. Out of hours theatre provision for trauma service is provided via a dedicated CEPOD theatre. The Trauma lists are consultant lists.

• Does the Trust offer an orthopaedics service: Orthopaedic services are provided on the Wrightington site. The service comprises of an dedicated outpatient department, pre-operative services day case unit and 3 inpatient wards. In addition there is a private wing on the site. The site has 8 operating theatres which provide 80 theatre sessions/week.

• Do all the Trust's orthopaedic ward/team have a linked geriatric team with whom they have regular meetings at least once a week: Orthogeriatrician services are provided within the trauma service. Patients are reviewed daily within the service. Weekly MDT meetings are conducted on the Trauma wards and the outcome of the meeting recorded within the patient pathway.

• 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)? : Currently there is limited pre-operative education provided within the pre-operative assessment clinic. From 3 October 2011 dedicated patient education classes will be provided. Attendence at the class is a pre-requisite to listing for surgery. This forms an essential component of the Enhanced Recovery Project which is scheduled to go live 3 October 2011. The education sessions will be delivered by generic workers and will include further information relating to their procedure, anaesthetic techniques, pain management, education on mobility aids and equipment requirements. In addition admission and discharge expectations will be provided for the patients. The education sessions will be supported by written information, redesigned patient information with goals and milestones, and planning information for patients to consider to ensure they are prepared for discharge. The patient pathway has also been redesigned to reflect the principles of Enhanced Recovery.

• Does the Trust have a standardised anaesthetic protocol for Total Knee Replacement (TKR) and Total Hip Replacement (THR) patients: The Trust utilises the A-Z of anaesthesia for NOF.

• Audited percentage compliance to this protocol: 88 The Trust has undertaken an audit (88% of patients received anaesthesia complaint with the protocol)

• Estimated percentage of the Trusts total knee replacement (TKR) and total hip replacement (THR) patients walk within 24 hours of surgery: 80 Baseline data is currently being collected against this performance indicator.

• 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 - audited figure was: 0 As there is a dedicated service provided there are no delayed discharges relating to lack of physiotherapy support

• Are patients for total knee replacement (TKR) and total hip replacement (THR) admitted prior to the day of surgery: 90% of all admissions occur on the day of surgery.

• What is the principle reason for patients not being admitted on the day of surgery: Patients are only admitted prior to surgery due to clinical need.

• Are patient records routinely recorded using a specific multi-disciplinary team THR/TKR pathway document: There are dedicated care pathways in place for both these procedures. The pathways are reviewed as a minimum annually to ensure that they are compliant with best practice and Trust policy.

• Is this data used to monitor compliance with the agreed pathway: From 3 October this information will be made available as part of the Divisions KPI's and individual clinician performance data will be provided.

• Is criteria-based discharge used: MDT discharge is undertaken throughout MSK services in accordance with agreed criterion. These are reviewed as a minimum annually to ensure they are compliant with best practice and Trust policy.

• Are patients routinely phoned in the first 48 hours after discharge to check on their progress: Face to face domicilliary or telephone follow up is conducted on all patients within 24 hours of discharge.

Paediatrics

Hospital Questions

• Does the hospital have a paediatrics service: Out-patient services 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:

• Do the Trust's anaesthetists with responsibility for paediatric anaesthesia participate in at least one paediatric list per week: There are no dedicated paediatric lists but all anaesthetists have lists that contain paediatric patients.

• 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: A multi-disciplinary specialist palliative care team The hospital based Macmillan specialist Nurses provide a service for patients and their families whose lives have been affected by a life changing diagnosis, resulting in the need for specialist palliative care. The nurses work as part of the MDT in order to offer the best quality of care possible.the consultant in Palliative medicine is on site to support the team clinically.

• Does the hospital's specialist palliative team includes: A consultant in palliative medicine,A palliative care nurse

• Is the Trust's specialist palliative care team available 24 hrs a day seven days a week: The hospice provide access to a 24hr helpline manned by a member of the nursing staff and the hospital team will be available 7 days per week from April 2012.

• 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: Palliative care is a very difficult area to survey, however, a member of the palliative care team attends the patient user group every month in order to gain feedback and make changes and developments within services where necessary. There will be an event in November 2011 where patients are invited to attend and help and inform health care professionals deliver the best possible care for our future patients.

Maternity Care

Maternity Sites

• Royal Albert Edward Infirmary - Consultant Led

• How many women gave birth in the unit during the year? (not including home births): 3060

• How many babies were born in the unit during the year? (not including home births): 3117

• How many women were booked for a home birth: 62

• How many women had a home birth? (not including births at home by accident): 58

• Number of antenatal rooms: 41 all on the maternity ward

• Total antenatal beds: 21 The maternity ward is mixed antenatal & post natal

• Number of assessment area rooms (for monitoring and / or induction): 41 all on the maternity ward

• Total assessment area beds: 21 all on the maternity ward

• Number of delivery rooms: 9

• Number of postnatal rooms: 41 On maternity ward

• Total postnatal beds: 21 On maternity ward

• Number of rooms in obstetric high dependency unit: 1 1 of the 9 rooms in delivery is designated for HDU

• Number of single rooms used for both delivery and postnatal care (labour, delivery, recovery and postnatal, or LDRP, rooms): 9

• Amenity rooms; Are women able to book a single room in advance of their birth: The Maternity Service has six amenity rooms which are allocated on a clinical need basis, whilst they cannot be booked in advance they can be requested and provided if available.

• 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:

• 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 unit

• Pain relief available - Epidural: Provided by unit

• Pain relief available - Mobile epidural: Provided by unit

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

• Pain relief available - Intramuscular injection: Provided by unit

• Other pain relief: Bradbury Bed

• Total number of WTE midwives at the unit in your funded establishment, including vacant posts: 98.4

• Total number of WTE midwives at the unit as staff in post, including agency and bank staff: 92.4

• 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 site

• 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):

• 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: 8-13 weeks

• Scan 2 available between: 18-20 weeks

Trust Statistics

Trust Questions

• You can view various measures relating to the Trust's performance by clicking the following link: Wrightington, Wigan and Leigh NHS Foundation Trust