St Helens and Knowsley Hospitals NHS Trust

Dr Foster Quality Account for 2008/9

  • Patient safety Rank: 1
    Banding for Patient Safety: 1 explanatory text We grouped hospitals into five bands where 1 is the poorest and 5 is the best. To put them in bandings, we have calculated the probability that hospitals are among the best or worst, based on their scores. Further details can be found in the methodology.
  • Patient Safety Summary Score:
    5.48

Compare this trust

  • Exceeded expected
  • In line with expected
  • Below expected
  • Patient advice

Summary: St Helens and Knowsley Hospitals NHS Trust

You can move through the three areas of care patient safety, clinical effectiveness and patient experience by clicking on the tabs above.

Patient safety summary

We measured trusts across 13 safety measures and then gave them an overall score out of 100. Those doing better than average got high scores and those doing not so well got low scores. To make it easier, we have put them into five bands, where 5 is for the top performers and 1 is for the bottom. You can see how they scored on each of the 13 measures below.

The trust says...

We are rated as one of the top performing Trusts in the country. Patients are our number one priority and our patient safety record is above average according to the National Patient Safety Agency. The level of patient safety and quality of care provided by the Trust is far higher than these figures illustrate.

Dr Foster's patient safety indictor illustrated as 'High' refers to reporting alerts to the National Reporting and Learning Service. Due to technical issues the Trust was unable to provide this data during the timeframe Dr Foster examined. These issues have since been resolved and according to figures published by the National Patient Safety Agency for the most recent period of October 2008 to March 2009, the Trust was performing better than the national average.

Dr Foster's indicator for 'fractured neck of femur procedure in 2 days' is also illustrated as 'High'. However the Trust achieves a higher level of care than these figures indicate and we strive to improve our care further. 'Daycase over stays' are also indicated as 'High'. The Trust cares for a large number of patients who have multifaceted underlying health problems and in many cases it is necessary to keep them in overnight. The indicator for 'palliative care team available 24/7' is 'High'. The Trust delivers this care where appropriate, but in the majority of cases, palliative care is provided, through a local hospice less than a mile away.

Reports conducted by various independent agencies outline high standards of care being delivered by the Trust. The Care Quality Commission, gave a rating of double excellent for the last two years running and we are the only Acute Trust in the country, which is not a foundation trust, to have achieved this. The Care Quality Commission rated the Trust as:

  • Excellent for the quality of services provided to patients
  • Excellent for the use of its resources

The report noted that:

  • Core standards were fully met
  • Existing commitments were fully met
  • Achieving national priorities were excellent

Our achievements include:

  • The only Trust in the North West and one of five in the country to meet each requirement of the Hygiene Code (2008)
  • The only acute Trust in Merseyside rated as Excellent in the Patient Environment Action Team (PEAT) report for every category, across both hospitals for the 4th year running (2009)
  • Numerous awards including being short-listed for Acute Healthcare Organisation of the Year in the Health Service Journal Awards (2009)
  • Maintaining one of the lowest MRSA infection rates in the country. These impressive accomplishments have been achieved whilst undertaking a £338 million PFI redevelopment of our hospitals to provide patients with the highest quality of care in world class surroundings. St Helens Hospital opened on schedule and on budget in October 2008 and Whiston Hospital is also on budget and set to open in April 2010, 6 months ahead of schedule. The Trust is committed to providing excellent patient care in world class hospitals.

Patient safety measures

Expand each section to see how the Trust performed against the individual measures.

  • show What is the hospital's overall death rate?

    HSMR all admissions 103.90 explanatory text This indicator uses a control limit (displayed on the graph as a white line), which we have set at 99.8%. Data points 'falling within the control limits are said to display 'common-cause variation', which means it may be due to chance. Data points falling outside the control limits are known as 'outliers' and chance is an unlikely explanation. They are said to display 'special-cause variation' that is, factors other than chance are the cause.

    This compares the actual number of deaths in a trust against the expected number.

    National average: 100.00
    Trust rate: 103.90
  • show What is the hospital's death rate for emergency admissions?

    HSMR non-elective 104.20 explanatory text This indicator uses a control limit (displayed on the graph as a white line), which we have set at 99.8%. Data points 'falling within the control limits are said to display 'common-cause variation', which means it may be due to chance. Data points falling outside the control limits are known as 'outliers' and chance is an unlikely explanation. They are said to display 'special-cause variation' that is, factors other than chance are the cause.

    Looking at emergency admissions only, this compares the actual number of deaths against the expected number.

    National average: 100.00
    Trust rate: 104.20
  • show What is the death rate for stroke patients?

    SMR Stroke 107.65 explanatory text This indicator uses a control limit (displayed on the graph as a white line), which we have set at 99.8%. Data points 'falling within the control limits are said to display 'common-cause variation', which means it may be due to chance. Data points falling outside the control limits are known as 'outliers' and chance is an unlikely explanation. They are said to display 'special-cause variation' that is, factors other than chance are the cause.

    This is the ratio of actual deaths to expected deaths for Stroke patients, which is then compared to the national average.

    National average: 100.00
    Trust rate: 107.65
  • show What is the death rate for heart attack patients?

    SMR AMI 129.90 explanatory text This indicator uses a control limit (displayed on the graph as a white line), which we have set at 99.8%. Data points 'falling within the control limits are said to display 'common-cause variation', which means it may be due to chance. Data points falling outside the control limits are known as 'outliers' and chance is an unlikely explanation. They are said to display 'special-cause variation' that is, factors other than chance are the cause.

    This is the ratio of actual deaths to expected deaths for heart attack patients (acute myocardial infarcation or AMI), compared to the national average.

    National average: 100.00
    Trust rate: 129.90
  • show What is the death rate for patients admitted with a broken hip?

    SMR FNOF 113.58 explanatory text This indicator uses a control limit (displayed on the graph as a white line), which we have set at 99.8%. Data points 'falling within the control limits are said to display 'common-cause variation', which means it may be due to chance. Data points falling outside the control limits are known as 'outliers' and chance is an unlikely explanation. They are said to display 'special-cause variation' that is, factors other than chance are the cause.

    This is the ratio of actual deaths to expected deaths for patient admitted with a broken hip, compared to the national average.

    National average: 100.00
    Trust rate: 113.58
  • show What is the death rate for patients admitted for low-risk conditions?

    Low mortality CCS groups: 0.0015 explanatory text This indicator uses a control limit (displayed on the graph as a white line), which we have set at 99.8%. Data points 'falling within the control limits are said to display 'common-cause variation', which means it may be due to chance. Data points falling outside the control limits are known as 'outliers' and chance is an unlikely explanation. They are said to display 'special-cause variation' that is, factors other than chance are the cause.

    Low risk conditions are those with a death rate of 0.5% or less, such as vasectomy or tonsillectomy.

    National average: 0.0016
    Trust rate: 0.0015
  • show Is the hospital fully compliant with National Patient Safety guidelines?

    NPSA alert compliance: Yes

    National Patient Safety guidelines advise trusts on how to improve patient safety. Compliance to these shows the trust is committed to improving patient safety.

  • show How consistently are Patient Safety Incidents reported to the NRLS?

    NRLS alerts: 0.00

    The National Reporting and Learning System (NRLS) measures the number of patient safety incident reports a trust has filed. Trusts that have filed lots of reports aren't necessarily bad - it means that they're keeping a close eye. more details

  • show How quickly are Patient Safety Incidents reported?

    NRLS alerts: Data not available

    The National Reporting and Learning System (NRLS) measures the number of patient safety incident reports a trust has filed. Trusts that have filed lots of reports aren't necessarily bad - it means that they're keeping a close eye. more details

  • show How many Patient Safety Incidents were reported in the first half of last year?

    NRLS alerts: 0.00

    The National Reporting and Learning System (NRLS) measures the number of patient safety incident reports a trust has filed. Trusts that have filed lots of reports aren't necessarily bad - it means that they're keeping a close eye. more details

  • show What is the ratio of hospital staff to bed?

    Staff to bed ratio: 1.82

    This is the ratio of clinical staff to patient bed

  • show How well does the hospital control infection?

    Infection control (composite) 100.00

    • Does the trust employ an antibiotic pharmacist? Yes
    • Does the trust have an assessment clinic or similar system where patients are screened for infection prior to being admitted? Yes
    • Do all patients identified as MRSA carriers through pre-assessment screening enter into a decolonisation routine in the 5 days immediately prior to being admitted or operated on? Yes
    • Does the trust have a dedicated isolation ward? Yes
    • Where appropriate, are patients with C Difficile isolated in single rooms as a priority? Yes
  • 0.91%show How committed is the trust to patient safety?

    Trust commitment to patient safety (composite) 91.00

    • Does the trust have a publicly named person at Board level responsible for patient safety? Yes
    • Is patient safety on the monthly agenda for the Trust's board meetings? Yes
    • Does the Trust board have definitions for the following:
      • The number and type of patient safety incidents Yes
      • Serious untoward incidents Yes
      • The implementation of safety alerts and other critical safety information Yes
      • Healthcare associated infections data Yes
      • Never events Yes
      • Investigations into patient safety incidents and any changes resulting from these Yes
    • How many staff are trained to be open with patients about patient safety incidents? 0.00 explanatory text 0 =0% trained, 0.25 = 1-10% trained, 0.5 = 11-30% trained, 0.75 = 31-60% trained, 1 = Over 60% trained
    • How many acute inpatients have a track and trigger warning system in place for the length of their stay in hospital? 1.00 explanatory text 0 = 0% 0.2 = 1-30% 0.4 = 31-60% 0.6 = 61-90% 0.8 = 91-99% 1 = 100%

Compare this trust

  • Exceeded expected
  • In line with expected
  • Below expected
  • Patient advice

Summary: St Helens and Knowsley Hospitals NHS Trust

You can move through the three areas of care patient safety, clinical effectiveness and patient experience by clicking on the tabs above.

Clinical effectiveness summary

We measured trusts across 16 indicators, looking closely at five commonly performed procedures to identify where hospitals are using the most up-to-date techniques, how quick they are to treat patients and how often patients have to be readmitted into hospital.

The trust says...

We are rated as one of the top performing Trusts in the country. Patients are our number one priority and our patient safety record is above average according to the National Patient Safety Agency. The level of patient safety and quality of care provided by the Trust is far higher than these figures illustrate.

Dr Foster's patient safety indictor illustrated as 'High' refers to reporting alerts to the National Reporting and Learning Service. Due to technical issues the Trust was unable to provide this data during the timeframe Dr Foster examined. These issues have since been resolved and according to figures published by the National Patient Safety Agency for the most recent period of October 2008 to March 2009, the Trust was performing better than the national average.

Dr Foster's indicator for 'fractured neck of femur procedure in 2 days' is also illustrated as 'High'. However the Trust achieves a higher level of care than these figures indicate and we strive to improve our care further. 'Daycase over stays' are also indicated as 'High'. The Trust cares for a large number of patients who have multifaceted underlying health problems and in many cases it is necessary to keep them in overnight. The indicator for 'palliative care team available 24/7' is 'High'. The Trust delivers this care where appropriate, but in the majority of cases, palliative care is provided, through a local hospice less than a mile away.

Reports conducted by various independent agencies outline high standards of care being delivered by the Trust. The Care Quality Commission, gave a rating of double excellent for the last two years running and we are the only Acute Trust in the country, which is not a foundation trust, to have achieved this. The Care Quality Commission rated the Trust as:

  • Excellent for the quality of services provided to patients
  • Excellent for the use of its resources

The report noted that:

  • Core standards were fully met
  • Existing commitments were fully met
  • Achieving national priorities were excellent

Our achievements include:

  • The only Trust in the North West and one of five in the country to meet each requirement of the Hygiene Code (2008)
  • The only acute Trust in Merseyside rated as Excellent in the Patient Environment Action Team (PEAT) report for every category, across both hospitals for the 4th year running (2009)
  • Numerous awards including being short-listed for Acute Healthcare Organisation of the Year in the Health Service Journal Awards (2009)
  • Maintaining one of the lowest MRSA infection rates in the country. These impressive accomplishments have been achieved whilst undertaking a £338 million PFI redevelopment of our hospitals to provide patients with the highest quality of care in world class surroundings. St Helens Hospital opened on schedule and on budget in October 2008 and Whiston Hospital is also on budget and set to open in April 2010, 6 months ahead of schedule. The Trust is committed to providing excellent patient care in world class hospitals.

Clinical effectiveness indicators

Expand each section to see how the Trust performed against the individual measures.

  • 0.80 show How many patients admitted with a suspected stroke are immediately given a brain scan?

    CT scan for stroke: 80.00%

  • 0.51 show How many patients admitted with a broken hip have this repaired within two days?

    FNOF procedure in 2 days: 51.00%

    National guidelines advise that patients with broken hips should be treated within two days.

  • 97.80 show How many heart attack patients received aspirin on arrival?

    Aspirin at arrival: 97.80%

  • 100.00 show How many heart attack patients had aspirin prescribed at discharge?

    Aspirin prescribed at discharge: 100.00%

  • 100.00 show How many heart attack patients had beta blockers prescribed at discharge?

    Beta blocker at discharge: 100.00%

  • 116.43 show What is the rate of unplanned readmissions for coronary atherosclerosis and other heart operations?

    Readmissions indicator Coro Ather and other heart: 116.43 explanatory text This indicator uses a control limit (displayed on the graph as a white line), which we have set at 99.8%. Data points 'falling within the control limits are said to display 'common-cause variation', which means it may be due to chance. Data points falling outside the control limits are known as 'outliers' and chance is an unlikely explanation. They are said to display 'special-cause variation' that is, factors other than chance are the cause.

    This compares this trust's rate of unplanned readmissions into hospital within 28 days of discharge against the national average.

    National average: 100.00
    Trust rate: 116.43
  • 119.99 show What is the rate of unplanned readmissions for urinary tract infections?

    Readmissions indicator Urinary Tract Infection: 119.99 explanatory text This indicator uses a control limit (displayed on the graph as a white line), which we have set at 99.8%. Data points 'falling within the control limits are said to display 'common-cause variation', which means it may be due to chance. Data points falling outside the control limits are known as 'outliers' and chance is an unlikely explanation. They are said to display 'special-cause variation' that is, factors other than chance are the cause.

    This compares this trust's rate of unplanned readmissions into hospital within 28 days of discharge against the national average.

    National average: 100.00
    Trust rate: 119.99
  • 109.86 show What is the rate of unplanned readmissions for a broken hip?

    Readmissions indicator FNOF: 109.86 explanatory text This indicator uses a control limit (displayed on the graph as a white line), which we have set at 99.8%. Data points 'falling within the control limits are said to display 'common-cause variation', which means it may be due to chance. Data points falling outside the control limits are known as 'outliers' and chance is an unlikely explanation. They are said to display 'special-cause variation' that is, factors other than chance are the cause.

    This compares this trust's rate of unplanned readmissions into hospital within 28 days of discharge against the national average.

    National average: 100.00
    Trust rate: 109.86
  • 151.54 show What is the rate of unplanned readmissions for a hip replacement?

    Readmissions indicator Hip Replacement: 151.54 explanatory text This indicator uses a control limit (displayed on the graph as a white line), which we have set at 99.8%. Data points 'falling within the control limits are said to display 'common-cause variation', which means it may be due to chance. Data points falling outside the control limits are known as 'outliers' and chance is an unlikely explanation. They are said to display 'special-cause variation' that is, factors other than chance are the cause.

    This compares this trust's rate of unplanned readmissions into hospital within 28 days of discharge against the national average.

    National average: 100.00
    Trust rate: 151.54
  • 120.08 show What is the rate of unplanned readmissions for gallbladder removal?

    Readmissions indicator Cholecystectomy: 120.08 explanatory text This indicator uses a control limit (displayed on the graph as a white line), which we have set at 99.8%. Data points 'falling within the control limits are said to display 'common-cause variation', which means it may be due to chance. Data points falling outside the control limits are known as 'outliers' and chance is an unlikely explanation. They are said to display 'special-cause variation' that is, factors other than chance are the cause.

    This compares this trust's rate of unplanned readmissions into hospital within 28 days of discharge against the national average.

    National average: 100.00
    Trust rate: 120.08
  • 82.67 show What is the rate of unplanned readmissions for hysterectomy?

    Readmissions indicator Hysterectomy: 82.67 explanatory text This indicator uses a control limit (displayed on the graph as a white line), which we have set at 99.8%. Data points 'falling within the control limits are said to display 'common-cause variation', which means it may be due to chance. Data points falling outside the control limits are known as 'outliers' and chance is an unlikely explanation. They are said to display 'special-cause variation' that is, factors other than chance are the cause.

    This compares this trust's rate of unplanned readmissions into hospital within 28 days of discharge against the national average.

    National average: 100.00
    Trust rate: 82.67
  • 0.0015 show What is the rate of patients who have a hip replacement revised?

    Hip revision rates: 1.50 explanatory text This indicator uses a control limit (displayed on the graph as a white line), which we have set at 99.8%. Data points 'falling within the control limits are said to display 'common-cause variation', which means it may be due to chance. Data points falling outside the control limits are known as 'outliers' and chance is an unlikely explanation. They are said to display 'special-cause variation' that is, factors other than chance are the cause.

    This compares this trust's rate of hip revisions and manipulations under anaesthetic that took place within one year against the national average.

    National average: 1.32
    Trust rate: 1.50
  • 0.77 show What is the rate of patients who have a knee replacement revised?

    Knee revision rates: 0.77 explanatory text This indicator uses a control limit (displayed on the graph as a white line), which we have set at 99.8%. Data points 'falling within the control limits are said to display 'common-cause variation', which means it may be due to chance. Data points falling outside the control limits are known as 'outliers' and chance is an unlikely explanation. They are said to display 'special-cause variation' that is, factors other than chance are the cause.

    This compares this trust's rate of knee revisions and manipulations under anaesthetic that took place within one year against the national average.

    National average: 0.42
    Trust rate: 0.77
  • 78.13 show What is the rate of keyhole surgery compared to open surgery for gall bladder operations?

    Laparoscopic vs open for gall bladder operations: 78.13 explanatory text This indicator uses a control limit (displayed on the graph as a white line), which we have set at 99.8%. Data points 'falling within the control limits are said to display 'common-cause variation', which means it may be due to chance. Data points falling outside the control limits are known as 'outliers' and chance is an unlikely explanation. They are said to display 'special-cause variation' that is, factors other than chance are the cause.

    This compares this trust's rate of keyhole vs open surgery compared to the national average. In most cases, keyhole is the preferred option.

    National average: 100.00
    Trust rate: 78.13
  • 106.50 show What is the rate of vaginal compared to abdominal hysterectomies?

    Hysterectomy (Abdominal vs vaginal): 106.50 explanatory text This indicator uses a control limit (displayed on the graph as a white line), which we have set at 99.8%. Data points 'falling within the control limits are said to display 'common-cause variation', which means it may be due to chance. Data points falling outside the control limits are known as 'outliers' and chance is an unlikely explanation. They are said to display 'special-cause variation' that is, factors other than chance are the cause.

    This compares this trust's rate of vaginal vs abdominal hysterectomy to the national average. In most cases, vaginal is the preferred option.

    National average: 100.00
    Trust rate: 106.50
  • 1 show Are all patients fitted with NICE-approved blood clot prevention devices post-surgery?

    Percent fitted with NICE blood clot post-surgery: 100.00%

  • 2 show How many patients are risk assessed for venous thromboembolism on admission (as recommended by NICE)?

    NICE guidance blood clots: 40.00%

    Venous thromboembolism is commonly referred to as blood clots, i.e. what percentage of patients are assessed for risk of developing blood clots?

  • 0.10 show What proportion of day-case patients end up staying longer for treatment?

    Daycase over stays: 10.00%

    Day-case patients should be able to go home at the end of the day and not spend the night in hospital.

Compare this trust

  • Exceeded expected
  • In line with expected
  • Below expected
  • Patient advice

Summary: St Helens and Knowsley Hospitals NHS Trust

You can move through the three areas of care patient safety, clinical effectiveness and patient experience by clicking on the tabs above.

Patient experience summary

We looked at a range of measures, including how equipped a hospital is to deal with us at our most vulnerable, to give an overview of patient experience in a hospital.

The trust says...

We are rated as one of the top performing Trusts in the country. Patients are our number one priority and our patient safety record is above average according to the National Patient Safety Agency. The level of patient safety and quality of care provided by the Trust is far higher than these figures illustrate.

Dr Foster's patient safety indictor illustrated as 'High' refers to reporting alerts to the National Reporting and Learning Service. Due to technical issues the Trust was unable to provide this data during the timeframe Dr Foster examined. These issues have since been resolved and according to figures published by the National Patient Safety Agency for the most recent period of October 2008 to March 2009, the Trust was performing better than the national average.

Dr Foster's indicator for 'fractured neck of femur procedure in 2 days' is also illustrated as 'High'. However the Trust achieves a higher level of care than these figures indicate and we strive to improve our care further. 'Daycase over stays' are also indicated as 'High'. The Trust cares for a large number of patients who have multifaceted underlying health problems and in many cases it is necessary to keep them in overnight. The indicator for 'palliative care team available 24/7' is 'High'. The Trust delivers this care where appropriate, but in the majority of cases, palliative care is provided, through a local hospice less than a mile away.

Reports conducted by various independent agencies outline high standards of care being delivered by the Trust. The Care Quality Commission, gave a rating of double excellent for the last two years running and we are the only Acute Trust in the country, which is not a foundation trust, to have achieved this. The Care Quality Commission rated the Trust as:

  • Excellent for the quality of services provided to patients
  • Excellent for the use of its resources

The report noted that:

  • Core standards were fully met
  • Existing commitments were fully met
  • Achieving national priorities were excellent

Our achievements include:

  • The only Trust in the North West and one of five in the country to meet each requirement of the Hygiene Code (2008)
  • The only acute Trust in Merseyside rated as Excellent in the Patient Environment Action Team (PEAT) report for every category, across both hospitals for the 4th year running (2009)
  • Numerous awards including being short-listed for Acute Healthcare Organisation of the Year in the Health Service Journal Awards (2009)
  • Maintaining one of the lowest MRSA infection rates in the country. These impressive accomplishments have been achieved whilst undertaking a £338 million PFI redevelopment of our hospitals to provide patients with the highest quality of care in world class surroundings. St Helens Hospital opened on schedule and on budget in October 2008 and Whiston Hospital is also on budget and set to open in April 2010, 6 months ahead of schedule. The Trust is committed to providing excellent patient care in world class hospitals.

Patient experience indicators

Expand each section to see how the Trust performed against the individual measures.

  • minimise Does the hospital give discharged patients a clinical staff contact number?

    National patient survey questions: 89.80

  • minimise Does the hospital communicate clearly with patients and their GPs?

    National patient survey questions: 77.70

  • minimise Does the hospital treat patients with respect and dignity?

    National patient survey questions: 9.11

  • minimise Does the hospital offer an integrated end-of-life care pathway?

    Liverpool care pathway: Yes

  • minimise Does the hospital have a specialist palliative care team available 24/7?

    Palliative care team available 24/7: No

  • minimise Does the hospital provide overnight stay facilities for relatives?

    Facilities for relatives to stay overnight: Yes

  • minimise How many operations were cancelled due to missing notes?

    Operations cancelled due to missing notes: 0

    This looks at how many operations were cancelled late in the day as the hospital could not find the patient notes. Low is good, high is bad.

  • minimise What are the waiting times for hospital-based out patient treatments?

    Outpatient waiting times for acute specialties: 21.00