City Hospitals Sunderland NHS Foundation Trust South Tyneside NHS Foundation Trust Quality Report Primary Goals: Reduce avoidable harm Achieve the best clinical outcomes Provide the best patient experience Support patients to be actively involved in their own care and treatment July data Presented in September City Hospitals Sunderland and South Tyneside NHS Foundation Trusts working in partnership
Patient Story City Hospitals Sunderland A letter was sent in by family members to thank staff on E for the care they provided to their father: My dad, who had Alzheimer s, was admitted after a fall at home. During his stay we experienced a range of emotions as we moved from dad coming home, being admitted to nursing/emi care and then end of life care in what was, we felt a very short period. However, your team were always available to provide information, support and nursing care of the highest standard, often during very busy periods/emergencies on the ward. It was also the little touches that your team provided, from staff at every level which helped our family cope during this sad time For the cups of tea provided by your domestic staff to the personal message provided to mum and dad on their wedding anniversary. On th February mum & dad celebrated their 3 rd wedding anniversary and the nurses wrote a congratulatory message on his headboard. Small acts of kindness which are above and beyond basic nursing care and which meant a huge amount to our family particularly our mum. Thank you also for making dads last few days so much easier for us. We continued to be impressed by the kindness, professionalism and compassion given to dad and his family during this very difficult period. From open visiting, gentle music playing of dads favourite songs, letting us stay overnight and allowing us to be with him while he died pain free and peacefully in his sleep, we cannot thank you enough. The patients family went on to donate a sum of. to contribute to the continued care for patients on E South Tyneside The following letter was sent in by a patient who attended Cardiology Rehabilitation: I would like you pass on my thanks to the Cardiology Rehabilitation Team. I received excellent treatment after a heart attack, and over the last years I have received brilliant follow up treatment and rehabilitation. I have found the exercise classes very beneficial and also the chance to meet and talk to staff and fellow patients who caringly understand my situation. The professionalism and care from the Cardiology Team have kept me ALIVE, I am grateful as this has given me quality time with my friends and family, it has also allowed me to lead an active life. We have just had a wonderful celebration from the hospital to celebrate years of the rehabilitation services. I would be grateful if you could pass on my thanks to the Cardiology Team, hospital mangers and the Chief Executive. The idea for the group came from coronary care sister Dorothy Pearson who saw it as a good way to encourage patients to carry on with exercise following their cardiac rehabilitation programme.
% of patients in the survey with a new PU Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan-9 Feb-9 Mar-9 % of patients in the survey with a new PU Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan-9 Feb-9 Mar-9 Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan-9 Feb-9 Mar-9 Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan-9 Feb-9 Mar-9 Rate per, bed days Rate per, bed days Patient Safety Reduce incidence of Category to pressure ulcers developed in our care (by %) City Hospitals Sunderland Total PUs // to 3/3/ Total PUs July South Tyneside Total PUs // to 3/3/ Total number of category : 9 89 Total number of category : 8 3 Total number of category 3: 3 Total number of category 3: 3 (*) 3 (*) Total number of category : Total number of category : * * Total number: 9 9 Total number: 8 Rate per, bed days:.3 -.3 Rate per, bed days: 3. (Aug -Jan ) - 3. * Awaiting review at PURP Total PUs July CHSFT Pressure ulcers (incidence) April to July with improvement trajectory up to March 9 STFT Acute Pressure ulcers (incidence) April to July with improvement trajectory up to March 9. Improvement target re-based due to validation of / data collection methodology Data collection methodology changed Improvement target re-based due to validation of / data collection methodology. 3. CHSFT Total PU per, bed days CHSFT Target - PU rate per, bed days STFT Total PU per, bed days STFT Target - PU rate per, bed days Safety Thermometer Results (prevalence) - CHSFT new pressure ulcers April to July Safety Thermometer Results (prevalence) - STFT (combined) new pressure ulcers April to July 3 3 CHSFT National figure STFT (combined) National figure 3
% of patients in the survey who had a fall with harm (within hours of the survey) Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan-9 Feb-9 Mar-9 % of patients in the survey who had a fall with harm (within hours of the survey) Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan-9 Feb-9 Mar-9 Rate per, CCG population Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan-9 Feb-9 Mar-9 Rate per, CCG population Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan-9 Feb-9 Mar-9 Sunderland Community Total PUs // to 3/3/ Total PUs July South Tyneside Community Total PUs // to 3/3/ Total number of category : 8 Total number of category : Total number of category 3: 9 3 Total number of category 3: Total number of category : Total number of category : Total number: 9 8 Total number: Rate per, CCG population: - -. Rate per, CCG population: - -. Total PUs July Sunderland Community pressure ulcers April to July with improvement trajectory up to March 9 Data collection methodology changed.. South Tyneside Community pressure ulcers April to July with improvement trajectory up to March 9 Data collection methodology changed Sunderland Community Total PU per, CCG Sunderland Community Target rate per, CCG South Tyneside Community Total PU per, CCG South Tyneside Community Target Rate PU per, CCG Reduce incidence of severe harm from patient falls (to be in the lower quartile of reporting Trusts nationally) Severity of injury CHSFT Falls - (from Sept ) CHSFT Falls July STFT Falls - STFT Falls July No harm 8 9 8 Low harm 33 3 99 Moderate harm (number resulting in fractures) (3) () () () () Severe harm (number resulting in fractures) () () () () Death Total falls Rate/, bed days -.98-33 8. National falls - -.3 - -.3 Rate/, bed days Total with moderate/severe harm or death Rate/, bed days -. -. National rate for falls with moderate/ severe harm or death - Rate/, bed days - -.9 - - Note: Charts show % of patients in the Safety Thermometer Survey who had a fall with harm (within hours of the survey).9.8....8... Safety Thermometer Results - CHSFT falls with harm April to July CHSFT National figure Safety Thermometer Results - STFT (combined) for falls with harm April to July STFT (combined) National figure
Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan-9 Feb-9 Mar-9 Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan-9 Feb-9 Mar-9 Infection control CHSFT MRSA CHSFT MRSA STFT MRSA STFT MRSA MRSA (targets for avoidable cases as // to 3/3/ July // to 3/3/ July stated) (Annual target ) (Annual target ) (Annual target ) (Annual target ) Number of hospital acquired cases: 3 CHSFT MSSA CHSFT MSSA STFT MSSA STFT MSSA MSSA (no national target) // to 3/3/ July // to 3/3/ July Number of hospital acquired cases: 9 3 9 CHSFT E Coli CHSFT E Coli STFT E Coli STFT E Coli E Coli (target % reduction) // to 3/3/ July // to 3/3/ July (Annual target 3) (Annual target ) (Annual target ) (Annual target 3) Number of hospital acquired cases: CHSFT C Diff CHSFT C Diff STFT C Diff STFT C Diff C Diff (targets as stated) // to 3/3/ July // to 3/3/ July (Annual target 3) (Annual target 33) (Annual target 8) (Annual target ) Number of Trust apportioned cases: Number of cases awaiting appeal: - - Hand Hygiene (target >98%).% 98.% 9.% 9.% 9.% 9.% CHSFT Total Hand Hygiene % April to July.% 98.% 9.% 9.% 9.% 9.% STFT Total Hand Hygiene % April to July CHSFT Total Hand Hygiene STFT Total Hand Hygiene STFT Hand Hygiene (Exception Report)
Number of formal complaints Number of formal complaints Number of formal complaints Number of formal complaints Patient Experience Complaints City Hospitals Sunderland There were 38 complaints received in July and no new cases from the PHSO. Clinical treatment is again the highest category. South Tyneside There were eight complaints received in July and one new case received from the PHSO. The majority of complaints related to communication. 8 9 CHSFT Formal complaints by category - July 3 3 8 STFT Formal complaints by category - July Communications Patient Care Clinical Treatment Values And Behaviours (Staff) In July there were nine complaints at CHS which took > days to complete and which have taken > days to complete. Cases are complex and involve multi-agencies or Coroner s review. In July there were two complaints at STFT which took > days to complete and three which took > days. The reasons include complexity of the complaint ranging over a number of services, multi-organisational complaints that require a co-ordinated response and the completion of a serious investigation. Six local resolution meetings have been held with complainants in order to resolve ongoing concerns. CHSFT current formal complaints awaiting first response by working days - May to July STFT current formal complaints awaiting first response by working days - May to July 9 9 to days to days + days 3 3 3 to days to days + days May- Jun- Jul- May Jun July
Dementia screening % of all patients aged and above admitted as emergency inpatients, with length of stay > hours, who are asked the dementia case finding question within hours of admission, or who have a clinical diagnosis of delirium on initial assessment or known diagnosis of dementia, excluding those for whom the case finding question cannot be completed for clinical reasons. % of all patients aged and above admitted as emergency inpatients, with length of stay > hours, who have scored positively on the case finding question, or who have a clinical diagnosis of delirium, reported as having had a dementia diagnostic assessment including investigations. % of all patients aged and above admitted as emergency inpatients, with length of stay > hours, who have had a diagnostic assessment (in whom the outcome is either positive or inconclusive ) who are referred for further diagnostic advice in line with local pathways. CHSFT CHSFT STFT STFT // to July // to July 3/3/ 3/3/ 99.8% 99.% 99.%.% 8.93% 9.8% %.% %.9%.8%.% 99.% 9.% 9.% 9.%.9%.% There have been ongoing challenges with dementia screening at South Tyneside, with a small working group who are currently looking into this and how improvements can be made. The group has ascertained that key issues such as screening on admission is not always completed on EAU and the base wards are poor at following this up; data collection is retrospective and often notes are not available; and the percentage numbers are low because the denominator from the initial screening is low. Actions to address these issues include progressing the clinical pathway for data collection, the roll out of the new nursing and medical documentation to improve screening compliance and increased communication of the need to improve screening compliance. Mixed sex breaches CHSFT // to 3/3/ CHSFT July STFT // to 3/3/ STFT July Mixed sex breaches Patient safety walkrounds There was one Patient Safety Walkround held in July. The area visited was B at Sunderland Royal Hospital. The Walkround was attended by one Non-Executive Director (NED), one Executive Director, one Senior Nurse and one Divisional General Manager. Good areas of practice identified were that the ward had implemented and sustained snack rounds with fortified drinks and high calorific snacks for patients. This is now replicated on some wards across the Trust. The issues of concern raised were: The ward temperature was 3⁰C. This is very uncomfortable for patients and staff. The ward keeps lights switched off and leaves windows open wherever possible. An enquiry was made to Estates about the possibility of air conditioning units for the ward, however, these would need to be hired in and there was no space available to house them. There were ongoing issue with laptops. The ward has seven laptops available for use and two are frequently in need of repair and are taken away from the department. Three are used for ward rounds and sometimes there are two ward rounds running simultaneously. It is now becoming increasingly difficult for all staff to access a laptop to document patient records timely.
Clinical Effectiveness Participation in national clinical audits National Emergency Laparotomy Audit The National Emergency Laparotomy Audit (NELA) aims to improve the quality of care for patients undergoing emergency laparotomy (exploratory opening of the abdomen). City Hospitals and South Tyneside have taken part in the audit since it was commissioned years ago. The latest Hospital Level Achievement Key Processes of Care data set has been published by NELA for Year 3 (December - 3 November ). The table below summarises key performance indicators across North East Trusts. Hospital size: =smallest quartile, =largest. In summary, most performance indicators are in the green for both Trusts. Mortality is slightly above the national average (CHS.%, ST.% v.% national average) although this has improved year on year since the start of the audit. For CHS, unplanned returns to theatres are high (% V 8.3%). Work has already been done to understand this outcome. It may be less of a problem now as NELA has amended the question which now differentiates between unplanned and planned returns to theatre. The audit shows that nationally the involvement of elderly medicine specialists in patients over is poor. Learning from other local Trusts is being considered in order that this can be improved. 8
Patient Reported Outcome Measures (PROMS) Update Trust participation in the national PROMS programme is mandatory and forms part of the NHS standard contract. Following the decision by NHS England to formally discontinue the varicose vein and groin-hernia surgery collections, this update is limited to the two remaining joint replacement procedures. Information has been extracted from the PROMs data file April to March (provisional) published by NHS Digital in June, which is the latest release. The procedure-specific Oxford Scores for hip and knee replacement have been used in the report rather than the generic measures, i.e. EQ-D, in view that they are proven to be more accurate in determining health gain status. Summarised below is the performance for City Hospitals and South Tyneside: Primary hip replacement 9.3% of patients at City Hospital s reported improved health gain status with only 3 patients reporting worse outcomes. For South Tyneside, 9.3% of patients reported improved outcomes and patients said their health status was worse. Note that a larger numbers of cases are undertaken at City Hospitals. Primary knee replacement very similar health gain profile to the England average. For CHS, 93.8% reported improved and ST 9.%. 9
Antimicrobial Audit (South Tyneside only) At South Tyneside, an audit of medicines charts is carried out each week on the wards to monitor compliance with the antimicrobial guidelines as well as the completion of the hour review. The audit monitors whether the sections have been completed on the medicine charts. The results for Q -9 can be found below: % 8% 9% Audit of IV Antimicrobial Prescribing -9 9% 9% % 8% Audit of IV Antimicrobial Prescribing -9 hr Review Results by Ward 8% % % % % Allergy Documented % Indication Allergy Documented Compliant with Guidelines Switch or plan % Compliant with Guidelines 8% % hr Review Switch or plan % Duration Indication hr Review Duration 8% % % % % 38% 3% % % Ward Ward 3 Ward Ward Ward Ward Ward 9 Ward SCIP 8% 3% Q -9 Q -9 Q3-9 Q -9 39% CQUIN Part d This consists of 3 elements the overall reduction of DDD usage per, admissions, the reduction of Carbapenem usage per, admissions and increasing the proportion of AWaRe category antibiotics used to %. Measure -9 Target -9 Forecast CQUIN achievement Q -9 Reduction in antibiotic consumption per, admissions 9 Yes Reduction in carbapenem per, admissions 3 8 Yes Increase in proportion of antibiotic usage within AWaRe category (the Access, Watch and Reserve antibiotic categories assist antimicrobial stewardship and reduce antimicrobial resistance) % 9% No
Total number of referrals Total number o referrals Key Enablers Culture of safety Safeguarding City Hospitals Sunderland Children Of the, ( ) patients attending AED, PED and SEI, ( ) (.%) ( ) resulted in a referral. Of the 8 ( ) pregnancy bookings (%) ( ) resulted in a referral. One further concealed pregnancy has been reported, taking the total to in past four months. Together for Children have received the final OFSTED report. Key areas impacting on CHSFT and STFT are referrals and the function of the Integrated Contact and Referral Team (ICRT) in managing the volume of referrals and thresholds being too high. The team are working in partnership to review the thresholds document. Area Judgement Judgement. Children in need of help and protection Inadequate Inadequate. Children Looked After and achieving permanence Inadequate Requires improvement. Adoption performance Inadequate Good. Experience and progress of care leavers Inadequate Requires improvement 3. Leadership management and governance Inadequate Inadequate Children s services in Sunderland are inadequate South Tyneside Children Of the, ( ) patients attending AED and PED, ( ) (.8%) ( ) resulted in a referral. Of the 3 ( ) maternity bookings 8 (.93%) ( ) resulted in a referral. A further decline in the number of community based referrals can be attributed to the loss of the -9 services. Still awaiting report from Royal College of Child Health and Paediatrics (RCCHP). CHSFT Safeguarding children referrals August to July STFT Safeguarding children referrals August to July 8 3 3 9 38 3 3 3 38 3 9 9 9 8 8 9 9 3 3 3 8 8 9 39 9 9 3 3 9 3 8 8 9 9 Paediatric ED Adult ED Maternity Other Paediatric ED Adult ED Maternity Other Total community
Number of Looked After Children Number of children Number of Child Protection Medicals City Hospitals Sunderland and South Tyneside The Main themes for STFT and CHSFT Maternity referrals continue to be domestic abuse, parental mental health, maternal substance misuse, previous involvement with Childrens Services. The new emerging theme for CHSFT continues to be concealment of pregnancy. Concerns around Human Trafficking and Modern Day Slavery resulted in two referrals. There were two reported FGM cases. The main themes for all children s referrals across STFT and CHSFT acute settings were due to parental alcohol, substance and mental health issues (Compromised Parenting) and adolescents presenting with mental health concerns including self-harm and overdose. The new emerging theme continues to be the use of Class A drugs in adolescents within CHSFT. There were three further non-accidental injuries in CHSFT making a total of in the past three months. STFT had one non accidental injury making a total of seven in the past three months. STFT child protection medicals continue to be completed in CHSFT until the RCPCH report is received on the 3 August. The numbers of children on a Child Protection or Looked After plan have increased in Sunderland TfC which can be related to the OFSTED report. The STFT have reduced with no identifiable factor. Number of Child Protection Medicals CHSFT & STFT January to July 3 3 3 9 3 3 3 3 Jan- Feb- Mar- Apr- May- Jun- Jul- Child Protection Medicals CHSFT Child Protection Medicals STFT Number of Looked After Children June and July Number of children subject to a Local Authority Child Protection Plan June and July 3 Jun- Jul- 8 Jun- Jul- South Tyneside Sunderland South Tyneside Sunderland
Number of DoLS applications Number of DoLS applications Number of adult safeguarding referrals Number of adult safeguarding referrals City Hospitals Sunderland Adults Of the,93 ( ) patients attending AED and SEI, (.%) ( ) resulted in a referral. South Tyneside Adults Of the, ( ) patients attending AED, (.%) resulted in a referral. City Hospitals Sunderland and South Tyneside The themes for all referrals were due to neglect, self-neglect, domestic abuse, organisational, physical abuse, emotional abuse, financial and sexual abuse. CHSFT Adult safeguarding referrals received August to July STFT Adult safeguarding referrals received August to July 3 3 3 8 9 8 3 3 9 9 3 8 3 3 39 3 38 38 3 8 8 9 9 9 8 3 3 3 CHSFT acute referrals (Emergency Department) CHSFT other referrals (ward areas and AHPs) STFT acute referrals (Emergency Department) STFT community referrals STFT acute referrals (wards areas AHPs) DoLS Of the 9,( ) inpatients,.8%( ) applications were completed. The withdrawal of applications has increased demonstrating robust oversight of the applications. (Note: The numbers of withdrawn applications from January to June have increased significantly from the previous report. This is due to a reporting error.) Number of DoLS applications made August to July DoLS Of the,33( ) inpatients,. %( ) applications were completed. Number of DoLS applications made August to July 39 3 38 3 8 8 8 83 33 8 9 3 3 3 3 3 39 3 9 3 9 9 3 3 CHSFT total number of DoLS applications DoLS withdrawn Total number of DoLS applications DoLS withdrawn DoLS awaiting Best Interest Assessment DoLS awaiting Best Interest Assessment 3
Number of incidents reported Number of incidents reported City Hospitals Sunderland Incident reporting South Tyneside Incident reporting CHSFT Number of incidents reported August to July STFT Number of incidents reported August to July 8 8 Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- CHSFT Incidents reported Linear (CHSFT Incidents reported) STFT incidents reported Linear (STFT incidents reported) CHSFT Incidents reported by severity August to July STFT Incidents reported by severity August to July Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Near miss 33 3 9 9 3 Near miss 38 3 9 9 8 No harm 3 3 8 9 88 3 8 9 No harm 9 3 3 9 9 3 388 Minor harm 8 39 33 8 9 388 39 3 33 38 Minor harm 9 9 3 9 88 8 Moderate harm 3 3 33 3 3 Moderate harm 3 8 9 9 9 Major harm 3 3 3 Major harm 3 Extreme harm 3 3 Extreme harm Total 9 3 38 Total 8 8 8 8 3 83 93 9 9 Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul
Number of SIs reported Number of SIs reported Duty of Candour Three Incidents required Duty of Candour in July. In two cases all requirements were met; the third case was raised via a complaint and therefore the initial notification phase was dealt with via the complaints process. Serious Incidents (SIs) Duty of Candour There was one incident requiring Duty of Candour in July where all requirements were met. Serious Incidents (SIs) CHSFT SIs reported to StEIS August to July STFT SIs reported to StEIS August to July 3 3 Patient admitted with stroke and thombolysed. Patient reviewed on // for lower limb discolouration and diagnosed with possible DVT. Description was of ischaemic limb but was misdiagnosed as DVT. Patient referred to vascular for review. Required above knee amputation. Fetal bradycardia, delivery expedited with forceps. Baby born in poor condition and transferred to NICU. Therapeutically cooled. Fall with fracture Never Events No Never Events were reported in July. Never Events No Never Events were reported in July.
Spend Number of Wards Recruitment and retention of nursing staff and allied health professionals City Hospitals Sunderland Nursing During the month of July, three escalation beds open on D and three on D for part of month. In July the total absences for RNs was.8%, which is an increase from June (9.%). The table below shows a breakdown of this data and shows the RN starters and leavers in July. May June July Maternity leave 3.3% 3.% 3.3% Sickness 3.%.% 3.% RN vacancies 3.% 3.%*.% Available RNs 89.93% 9.8% 8.% Starters 3 Leavers 8 *Vacancy percentage for RNs is at.%, however, there is an additional.9% of RNs that are currently going through pre-employment checks. It should be noted that the significant increase in vacancies is because month budget information was used rather than submitted RAFs as it is becoming apparent that the RAF process is not timely, the budgets also included uplifts that had been agreed for IAU and ED. By comparison RN turnover for July was.%. There were 9 incident forms submitted in July relating to nursing and midwifery staffing, an increase from June (). There were seven incidents forms submitted by wards when RN staffing was below minimum numbers, an increase from June (), with Medicine and Surgery submitting three each of these. They were attributed due to staff sickness and staff being moved to support other wards where numbers of RNs are below. CHSFT Spending on Nursing Agency, NHS Professionals and Overtime July - July,, 3,,, - Jul- Aug- Sep-Oct- Nov- Dec-Jan- Feb- Mar- Apr- May- Jun- Jul- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Overtime - - - - - - 9,38,99,9 8,9 3,833,9 8,3 NHS Professionals 3, 3,3 3,8 9,9,933 3,3 3,83 33, 3,3 33,, 338,8 3,89. Agency Nursing,,,8,8,88-9 3,98 - - - - 8 CHSFT Nurse to patient ratios showing 3 month trend May to July Exceed :8 Exceed : Exceed :8 Exceed : Exceed :8 Exceed : May June July Theatres Family Care Surgery 3 Medicine 9 8 8 8 8
Spend Allied Health professionals The table below shows a breakdown of AHP vacancies, absences and turnover for July. Note - ODPs are included in the sickness and maternity leave below, however, they are not included the AHP vacancies, as they are included in the Theatre vacancies within nursing. July Maternity leave.% Sickness.93% AHP vacancies % Starters Leavers There was no AHP staffing incidents submitted in July. CHS spending on AHP Agency and Overtime July 8,,,, - Jul- Jul- Overtime 8, Agency AHP, South Tyneside During the month of July, there were no escalation beds open. In July the total absences for RNs was 3.9% (Acute) a decrease from June (.9%); and.% (Community) a decrease from June (3.%). This should be interpreted with caution as the data is based on financial data, not real time HR data, and the actual position may be slightly worse. The table below shows a breakdown of this data and shows the RN starters and leavers in July. May June July Acute Community Acute Community Acute Community Maternity leave.% 3.8%.8% 3.8%.39% 3.% Sickness.3%.%.%.%.%.% RN vacancies.38%.%.9%.83%.%.% Available RNs 8.% 8.9% 8.% 8.3% 8.9% 93.8% Starters 3 Leavers 3 9 *Vacancy percentage for RNs is at.%, however, there is an additional.% of RNs that are currently going through pre-employment checks.
Spend Spend Number of wards There were 93 safe care/incident forms submitted in July relating to nursing and midwifery staffing, a slight decrease from June (9). There was one incident form submitted by paediatric ED when RN staffing was below minimum numbers. STFT Spending on Nursing Agency, NHS Professionals and overtime - October to July, 3,,, - Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Overtime - - - 3,,8,8,38 3,38,8,8 NHS Professionals -, 3,99,3 8,8, 9,3 8,,9,89 Agency Nursing,9,9, 9, 9,9 8, 83,89,98,9,9 STFT - Nurse to patient ratios showing 3 month trend April to July 3 Exceed :8 Exceed : Exceed :8 Exceed : Exceed :8 May June July Surgical Specialities & Maternity Medicine & COTE 3 3 Acute & Urgent Care Exceed : Allied Health Professionals The table below shows a breakdown of AHP vacancies and absences and turnover for July. July Acute Community Maternity leave.9% 3.3% Sickness.9%.% AHP vacancies 9.9%.9% Starters Leavers 3 There were no incident forms submitted in July relating to AHP staffing. STFT spending on AHP Agency and Overtime July,,,, - Jul- Jul- Agency AHP 9,3 Overtime 3,
HEENE National Rankings by Trust 9
Frequency of Reporting Matrix Section Priority Workstream Frequency Patient Story Patient Safety Reduce incidence of Category to pressure ulcers developed in our care Monthly Reduce incidence of severe harm from patient falls Monthly Improve the recognition and management of deteriorating patients Accurate and timely recording of Early Warning Scores Reduction in the number of preventable cardiac arrests Ensuring high-quality timely communication, decision-making and recording in relation to decisions about Cardio Pulmonary Resuscitation Achieve 9% compliance with Nutritional Screening Achieve 9% compliance with recording of fluid input Improve medicines management Infection control Monthly Monthly Monthly from July Annually monthly Monthly from July Monthly from June Quarterly Patient Experience Complaints Monthly Learn from patient feedback Quarterly Patient Led Assessment of the Care Environment (PLACE) results Annually Ensure that patients are involved as much as they want to be in decisions about their care and treatment Quarterly Ensure that patients receive adequate information and support for safe discharge from hospital Quarterly Ensure that patients receive patient centred care based on their needs and preferences Quarterly Dementia screening Monthly Mixed sex breaches Monthly Clinical Effectiveness Implementation of recommendations from the National Maternity Strategy Quarterly Improve the outcomes of patients with serious infection Quarterly Implementing recommendations from the Getting it Right First Time programme monthly Participation in national and local clinical audits As published Learning on review of patient deaths Quarterly day services ( priority clinical standards) monthly Key Enablers Culture of safety Safeguarding children Safeguarding adults DoLS Incidents (including mixed sex breaches) WHO checklist Safe nurse staffing Monthly Monthly Monthly Monthly monthly Monthly