122 people at Southmead Hospital were left on trolleys in corridors for more than 12 hours during December. We aim to be an anti-discriminatory organization and are committed to building a team that represents a variety of backgrounds,. _lvO%x(3yH;< 6={' !)|; W^[}' Staff then referred the young person to their local team for on-going work once the crisis had passed. 466 0 obj <>stream Any guidance issued needs to be clear that they are referring to biological sex and it needs to be followed up by legislation which cannot be ignored by NHS trusts.. Not all areas were following best practice and we were not assured the trust had full oversight of cleaning regimes in some areas. This is the South West version of the Department of Health Your Welcome standards. In all areas of end of life care we visited, we saw that staff were truly person centred. Overall we saw improvements had been made at this hospital, although the rating remained requires improvement. Staff were reaching out to promote the use of the unit and natural births not excluding woman who traditionally may have not been thought suitable to have their birth in a midwifery led unit. We aim to be an anti . The trust's treatments and advances in care have won national and international recognition. Accessibility tools. Leaders understood and managed the priorities and issues the service faced. The shift to staff health and wellbeing being considered as important as patients health and wellbeing put NBT in a good place to look after its staff during the response to COVID-19. We saw good evidence of collaborative working across the system. This was particularly strong in the maternity services at Cossham and the community services for children and young people. Tier 3 CAMHS were provided by a wide range of professionals, were effective and there was evidence of mutually supportive, multidisciplinary working across all of the CAMHS teams. Financial pressures were managed so that they did not compromise the quality of care. CCHP started the central intake team (CIT) to manage the risk of service users new to the service and subject to urgent referrals. [8][9] The first patients moved into the new Brunel building at Southmead in May 2014.[10]. Medical teaching facilities are provided in association with the University of the West of England, Bristol University, and the University of Bath. Leaders and staff actively engaged with patients, staff, the public and local organisations to manage services. Staff treated patients with compassion and kindness and took account of their individual needs. There were significant improvements within safety in urgent and emergency care services, with patients now receiving timely assessment on arrival. Requires improvement We saw evidence that partnership working was routinely included in every aspect of their work. We rated it as good because: Caring and Well led at core service level were rated outstanding. A new employee assistance programme was instigated, giving staff access to free financial and legal support, relationship advice and counselling 24/7. The reality is that any male can self-identify onto a womens ward, including in mental health settings, which the NHS will still insist is single sex. All services provided were caring. Safe improved to good. The leadership of the trust was knowledgeable about quality issues and priorities, understood the challenges are and took action to address them. It comes as the Government is poised to rewrite equality law to protect women by making it easier to bar trans people from single-sex spaces such as wards. 7 Appendix A: North Bristol NHS Trust today 24 8 Appendix B: The challenges we face 30. If this service has not had a CQC inspection since it registered with us, our judgement may be based on our assessment of declarations and evidence supplied by the service. It was clear that many of the pressures could be resolved by minimising delays in patient care. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. North Bristol NHS Trust is an acute trust located in Bristol that provides acute hospital and community services to a population of about 900,000 people in Bristol, South Gloucestershire and North Somerset. The CCHP worked in partnership with other agencies such as the local authority, education and Barnardos. They reviewed patients medications, wrote them up on the medication chart and gave advice to patients about their medication (what needed to be stopped prior to admission). All staff were committed to continually learning and improving services. One patient had their operation cancelled on the day of operation for the second time. Patients were treated dignity and respect and the leadership, governance and culture promote the delivery of high-quality person-centred care. We rated it as requires improvement because: Published A&E was transferred on 19 May 2014. In the past, we summarised themes from the visits and published an annual statement followed by the provider's response where applicable. This was not optimal for patient social and psychological wellbeing. CQC Overall Rating North Bristol NHS Trust CQC overall rating Staff, teams and services worked well together to deliver effective care and treatment. On health and wellbeing, it moved from well below average to . The 2018 staff engagement survey, conducted in November, also showed an increase in staff engagement from 6.8 to 6.9. There was more to do to ensure staff felt equality and diversity were promoted in their day to day work and when looking at opportunities for career progression. Although the trust was meeting its target for the number of staff receiving safeguarding training there were large variations in compliance with this. There was a large focus on celebrating success every day, which in turn helped staff to feel pride in their achievements. [28] The Wellbeing Programme is funded by their charity, Southmead Hospital Charity, and is made up of a range of physical, psychological and lifestyle support. This includes bespoke rotations, wellbeing support, personalised travel plans, and a structured preceptorship. v1c[4/z#u-. We rated the overall effectiveness of services in the hospital as requires improvement. The trust performed worse than the England average for most national targets, this included the Admitted Adjusted Referral to Treatment time (where the time from referral to treatment should be less than 18 weeks). [1] The trust was also rated outstanding for well-led. Lord Blencathra told the Telegraph: The response from Lord Markham is 100 miles away from the replies that we were receiving from the Department of Health on these issues a year ago and shows that ministers are moving in the direction of offering proper protection to biological women. This is what started to create a shift in attitudes. NBT saw a demand increase of 12.2 per cent, with bed occupancy regularly running at 102 per cent, meaning patients waiting in corridors. We rated the responsive domain as inadequate. We are the regional Major Trauma Centre, and an internationally recognised centre of excellence in a range of services and major specialities. Nine patients were unable to have their operation rebooked with 28 days. The young person and their carer received contact information for the C.I.T. team and the Samaritans should they enter crisis again before their follow up appointment. Published for current vacancies in Bristol and Weston, then why not join us? Developed with staff, these values go to the heart of our organisation and are our guiding principles. We use our system of intelligent monitoring of indicators to direct our resources to where they are most needed. Your staff have the answers. NBT engaged professional services firm PWC to help develop an approach to improving patient flow, using a staff coaching and empowerment methodology called Perform. This was a significant event with the majority of services moving from the 'old' Southmead and Frenchay Hospitals into this newbuilding. This includes ensuring that patients are cared for in the most appropriate place and are supported to leave hospital when they are ready to do so. improve compliance with hand washing and ensure that all staff are bare below the elbows in clinical areas. The maternity service at Cossham Hospital was meeting the needs of each individual woman who attended, services were flexible and choices offered. Infection control processes were not always followed. Find out more, Lord Markham, the health minister, said that the NHS is reviewing its current guidance on delivering same-sex accommodation, Donald Trump celebrates his family roots on visit to Scotland, One in four children suffered greater anxiety and depression during pandemic, Labour accused of plotting widows tax by scrapping single person council tax discount, Ant and Dec among congregation at Westminster Abbey for King Charles's Coronation, Fierce clashes erupt as France faces largest May Day protests in 30 years, Russia disrupts Ukrainian counter-offensive with ammunition depot strike, transgender NHS staff to treat patients based on their gender identity, patients privacy and dignity is respected, Concerns have also been raised about the NHS England policy, reviewing its current guidance on delivering same-sex accommodation, guidance on the importance of same-sex care, NHS is increasingly compromised by an ideology, NHS policies allow transgender people to be included. Staff were supported by their team colleagues and peers, and had access to regular clinical supervision, training and continuing professional development opportunities. Your information helps us decide when, where and what to inspect. Staff in the pre-operative assessment clinic were able to assess patients cognition and report back to GPs if it was below expected levels. [22] Southmead Hospital is host to regular engagement days and study days. The trust board had the appropriate range of skills, knowledge, integrity and experience to perform its role and were dedicated to delivering high quality patient centred care. In the community services for children and young people such working was excellent, with work with Barnardos Child Sexual Exploitation (BASE) project which focused on young people who were at risk of exploitation being recognised nationally as an area of outstanding practice. there are some services which we cant rate, while some might be under appeal from the provider. increased staffing in ED, including mental health, community teams and GP support. take action, with others as needed, to improve the flow of patients into, through and from the hospital. Governance arrangements were in place, with clear lines of reporting from clinical hubs through to the trust board. "It will mean our community can access the care they need closer to home," Mr Hall said. It may be difficult for new staff or those unfamiliar with individual children and young people to identify what care and treatment had been agreed or should be provided. Suspended ratings are being reviewed by us and will be published soon. Et [13] Of the other services four were rated as good and the remaining seven as requiring improvement. North Bristol NHS Trust owns the hospital but the adjacent health centre is owned by NHS Property Services. Ensure patient information remains confidential through appropriate storage of records in the outpatient clinics and theatre departments to prevent unauthorised people from having access to them. Patients felt involved in their care. In the 2019 staff survey, NBT improved its wellbeing score from 5.7 to 5.9 and staff engagement from 6.9 to 7.1. Patients with dementia received care and treatment that was sympathetic and knowledgeable. Staff were well trained and competent. This was an improvement from 5.6 and 6.8 respectively in 2017. Improvements were need in safety, effectiveness, responsiveness and leadership. The trust employs over 8,000 staff delivering healthcare across Southmead Hospital, Cossham Hospital, and the Bristol Centre for Enablement, as well as the local communities. We recognise the person, and treat each one with dignity and respect. Although bed occupancy remained high within maternity services (excluding the central delivery suite) this had improved flow within the service. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. There were long waiting times, delays and cancellations ongoing. These replace any issued under embargo or published on this website prior to this time. . We rated urgent and emergency services as good overall. endstream endobj 409 0 obj <>stream People were truly respected and valued as individuals and staff were highly attentive to patients individual needs. There was a big improvement in the willingness of staff to recommend North Bristol as a place to work, rising from 59 to 69 per cent. By respecting our differences inside our common humanity, regardless of race, colour, religion or sexual orientation, we will build a fairer organisation, where everyone can thrive. There was a high level of delayed transfers of care which was frequently above 100 patients per day and at the time of the inspection was 114.However, there had been significant work undertaken since the inspection in November 2014 to facilitate patient discharges. Relationships with commissioners had improved and matured. The concourse, known as the 'atrium', is naturally lit and ventilated and provides cafes, winter gardens and artwork. Admissions to the unit were appropriate and there was a system in place to triage referrals. At least one standard in this area was not being met when we inspected the service and Leaders had the integrity, skills and abilities to run the service. There have been several unsuccessful attempts to upgrade the facilities over the past 30 . There are over 8,000 reasons why North Bristol NHS Trust is a place to be #NBTProud of. A variety of swift programmes have been instigated and accessed by staff during the response phase, and staff have taken the initiative to put support in place for themselves and their teams, including reallocating unused rooms for wellbeing spaces and starting yoga sessions before the start of shifts. ensure that the privacy and dignity of patients in the Brunel building is maintained. %%EOF In addition, the lack of individual risk assessments and clearly documented care plans had the potential to put children and young people at risk of receiving unsafe or inappropriate care and treatment. This was an improvement from our last inspection in 2018. The systems in place to monitor the completion of mandatory training were not effective. [18] It spent 20.8M, 7.1% of its total turnover, on agency staff in 20142015. Staff at all levels were very committed to providing good patient care and frustrated when they felt they could not achieve this. Safeguarding procedures were in place with clear lines of reporting. On staff engagement there was an improvement in questions on staff feeling their feedback was acted on. ensuring that the organisation's values are brought to life in everyday behaviour. The national target time was not being met for the 18 week pathway for referral to treatment waiting times for outpatient services. The impact of the programme included releasing 50 beds, reducing length of stay by 13 per cent and enabling a 10.2 per cent increase in the four-hour performance. Bristol, The vision and values within the trust were clearly articulated by staff and board members alike. Bedrooms have large areas of unobstructed glazing and are naturally ventilated, providing the patient with control of their own environment. The BBC is not responsible for the content of external sites. Although there was a trust wide focus on patient flow within the hospital and improvements had been made this still required improvement. The minister said that the NHS is reviewing its current guidance on delivering same-sex accommodation. There was clear visibility of risks at board level. The trust had a deficit of 20.1million at the end of August, 6.7M worse than planned. The trust needed to maintain focus on culture, particularly in maternity, facilities management and the BME population and continue to promote freedom to speak up. The Community Childrens Health Partnership (CCHP) had systems in place for incident recording, investigating and monitoring. Building wellbeing into the normal working day has also helped staff understand that they are not only able to look after their own wellbeing, they are expected to. With staff health and wellbeing so firmly embedded into its culture it has been easy to make swift changes to support its teams. They deployed patient flow transformation discharge teams to help staff at all levels. The volunteers proved useful, so it was decided to keep them on indefinitely. Records within the service were in paper format, sometimes disorganised, and it was difficult to find information within them. Lord Markham, a health minister, has said that the Government is considering whether clearer guidance is needed on the provision of same-sex staffing for patients receiving intimate care, given the importance of ensuring that patients privacy and dignity is respected. Mortality rates were significantly lower than expected when compared with other hospital trusts, as measured by the Hospital Standardised Mortality Ratio and the Summary Hospital-level Mortality Indicator. reduce the number of operations cancelled. North Bristol NHS Trust values all people as individuals. Staff were clear about the processes they should follow to risk assess patients and respond to those who may deteriorate. The environment at Monk Park House was not clean and young people had access to hazardous cleaning products and knives. They are at the very heart of all that we do, and should inform every action we take and every decision we make. This was because the environments for patients were not always safe, especially during times of escalation when patients were accommodated in inappropriate areas on wards and in the interventional radiology department. We were not assured that the care provided was always as safe as it could be. Improvements were made to the quality of care as a result of complaints and concerns. . However, improvement was required in patient outcomes as they were below the England average in many areas. Published Most staff felt a connection to the CCHP and saw the benefits for effective service delivery. Two themes emerged: workload, and staff health and wellbeing. The letter also suggested that the trust does not require clinicians to disclose their sex. The vision and values within the trust were clearly articulated by staff and board members alike.
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