We are pleased that the CQC found improvement when its inspectors visited ROH earlier this year. We were open and honest with the inspectors about the challenges we have, and the work we are doing to strengthen care for patients. We are pleased that the hard work we have put in so far has been acknowledged, and is already benefiting our patients, who remain our top priority.
We are pleased to see the improvement in the responsive rating in Outpatients. In the last few months we have worked really hard to reduce waiting times in the department. We know that we still have a lot to do. We are putting in place new systems and processes, supported by state of the art technology, to ensure that our clinics are better organised and more responsive to the needs of patients. This technology will be in place in early 2016, and patients will see a significant improvement as a result.
We are disappointed that the rating for HDU remains the same, as the CQC themselves acknowledged that every concern and criticism raised in 2014 regarding HDU had been resolved effectively.
With specific reference to the issues raised around paediatric care, it is worth noting that recruiting specialist paediatric nurses is a challenge not only for us here at the ROH, but nationally. In the last 12 months we have advertised for paediatric nurses on seven occasions, but have only succeeded in recruiting one nurse due to the national shortage. To make sure that paediatric patients are safe, we ensure that all our registered nursing staff on HDU are trained in how to identify and treat children who may be unwell following surgery, as well as specialist medicines management training. There are always nurses and doctors on duty who are able to provide lifesaving care in emergencies.
In terms of medical staff, we have a paediatrician on site twice a week, with a 24/7 telephone advice from our neighbouring specialist children’s hospital. In addition, we have a team of consultant anaesthetists who have the skills and competencies to care for unwell children. Paediatric care is factored into their training as standard, and all meet the Royal College of Anaesthetists Level 2 Competency Matrix.
The CQC found no serious incidents in the 12 months prior to the inspection, or any harm to young patients. We are very careful to risk assess and pre-select our paediatric patients, and where appropriate they are treated by our surgeons at Birmingham Children’s Hospital, where there is access to a Paediatric Intensive Care Unit (PICU). If we have any concerns at all about a young patient in our High Dependency Unit, we transfer them to Birmingham Children’s Hospital. Since 2014 there have been no complaints received by HDU, and Friends and Family Surveys receive a satisfaction rate of 96.8% from patients and carers.
We do however welcome any opportunity to further improve the care we offer to our patients, particularly children. With that in mind, we continue to recruit specialist paediatric nurses in the face of a national shortage, and continually review the care of children.
We remain committed to providing the best possible care to our patients, and will take into account all the recommendations and advice received from the CQC, alongside our broader transformation plans for the hospital. In 2014 we published our Five Year Strategy outlining our vision to be first choice for orthopaedic care, with clear strategic objectives, which are:
- Delivering exceptional patient experience and world class outcomes
- Developing services to meet changing needs, through partnership where appropriate
- At the cutting edge of knowledge, education, research and innovation
- With safe, efficient processes that are patient centred
- Delivered by highly motivated, skilled and inspiring colleagues.
We are one year into a five year strategy which will radically change the way patient care is delivered, and make a positive impact in all areas. This inspection report helps us focus some of our work in the coming years.