Hospitals trusts reflects on this year's improvement efforts

Dr Jeremy Rushmer, executive medical director at Northumbria Healthcare NHS Foundation Trust.
Dr Jeremy Rushmer, executive medical director at Northumbria Healthcare NHS Foundation Trust.

Continuing to provide the best care for older people and improving patient flow are ongoing priorities at Northumberland and North Tyneside’s hospitals.

Northumbria Healthcare’s executive medical director, Dr Jeremy Rushmer, made a presentation on improvement efforts at last Tuesday’s (March 5) meeting of Northumberland County Council’s health and wellbeing committee.

He was discussing the quality account for 2018-19, which is a statutory requirement for all NHS trusts to inform the public of delivery of safety and quality priorities.

The full draft account will not be completed until April before being finalised and submitted to NHS Improvement and Parliament at the end of May, however, the overall picture for Northumbria Healthcare is a positive one in terms of meeting performance targets.

The five key areas for this financial year were:

To continue with the flow project to reduce delays in the system, with a focus on emergency-department performance and long-stay patients;

To continue to improve the quality of care and services for older people;

To continue to improve the management of sepsis in hospital and community settings;

To reduce the number of people that fall in hospital and also that fall with harm;

To improve staff and patient experience scores.

And the data shows that the trust is performing above target for a number of the indicators related to these priorities, for example, screening for sepsis and reducing the number of falls per 1,000 bed days.

In terms of flow, the trust has reduced the number of ‘stranded’ patients – those with a length of stay of seven days or more – while also hitting the national target for seeing 95 per cent of patients at A&E within four hours.

Coun Jeff Watson asked if the waiting issues at the emergency-care hospital in Cramlington were masked by the figures including other sites, but was told that this is a national measure and urgent-care centres have to be included.

Dr Rushmer added: “Hexham, North Tyneside and Wansbeck are better than Cramlington, but overall the figure has improved this year and the biggest improvement has been at Cramlington.”

The area where performance is shortest of the target is in relation to delivering the sepsis bundle within one hour, which improved significantly from 10 to 30 per cent, but is still way behind the 65 per cent target. Compliance with the bundle within 70 minutes is now around 50 per cent.

Councillors were told that this target was perhaps too ambitious in the first year, given that the bundle is very challenging, as it requires six different things to happen within an hour, including getting blood results before administering antibiotics.

Looking ahead, the safety and quality objectives for the coming year are:

Frailty – continuing to provide the best health care for older people;

Flow – ensuring appropriate care/enhanced care plans are in place for people who attend emergency departments regularly and are admitted to hospital frequently;

Deteriorating patient – increasing screening rates for sepsis and acute kidney injury, both of which indicate that a patient is deteriorating;

Staff experience – as evidence shows that patients have better outcomes when treated by happy, engaged staff;

Cancer – looking in detail at specific cancer pathways, starting with colorectal;

Bereavement – learning and improving the care that we provide at end of life, which includes introducing its own medical examiners to review deaths;

Maternity – to further improve the care and experience especially in light of increased birth rates;

Every contact counts (prevention and public health) – working to improve self-care among the population via initiatives such as social prescribing, care and support planning, and connecting people to community and social networks and initiatives.

The meeting also heard a presentation from Newcastle upon Tyne Hospitals NHS Foundation Trust on its quality account for 2018-19, given that patients in Northumberland also use city hospitals, particularly for specialist treatments.

Northumberland, Tyne and Wear, which provides mental-health services, and the North East Ambulance Service will be providing updates to the committee later this month.

Ben O'Connell, Local Democracy Reporting Service