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Special measures

NEWS

However, discharging a patientoften involves input from avariety of disciplines. Gettingeveryone together can cause adelay in itself, so newly-introduced “huddle meetings”at our community hospitals aretackling this head on andmean patients are gettinghome quicker than ever.Every Tuesday and Fridaymorning the huddlemeetings are held oncommunity hospital wards.Those attending include thenurse in charge, hospitalsocial worker, district nurseand ward therapist with theComplex Discharge co-ordinator (CDC) joining viaconference call.“We get the key peopletogether so we can discussour patients and giveupdates on progress andhow we are moving forwardwith discharge plans,” saidClaire Hughes, acting juniorward sister at LeominsterCommunity Hospital.

“The meetings, which beganat Bromyard CommunityHospital, last around half anhour. As we’ve got the rightpeople it allows us to workcollaboratively to maintainsmooth and timelydischarges and gain supportand advice from the CDC aswe manage increasingly

complex discharges,” addedClaire.Sarah Holliehead, the Trust’sacting lead nurse forcommunity hospitals, saidthe meetings had comedirectly out of the PatientCare Improvement Plan.“This is a positive steptowards reducing

unnecessary delays indischarge and we’ve alreadyseen a decrease in length ofstay which benefits patientsand also helps to relievepressure on services”.Our hospitals at Leominster,Ross and Hillside are nowalso holding the huddlemeetings.

Youngsters comingto the CountyHospital foremergencytreatment now havetheir own area inthe waiting room inour EmergencyDepartment.

The CQC inspectors - whopicked up that the previousarea allocated for youngsterswas not appropriate -confirmed what we believedto be the case as we hadalready commissioned areview of the waiting roomby patients who would usethis area.Earlier last year we’d askedyoungsters from ourchildren’s ward to pop intoour Emergency Departmentto see the waiting roomthrough children’s eyes.

Work is now complete andthe result is an area in themain waiting area divided bytranslucent glass panelswhich allow the room to belight and airy while keepingyoungsters away from adultswaiting in the main area.A colourful mural painted bya local artist covers two of thewalls and is designed to keepchildren occupied as they areinvited to try and spot variousitems hidden in the flowingdesign.

Soft furnishings and new toyshave been ordered to add thefinal touches to the room.“This is so much better thanwhat we had before andparents are already sayingwhat a benefit it is to have aroom like this to wait in withtheir children,” said VickyWildig, business lead for thedepartment.The room is connected to thetwo children’s bays in theEmergency Department, soyoungsters can move into the

Emergency Departmentwithout re-entering the mainwaiting room.

Emergency Departmentwaiting room is child’splay

Huddle meetingshelp patients gethome quickerThe best place for many of our patients to recuperatefollowing treatment in hospital is in their own home.

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As the improvement director,I have been at the Trust twodays a week since thebeginning of February.During my time here I havebeen impressed with thestaff I have met, not only intheir enthusiasm but in theirpassion and desire to learnand continually improve.As a trust we need to be able

to clearly articulate thethings we are doing well andbe able to describe thejourney we are on, what haschanged and how this feelsdifferent.Of course there arechallenges, but how we talkabout these and set out ouractions to address these willbe critical to our success.

It is important you sharewith our chief executive,Richard Beeken, and theother members of theexecutive team any concernsand areas for developmentnow so we have the time todo something about them.I would encourage you toattend these roadshows andthe staff briefings we are

holding, andshare with usyourthoughts onwhat we aredoing welland what weneed to bebetter at.Andrea Gordon,improvement director

Message from ourimprovement director

April/May 2015

Unlocking our potential...

...Improving services for local people

Patient Care Improvement Programme

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Michelle Clarke, director ofnursing and quality getsfeedback from youngsters inthe Emergency Department

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We’ll be holding roadshowsand face-to-face meetings inall wards and venues aroundthe Trust to keep you abreastof what’s happening and helpyou understand your role inmaking sure that theincredible work you all dogets talked about. We need to demonstrate thatwe have not only made theimprovements, but that ourorganisation is more capableand sustainable.You, as frontline staff, are ourambassadors - not only whenthe inspectors are here, butalso as you care for ourpatients and their friends andfamilies.To make sure you’ve got thelatest information at yourfingertips I’m inviting anymember of staff to contactme directly.We’ve set up a newaskrichard@wvt.nhs.ukemail address which you canuse to ask me anything about

the CQC inspection and PCIP,and I’d particularly like tohear suggestions you mayhave to improve your service.Also, if you’ve heard arumour and want to know ifthere’s any truth in it, dropme a line and I’ll get back toyou as quickly as possiblewith an answer.Where it’s suitable, we’llpublish questions andresponses on the intranet andshare them with you throughTrust Talk and Team Brief.In a recent Team Brief surveywe carried out, many of yousaid that you felt part of ateam and a family. That issomething to be very proud of.Let’s make sure that everyone- from CQC inspectors to ourpatients - knows that whatmakes us special isthat we are theWye Valley Team.

Richard Beeken,chief executive

Special measures - six months inThere’s a raft of activities taking place across the Trust as the countdownbegins to our follow-up CQC inspection in the autumn.

What the CQCinspectors willbe looking forThere are five domains -Caring, Responsive,Effective, Well-led, Safe.The Trust performed poorlyunder the Safe, Effective andWell-led sections, but verywell under caring. Many staff will be involvedin discussions withinspectors and it’simperative that we tell themabout the many things wehave improved and whichwe are doing well at.These are the kind ofquestions the inspectors willbe asking and measuring uson – the questions they’llexpect you to be able toanswer:

Are services caring, peopletreated with compassion,respect and dignity?• Are people treated with

kindness dignity, respectand compassion?

• Are people who useservices and those closeto them involved aspartners in their care?

• Do people who useservices and their familiesreceive the support theyneed to cope emotionallywith their caretreatment/condition?

Are services organised tomeet needs, right care, righttime, right place?• Are services planned and

delivered to meet theneeds of people?

• Do services take accountof the needs of differentpeople, including thevulnerable?

• Can people access careand treatment in a timelyway?

• How are people’sconcerns and complaintslistened and respondedto and used to improvequality of care?

Does people’s care,treatment and supportachieve good outcomes,promote quality of life andis it based on evidence?• Are people’s needs

assessed and care andtreatment delivered inline with legislation,standards and guidance?

• How are care andtreatment outcomesmonitored; how does thiscompare with otherservices?

• How well do teams worktogether to delivereffective care/treatment?

• Do staff members haveall the information theyneed to deliver care?

• Is consent to care andtreatment always soughtin line with legislationand guidance?

• Is there a clear vision andstrategy to deliver goodquality?

• Does the governanceframework ensure thatresponsibilities are clearand that quality,performance and risks areunderstood andmanaged?

• How does the leadershipand culture reflect thevision and values,encourage openness andtransparency andpromote good qualitycare?

• How are people who useservices, the public andstaff engaged andinvolved?

• How are servicescontinuously improvedand sustainabilityensured?

Are people protected fromavoidable harm as well asphysical, psychological oremotional abuse?

• What is the track recordof safety in your team?

• Are lessons learned andimprovements madewhen things go wrong?

• Are there goodsystems/processes in placeto safeguard people fromharm?

• How are risks assessedand safety monitored?

• How well are risksplanned for in advance?

Caring• Simple pocket guidelaunched for patientsproviding them withessential informationabout how they can STAYSAFE, PARTICIPATE andCOMMUNICATE in theirown care and treatment.

• Improved results ininpatient and local surveysplus positive results fromHerefordshire Healthwatchfollowing enter and viewvisits

• Improvements to thechildren’s waiting area inour Emergency Departmentare now complete - basedon wishes of children whoreviewed the facility for us

• We are now carrying outpatient survey checks inEmergency Department attimes of high pressure

What’s been happening recently?• Roll-out of early supporteddischarge service in strokeunit

Responsive• We are reviewing our clinicbooking system andcapacity plans to reduce“over booking” as well asspreading clinics across theweek and providingadditional sessions,including on Saturdays

• We have consolidated ourstroke service at theCounty Hospital, bringingall aspects of the the

service together on WyeWard

Effective• Increased opportunities fore-learning for all statutoryand mandatory training

• We have recruited 40 percent of our requiredspecialist nursing staff

Well-led• Work is taking place withstaff to develop our values.This will be included inappraisals and personaldevelopment, as well as inour recruitment

• Introduced a leadershipdevelopment programme

• Extensive staffengagement sessions forour Patient CareImprovement Plan areunderway and led by thechief executive

Safe• There’s been a 38 per centincrease in incidentreporting over the last 12months - with no increasein reported harm

• 90 staff have volunteeredto take part in Root Cause

Analysis training to help usmake recommendations forimprovements usingevidence from instanceswhere mistakes have beenmade

• Relaunched care bundlesand introduced a mortalityreview process

No time likethe present!The CQC inspection focuses on five key domains. Many staffmembers will be involved in discussions with inspectors andit’s imperative we tell them about the many things we aredoing well.If you feel that in your service area there are improvementsto be made, let’s make them now. Don’t wait to make asuggestion until the CQC inspectors are here. Send your suggestions to askrichard@wvt.nhs.uk

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