Integrated Governance Report 2008 - Nuffield Health

10 INTEGRATED GOVERNANCE REPORT 2008
11
EXECUTIVE SUMMARY
Hospital Sterile Services Units (HSSU)
Our Hospital Sterile Service Unit programme developed
well with the last of our six sterilisation hubs opening to
service our 30 hospitals. The first four units have been
accredited against the new European Union directive
by the Medicine and Healthcare products Regulatory
Authority 4 and the final two are awaiting inspection.
Nuffield Health will be amongst the first major network
providers to reach full compliance. Our team is held in high
regard by the Sterile Services industry as a result of this.
Radiology
Our attention to radiation protection was accredited by
our external partners at St George’s Hospital. The digital
radiology PACS NHS project has proved a technological
challenge to complete with work progressing well. A
£40 million radiology upgrade was completed with the
delivery of a seventh mobile MRI and second mobile 64
slice CT scanner. Our first mobile and ten static digital
mammography units have been a major addition to our
screening capability.
Pathology
The upgrade for our pathology centres continues to go
well with a central Winpath computer database becoming
fully operational. All hospitals are now using the blood
automated release system (BARS) to meet modern
safety criteria with successful accreditation by the
Medicines and Healthcare Products Regulatory Agency
(MHRA) at the first three sites to be inspected.
Health and Safety
With the Corporate Manslaughter and Corporate
Homicide Act 2007 5 greater focus is now given to health
and safety matters. Training sessions for senior managers
and audits are prescribed throughout the group. Health
and Safety is the main priority in the Wellbeing division.
Taking a proactive and open stance we met the Health
and Safety Executive with our Advisors from Quadriga.
Enhanced automated and monitored fire systems were
installed in all our hospitals following the lessons learnt
from the Royal Marsden fire. Our expertise in hospitals has
enabled us to raise the bar for our approach to managing
the risks associated with Legionella in our swimming pool
strategy, published in December 2008.
Operational excellence forms part of our Wellbeing ‘smart
leadership’, and reward for enhancing safety is as much a
part of performance management as financial or
customer service. We reported 43 incidents in the
Wellbeing Division involving injury to staff or clients and
had five significant episodes requiring serious escalation.
Learning & Development
Nuffield Health has appointed a Group Organisational
Development Director to develop a senior leadership
programme. At the same time our web based learning
management system has been launched to allow computer
aided induction and training in all areas, starting with
the key mandatory areas such as child protection. 2009
will see all our training databases and learning profiles
migrate to a single system. A training prospectus will
enable individuals to take control of their training needs
and its management.
The major training accomplishment for the year was in
the accreditation of our 174 Wellbeing Advisors to
undertake our Vi1 entry health screens, an important and
complementary part of our annual Wellbeing programmes
operated by our Fitness and Wellbeing centres.
Infection Prevention
Infection prevention is never far from the spotlight. We do
not believe in gimmicks and do not stray from the scientific
evidence. Nuffield Health continues to trust our senior
clinical staff with everything from patient care to ward
cleanliness. All our hospitals aim to have a trained
infection link nurse in every department of every hospital.
We maintain very low infection rates and in 2008 we had
no cases of MRSA blood stream infections, one case of
MSSA (Methicillin Sensitive Staph. aureus) and four cases
of Clostridia difficile. In all cases the patients were
potentially admitted with these conditions with the MSSA
missed on screening and the C. difficile becoming evident
during admission from elsewhere.
We are never complacent and have adopted best in class
hand hygiene tools 6 developed by the National Patient
Safety Agency and in 2009 will open our doors to the
external Patient Environment Action Team (PEAT)
inspections 7 .
Working with Doctors
Nuffield Health works with over 6,000 of the finest
specialists across the country. We met and discussed
challenges and the future at a series of roadshows
throughout the summer, hosted by David Mobbs, Group
Chief Executive and Trish Cassidy, Chief Executive –
Hospital Division and later in the year at a number of
forums on orthopaedics, clinical safety and medical
advisory committee leadership. The Nuffield Health
approach to practice privileges has been adopted as
a template across the independent sector celebrating
our understanding of working in partnership.
Clinical Effectiveness
Win-win-wins are possible in healthcare
High quality care is not achieved because of technology;
it is driven by careful attention to detail and the process of
care. Our pathway development has seen E-care modules
published on our intranet to guide and inform our clinical
teams. We now use standardised pre-assessment across
all our hospitals, a win-win-win for patient, consultant and
Nuffield Health alike. The results have swiftly quelled a
litany of issues in medication errors, infection prevention,
documentation, diagnostic tests and delays. This year will
see standardised care records and we will be completing
patient reported outcome measures in all sites by the end
of March 2009.
As a leading provider of health screening we celebrate the
early identification of issues when they arise. Our Vi1
health screens became available in our Wellbeing centres
for the last two months of 2008 and we have already
ensured that the 6% of clients with a potential serious issue
have received onward care. 2009 will see us complete
the largest number of health assessments outside the NHS.
Clinical governance ensures that anything from our
13,289 ECGs to 3,786 mammograms are all reviewed
and double checked within one electronic system.
Our audited physiotherapy pathways continue to go from
strength to strength with the growth of our Fusion and
Proximity partnerships ensuring that over 100,000 clients
benefited from evidence directed therapy.
Our approach to child standards in hospitals and child
protection has been reviewed and updated to ensure
industry leading compliance. Confidence comes from a
trained paediatric nurse being with your child every step
of the way.
Patient & Client Focus
Our client satisfaction scores remain world class with over
28% of patients rating their care as simply excellent and
68% as good, cumulatively 96% is hard to beat with over
27,000 responses. We always look for improvement and
we will address the 14% who need better medicine
information and 26% who need better aftercare guidance.
We work hard to put things right at a local level with
1573 complaints in our hospitals, of which only 2.6%
were not resolved with a local apology and corrective
action. The handful of Wellbeing complaints were all
reviewed in depth to the satisfaction of our clients.
Staff & Public Health
Our in house Occupational Health team continue to lead
in ensuring that we look after our staff, complete the
correct pre-employment health checks, address significant
health problems when they arise, ensuring safe driver
training is provided and when required facilitate access
to stress counselling.
During the year we also adopted the highest standards
in blood borne virus screening and training in response
to risks associated with inoculation injury.
Summary
Every member of our staff right across the Charity knows
that none of these things would be possible in isolation.
We are a giant team and I thank each and every person
who works with us to deliver high quality, safe care, with
good outcomes each day of the week. Our NHSLA level
2 success is made all the more special because it is both
an organisational and local achievement.
Quality is evolutionary, 2009 will witness the same
drive and attention.
Dr Andrew Jones
Group Medical Director