Northampton General Hospital NHS Trust Quality Account 2016-2017

Recommendations

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Performance Against National Quality Indicators In 2009, the Department of Health established the National Quality Board bringing the DH, the CQC, Monitor, the National Institute for Health and Clinical Excellence and the National Patients Safety Agency together to look at the risk and opportunities for quality and safety across the whole health system. The National Quality Board requires reporting against a small, core set of quality indicators for the reporting period, aligned with the NHS Outcomes Framework. Performance data for NGH is included together with the NGH data from the 2014/15 Quality Account. Where available, data has been provided showing the national average as well as the highest and lowest performance for benchmarking purposes. All information for the reporting period has been taken from the Health and Social Care Information Centre and the links provided therein. For the following information data has been made available to the Trust by NHS Digital. Where this has not been available, other sources have been used and these sources have been stated for each indicator. In accordance with the reporting toolkit the trust can confirm that it considers that the data contained in the tables below are as described, due to them having been verified by internal and external quality checking. Domain 1 – Preventing people from dying prematurely and Domain 2 – Enhancing quality of life for people with long term conditions Summary Hospital-Level Mortality Indicator (SHMI) – (value and banding of the SHMI) Period NGH Value NGH National National National Banding Average High Low Oct 15 – Sep 16 95 2 100 116 69 Oct 14 – Sep 15 102 2 100 117 65 Oct 13 – Sep 14 98 2 100 119 59 *SHMI banding: SHMI Banding = 1 indicates that the trust’s mortality rate is ‘higher than expected’ SHMI Banding = 2 indicates that the trust’s mortality rate is ‘as expected’ SHMI Banding = 3 indicates that the trust’s mortality rate is ‘lower than expected’ The Trust has an ‘as expected’ SHMI at 95 for the period October 2015 to September 2016 as demonstrated in the table above. Unlike HSMR, the SHMI indicator does include deaths 30 days after discharge and therefore patients, including those on palliative care end of life pathways, who are appropriately discharged from the Trust. NGH has taken the following actions to improve this rate and quality of its services; regularly analysing mortality data and undertaking regular morbidity and mortality meetings to share learning across the Trust and externally through countywide morbidity and mortality meetings. 82
Palliative Care Coding – (percentage of patient deaths with palliative care coded at either diagnosis or specialty level) Period NGH National National National Average High Low Oct 15 – Sep 16 36.62% 29.74% 56.26% 0.39% Oct 14 – Sep 15 25.9% 26.6% 53.5% 0.19% Oct 13 – Sep 14 26.6% 25.32 49.4% 0.0% NGH has taken the following actions to improve this rate and quality of its services; by prioritising end of life care and placing greater importance on palliative care Domain 3 – Helping people to recover from episodes of ill health or following injury Patient Reported Outcome Measures scores (PROMs) - (adjusted average health gain) o Hip replacement surgery o Knee replacement surgery o Groin hernia surgery o Varicose vein surgery Groin hernia surgery (EQ-5D TM Index) NGH Performance Reporting Period 2016/17 0.116 (provisional Apr16 to Dec16) NGH Quality Account 2015/16 0.103 (provisional Apr15 to Dec15) Reporting Period Average 0.087 (provisional Apr16 to Dec16) National Performance Reporting Period High 0.162 (provisional Apr16 to Dec16) Reporting Period Low 0.016 (provisional Apr16 to Dec16) Varicose vein surgery (EQ-5D TM Index) N/A (provisional Apr16 to Dec16) N/A (provisional Apr15 to Dec15) 0.093 (provisional Apr16 to Dec16) 0.0152 (provisional Apr16 to Dec16) 0.016 (provisional Apr16 to Dec16) Hip replacement surgery - primary (EQ-5D TM Index) Hip replacement surgery - revision (EQ-5D TM Index) Knee replacement surgery - primary (EQ-5D TM Index) Knee replacement surgery - revision (EQ-5D TM Index) 0.488 (provisional Apr16 to Dec16) N/A (provisional Apr16 to Dec16) 0.300 (provisional Apr16 to Dec16) N/A (provisional Apr16 to Dec16) 0.528 (provisional Apr15 to Dec15) N/A (provisional Apr15 to Dec15) 0.328 (provisional Apr15 to Dec15) N/A (provisional Apr15 to Dec15) 0.449 (provisional Apr16 to Dec16) 0.291 (provisional Apr16 to Dec16) 0.330 (provisional Apr16 to Dec16) 0.263 (provisional Apr16 to Dec16) 0.525 (provisional Apr16 to Dec16) N/A (provisional Apr16 to Dec16) N/A (provisional Apr16 to Dec16) N/A (provisional Apr16 to Dec16) 0.33 (provisional Apr16 to Dec16) N/A (provisional Apr16 to Dec16) N/A (provisional Apr16 to Dec16) N/A (provisional Apr16 to Dec16) N.B. - Where N/A is stated, this information has not been made available by NHS Digital at the time of publication. NGH has taken the following action to improve the rates, and the quality of its services by further developing the work undertaken in theatres. 83
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Introduction What is a Quality Acco
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Part One A statement on quality fro
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Statement from the Director of Nurs
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Statement of Directors’ Responsib
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Part Two Priorities for Improvement
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When: March 2017 Outcome: There wer
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A new Falls Care Plan has been tria
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We said we would: Reduce the number
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We said we would: Aim to Deliver Pa
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In December 2016 a change to the pr
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When there has been an increase in
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We said we would: Provide care that
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A&E (ED) NGH received the most favo
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When: In 2016/17, we are measuring
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Page 33 and 34: We made 25 submissions of QI work c
Page 35 and 36: Our reporting structure provides cl
Page 37 and 38: Some of our other projects include:
Page 39 and 40: Dare to Share Learning Events We ha
Page 41 and 42: Red2Green The Red2Green approach is
Page 43 and 44: NHS Staff Survey We have continued
Page 45 and 46: There have been improvements across
Page 47 and 48: Detailed below are some examples of
Page 49 and 50: Real Time Survey The survey adopts
Page 51 and 52: Improving our complaints process Si
Page 53 and 54: Pressure Ulcer Collaborative A pres
Page 55 and 56: Priorities for Improvement in 2017/
Page 57 and 58: Priority 4: To Lead and Promote a R
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Page 61 and 62: IBD Registry Y Data collection ongo
Page 63 and 64: o Safe discharge for children from
Page 65 and 66: National audit mortality and consul
Page 67 and 68: Consent in total hip and total knee
Page 69 and 70: The CQUINs for 2017/18 have been ag
Page 71 and 72: Care Quality Commission (CQC) The t
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Page 75 and 76: The HSMR 100 looks at all hospital
Page 77 and 78: Following on from this the Secretar
Page 79 and 80: An action plan, work schedule and a
Page 81: Themes of Good Practice Noted Stan
Page 85 and 86: NGH is reviewing the scores in orde
Page 87 and 88: The results show that the trust is
Page 89 and 90: Northamptonshire County Council FAO
Page 91 and 92: Private & Confidential Carolyn Fox
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Page 97: Q R S PROMs QCI QELCA QI RCPH R&D R
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Northampton General Hospital NHS Trust Quality Account 2016-2017

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