The Isle of Wight’s NHS Trust Quality Account 2012/13 was released earlier this week, outlining the progress of the Isle of Wight’s NHS Trust since the last one was released in 2012.
Some recognisable improvements have been made; however, in their own words: “2013/14 offers the Isle of Wight Trust a significant range of challenges.”
Focus needed on previously bad-performing areas
These challenges arrive in the form of a series of previously bad-performing areas that they need to focus on.
A number of agreed targets for the year were not met, including the adoption of high impact innovations and providing a positive patient experience. These target failures are joined by priorities for quality improvement, which are derived from the performance over the past year against quality and safety indicators.
Reducing mortality rates
The initial priority is to reduce mortality rates within the Isle of Wight’s NHS trust.
This is an area in which the Trust has previously received criticism for and they dispute – appearing in Dr Foster’s report in 2011 with second worst mortality rates in the country (second only to the George Eliot Trust in Nuneaton). The report states that Isle of Wight’s NHS Trust now has a Hospital Standard Mortality Ratio (HSMR) of 107.
Due to this improvement, the Trust has now moved from the position of a national outlier into one that is considered to be ‘acceptable’ – but there is still plenty of room to make improvements. Therefore, the trust have stated that they will continue to focus on reducing these mortality rates by building on last year’s action plan, which intends to work by further implementing clinical care and improving the quality of coding.
Prevention of Bed Sores
Priority number two is the prevention of pressure ulcers, or bed sores, defined here;
‘Pressure ulcerations (commonly called bed sores) are distressing and painful wounds that patients sometimes experience due to immobility, poor skin condition and /or other medical conditions which make them vulnerable.’
The Trust’s 2011/2012 report outlined clear guidelines and goals for the removal of bed sores, outlining a ‘zero tolerance’ approach, and
“although there has clearly been significant improvement, the Board remain dissatisfied with the current levels of patients acquiring Healthcare Acquired Pressure Ulcers (bed sores).”
This means that the Trust is going to have to put a significant amount of work in to help reduce the numbers of individuals acquiring bed sores whilst in their care.
Bed sores: An issue for four years
Bed sores have been a problem within the Trust for four years now, states the report, and there is more work to be undertaken in 2013/14 to resolve this issue.
One approach they are attempting to help reduce the rates of bed sores is to implement a reporting tool in which they have to report each individual case of ulcers. Something that is currently not compulsory.
Lack of patient communication
It is essential when in hospital or medical care for either yourself or a loved one that everything you need to know is communicated to you simply and effectively. However, the Isle of Wight’s NHS Trust Quality Account has outlined communication as a big problem.
It would appear that patients are not pleased with the level of communication given to them in the Isle of Wight’s NHS Trust establishments.
“Over the last 12 months the Isle of Wight’s NHS Trust has received many complaints and concerns relating to poor communication or a lack of communication.”
Some ward staff ‘unhelpful’
Complaints ranged from patients receiving incorrect information on their discharge summary, to relatives being given incorrect information about the health of the patient. There were mentions of poor communication about patients’ treatment plans or aftercare – with ward staff outlined as being ‘unhelpful’.
The Isle of Wight’s NHS Trust have been aware of this issue for some time, and last year provided patients, carers and relatives with the opportunity to speak face-to-face to hospital staff to give some feedback on their experiences. An analysis of their feedback was conducted, and the main area of concern appeared to be a fundamental lack of communication between the staff, patients and their relatives.
Matron not visible on the wards
Some of the more serious complaints were from those who felt that care was being compromised due to staff not having time to talk to patients because of staff-cuts and, relating to this, patients and their relatives described a difficulty in finding people to talk to at all, with no Matron visible on the wards in many cases.
The Isle of Wight’s NHS Trust has stated within the report that work is already underway to raise staff awareness of the importance of communication to try and enhance the patient experience in the following year.
Progress
The progress made in these areas will be recorded in a monthly report to the Board and monitored by the Quality & Clinical Performance Committee, ready to provide results for next year’s 2013/14 Quality Report.
While the Isle of Wight’s NHS Trust has come a long way since 2011 (and a result of second worst hospital in the country regarding HSMR rates), it is clear from the Quality Report that there is still a long way to go to improve.
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