Read about our approach to external linking. Our decisions on overall ratings take into account, for example, the relative size of services and we use our professional judgement to reach a fair and balanced rating. The hospital did not always ensure that appropriate patients were in escalation wards which meant some areas had unsuitable patients accommodated within them. Bringing together a combined workforce of over 13,000 staff, the new Trust delivers over 100 different clinical services across 10 different . NBT accelerated its planning ahead of winter 2019/19, developing a strategic plan in consultation with staff. With staff health and wellbeing so firmly embedded into its culture it has been easy to make swift changes to support its teams. Following our inspection the trust had updated the standard operating procedure to address concerns about the safety of placing patients in escalation areas. ensure that staff understand when a deprivation of liberty application should be made and that they are clear which patients are subject to such a restriction. These included the Be Safe project and a project managed by Barnardos Child Sexual Exploitation (BASE)to which theCCHP second a CAMHS nurse. ensure that equipment in theatre is sterile and available for use when required. Care records were not always managed safely. Surgery: was rated good overall. 466 0 obj <>stream Teams used national guidance and best practice tools to ensure children and young people received an evidence-based, good practice service. Most populous nation: Should India rejoice or panic? In the 2019 staff survey, NBT improved its wellbeing score from 5.7 to 5.9 and staff engagement from 6.9 to 7.1. The trust needed to maintain focus on culture, particularly in maternity, facilities management and the BME population and continue to promote freedom to speak up. All services had been rated as good for caring in November 2014 so we did not re-inspect this area, although we observed how people were cared for during the inspection. Because we rated childrens services as good in November 2014 we did not inspect them. Elective activity increased a sure indicator that the system was coping with winter pressures and able to deal with non-essential activity. Staff were clear about the processes they should follow to risk assess patients and respond to those who may deteriorate. That report, released in January, warned that the NHS is increasingly compromised by an ideology which disregards the realities and immutability of biological sex and that is diminishing the rights of women and girls. There were good systems in place to safeguard vulnerable young people and clear procedures for involving child protection services. On health and wellbeing, it moved from well below average to . Caring remained outstanding and effective, responsive and well-led all improved to outstanding. 431 0 obj <>/Filter/FlateDecode/ID[<9F7F01A3FAD1BB4F996402A1F4BA4419>]/Index[404 63]/Info 403 0 R/Length 120/Prev 384712/Root 405 0 R/Size 467/Type/XRef/W[1 2 1]>>stream NHS Employers (2020), Improving performance by improving staff wellbeing: North Bristol NHS Trust. The ratings we gave to these services on previous inspections in 2015, 2016 and 2017 are part of the overall rating awarded to the trust this time. Leaders collaborated with partner organisations to help improve services for patients. The bereavement midwife visited women in the CDS and also followed women up at home at any time, even beyond the normal time limit for postnatal midwifery care. We saw evidence that partnership working was routinely included in every aspect of their work. Of the 800 beds, 75% are single en-suite rooms, aiming to improve patient dignity and privacy. The quality and safety of patient care received sufficient coverage within board meetings and other associated meetings within the trust. Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. A new electronic records system had been implemented in the month prior to our inspection. In reaching this judgement we have taken account of the fact that the vast majority of services are provided at the Southmead site. North Bristol NHS Trust employs over 12,000 staff providing healthcare to the residents of Bristol, South Gloucestershire and North Somerset from our award-winning hospital building at Southmead. Inadequate We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. They reviewed patients medications, wrote them up on the medication chart and gave advice to patients about their medication (what needed to be stopped prior to admission). As much emphasis was placed in the caring for and about those close to patients as patients themselves. Participation in research and improvement in clinical outcomes as a result of obstetric skills training. Printable this page Accessibility tools. If you share them and want to be part of delivering an excellent service, then University Hospitals Bristol and Weston NHS Foundation Trust could be the place for you. There were clear streaming and triage arrangements in place which identified and prioritised patients with serious or life-threatening conditions. It was clear that many of the pressures could be resolved by minimising delays in patient care. These reports look at how NHS hospital trusts use resources, and give recommendations for improvement where needed. endstream endobj 410 0 obj <>stream North Bristol Trust values all people as individuals. [22] As well as shortages in some areas there were also issues, particularly in theatres and critical care, with regard to the skill mix of staff as a high proportion of staff were new and inexperienced in those areas. Post-COVID-19 pulse surveys have confirmed that during that difficult period, 57 per cent of staff said they felt cared for by the trust and only 18 per cent said they did not. Patients were treated dignity and respect and the leadership, governance and culture promote the delivery of high-quality person-centred care. Responsive at core service level was rated requires improvement. Any other browser may experience partial or no support. Having a robust occupational health service and working in partnership with them can lead to increased productivity, reduced absence and money saved. They encompass a desire in all of us to provide the highest quality of care to patients and each other. Staff monitored the effectiveness of care and treatment, using the findings to make improvements and achieve good outcome for patients. As part of each inspection, we look at the way health services provide care and treatment to people. Originally brought into help with the move to the new building their value was quickly realised and they are now an integral part of the service. Although bed occupancy remained high within maternity services (excluding the central delivery suite) this had improved flow within the service. For example, we respect their aspirations and commitments, and seek to understand their priorities, needs, abilities and limits. Please review our, You need to be a subscriber to join the conversation. Admissions to the unit were appropriate and there was a system in place to triage referrals. They had a clear vision, understood the challenges the organisation faced and were committed to sustainable care that extended beyond the borders of the hospital. There were significant issues with the flow of patients into, through and out of the hospital. North Bristol NHS Trust: Use of Resources published 25 September 2019 for - PDF - (opens in new window), North Bristol NHS Trust (May 2015) for - PDF - (opens in new window), North Bristol NHS Trust (December 2014) for - PDF - (opens in new window), North Bristol NHS Trust (July 2014) for - PDF - (opens in new window), North Bristol NHS Trust (March 2014) for - PDF - (opens in new window), North Bristol NHS Trust for - PDF - (opens in new window), South Gloucestershire: Children's Services Inspections Reports (2012) for - PDF - (opens in new window), Bristol: Children's Services Inspections Reports (2010) for - PDF - (opens in new window). NBT has moved from below average to above average in staff engagement and wellbeing terms since 2017, being one of the most improved organisations for health and wellbeing in the 2019 survey. There was a wide variety in the ratings with two services, maternity at Cossham Hospital and the services for children and young people rated as outstanding and the emergency services rated as inadequate. ensuring that the organisation's values are brought to life in everyday behaviour. It launched in the summer of 2018 and key elements included: Checking in with staff after the winter of 2018/19 revealed 86 per cent felt better prepared, and 77 per cent knew the winter plan had been designed from staff feedback. 3.1 Trust Values During 2012, in consultation with staff, the Trust developed a description of our underlying values that . People have confidence the organisation will look after them. In addition, the lack of individual risk assessments and clearly documented care plans had the potential to put children and young people at risk of receiving unsafe or inappropriate care and treatment. Neuromuscular services at the trust and University Hospitals Bristol and Weston NHS Foundation Trust have been recognised by Muscular Dystrophy UK for providing outstanding care for people with muscle-wasting conditions. BS1 3NU, In GQ(|T825T2".]]]wuyo=0{@@ @ @ @ @ @ @ @ @ 5U6k}mYN vyF8? North Bristol NHS Trust 8 years 5 months Data Quality Marshall North Bristol NHS Trust Feb 2021- Present2 years 4 months United Kingdom Supply Chain Analyst North Bristol NHS. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. The service managed patient safety incidents well and staff were clear on how to report incidents. H>H, The introduction of move makers. Medical care (including older peoples care): was rated good overall. Improvements had been made in supporting staff within their roles, through the appointment of nurse education practitioners and education programmes in the emergency department and in critical care. There were 3,923 WTE working days saved due to a reduction in sickness levels. Staff provided emotional support to patients, families and carers to minimise their distress. North Bristol NHS Trust values all people as individuals. and our acute colleagues in Weston Area Health NHS Trust and North Bristol NHS Trust, Although we had some concerns regarding the privacy and dignity of some patients in the Brunel building the majority of patients and relatives told us they felt their privacy and dignity was respected. [19] Separately, 100,000 has been secured from NHS England for a feasibility study to assess the need for rebuilding the GP-led health centre. Multidisciplinary team-working to plan patient care was an area of outstanding practice. endstream endobj startxref In addition, 84 per cent of staff felt able to share and comment on trust activity throughout the winter. [16] An unnamed whistleblower claimed a lack of beds was putting patient safety at risk because small rooms designed for minor procedures, such as injections, were being used to keep patients in overnight. Annual Statement 2009 for - PDF - (opens in new window), In Staff felt respected, supported and valued. Records must be fully completed and provide detailed information for staff regarding the care and treatment needs of patients. Read how North Bristol NHS Trust improved performance and saved thousands of pounds by prioritising and enhancing staff health and wellbeing. However, improvement was required in patient outcomes as they were below the England average in many areas. This is the South West version of the Department of Health Your Welcome standards. Patients felt involved in their care. GL53 7AN. Our rating of the trust stayed the same. People could not consistently access the service in a timely way and this was a continuing problem since our last inspection. Overall, North Bristol NHS Trust has been judged as requiring improvement. Families were involved in the referral and assessment process. In response, Lord Markham wrote: It is imperative that NHS trusts respect the privacy and dignity of patients. Caring and well-led ratings improved with a rating of outstanding. . The four hour target, within the emergency department, to admit or discharge patients to the hospital had been achieved for a three month period between June and August 2015. Leaders understood and managed the priorities and issues the service faced. There was a high level of delayed transfers of care which was frequently above 100 patients per day and at the time of the inspection was 114.However, there had been significant work undertaken since the inspection in November 2014 to facilitate patient discharges. Research has shown that bed occupancy of both 85% (and above 70% within critical care services) could start to affect the quality of care provided to patients. No rating/under appeal/rating suspended Staff then referred the young person to their local team for on-going work once the crisis had passed. Suspended ratings are being reviewed by us and will be published soon. This included the implementation of an integrated discharge lounge in October 2015.There was a focus on embedding discharge pathways and gaining pace in discharge activity. 2023 BBC. The vision and values within the trust were clearly articulated by staff and board members alike. Despite 2,500 more ED attendances and 3,000 more admissions, there were 600 fewer four-hour breaches and overall occupancy was down by 4 per cent. There have been several unsuccessful attempts to upgrade the facilities over the past 30 years. Leaders within outpatients had the skills, knowledge, experience, integrity and enthusiasm to lead effectively. However, the British public has been fooled into thinking the NHS is trying to eliminate mixed-sex accommodation. It was easy for people to complain or raise a concern and they were taken seriously when they did so. Requires improvement Lord Blencathra, a Tory peer and former minister, asked the Department of Health what steps they are taking to ensure that every hospital trust is able to guarantee same-sex accommodation and intimate same-sex care. The leadership team worked well with the clinical leads and encouraged divisions to share learning across the trust and there was a strong emphasis on improvement. [29], Coordinates: .mw-parser-output .geo-default,.mw-parser-output .geo-dms,.mw-parser-output .geo-dec{display:inline}.mw-parser-output .geo-nondefault,.mw-parser-output .geo-multi-punct{display:none}.mw-parser-output .longitude,.mw-parser-output .latitude{white-space:nowrap}512954N 23530W / 51.4984N 2.5916W / 51.4984; -2.5916. Let's make care better together. Existing staff had moved teams to help meet the needs of children and young people. A range of other interventions were accessible including online learning and others that were arts based. The reports available below were last updated on 9th March at 16.30pm. There were significant improvements within safety in urgent and emergency care services, with patients now receiving timely assessment on arrival. Our rating of well-led at the trust improved. There are over 8,000 reasons why North Bristol NHS Trust is a place to be #NBTProud of. Good Main Duties and Responsibilities Nursing Care (under direct supervision) 1. Staff within community CAMHS services had not consistently documented that they had assessed the risk to young people. Patients were not being cared for in the most appropriate ward, reviewed in a timely manner or supported to leave hospital when ready to be discharged. This deception is nothing short of scandalous., The Telegraph values your comments but kindly requests all posts are on topic, constructive and respectful. Campaigners on Wednesday welcomed Lord Markhams comments, but cautioned that the British public has been fooled into thinking the NHS is trying to eliminate mixed-sex accommodation when in reality any male can self-identify onto a womens ward. The trust had introduced new roles to improve communication between senior management and staff. Suspended ratings are being reviewed by us and will be published soon. This equated to a saving of 301,015 on sickness costs. It was their idea in response to what they were seeing on the wards. Mortality rates were below (better than) than the national average as measured by the Hospital Standardised Mortality Ratio. Within surgical services there was not timely access for patients to treatment and operations. we have taken enforcement action. Effective, responsive and caring ratings remained good. The service managed patient safety incidents well and monitored safety performance. The introduction of service line management had been well implemented and received positively. Avon and Wiltshire Mental Health Partnership NHS Trust (AWP) is the lead provider of healthcare for people with serious mental illness, learning disabilities and autism across Bath and North East Somerset (BaNES), Swindon and Wiltshire, and Bristol, North Somerset and South Gloucestershire. There was an outstanding example of responsiveness with the work of the dementia care team and the availability of 100 dementia champions in the trust including the Head of Facilities who was focussing on environmental changes. This was because incidents which related specifically to end of life care were not recorded consistently. In May 2014, the Brunel building on the Southmead Hospital site opened. Staff supported and involved patients, families and carers to understand their condition. The trust's treatments and advances in care have won national and international recognition. Actions had been instigated to address both of these. End of life care was rated requires improvement overall. They are volunteers who are highly experienced at their task. The support included one-to-one and team-based support, along with practical interventions such as fast access to physiotherapy and psychological support available for staff. The programme is available to staff and their families and NBT was careful to position it as being provided by an independent organisation so that staff had the confidence to use it. [21], In December 2017, the trust reported 122 breaches of the 12-hour target in A&E the worst performance in England and only 70.3 per cent of patients were seen within the four-hour target. Safe and effective remained the same with a rating of good. However, in the theatre department and outpatients areas, some were stored in rooms which were not secured. If you like what you have seen so far and are looking The reality is that any male can self-identify onto a womens ward, including in mental health settings, which the NHS will still insist is single sex. There were clear pathways for addressing the particular risks associated with the care and treatment and referral of, for example, children, frail elderly or patients with sepsis, stroke or mental health conditions. Staff engagement metrics told the story of a happier and more engaged workforce, evidenced by more than 3,500 contacts to the trusts wellbeing offering. Riverside Unit ran as a therapeutic space, which meant all aspects of the service and all relationships between young people and staff and young people and each other were part of inpatient treatment. We respect each other, acknowledge everyone's strengths and communicate effectively in an open and trusting environment. [26], In September 2019, the trust was rated by the Care Quality Commission (CQC) as outstanding for caring, and good overall. The trust had been on a difficult trajectory, being graded requires improvement by the CQC, in financial special measures, and feeling the strain of an expensive move from two hospitals to one purpose-built site. This was an improvement from our last inspection in 2018. 25 September 2019. There were long waiting times, delays and cancellations ongoing. This continues on appointment to a role at the trust, as the trust offers a wide range of benefits. This includes bespoke rotations, wellbeing support, personalised travel plans, and a structured preceptorship. Staffing levels varied across the trust. Overall, there was a 6 per cent increase in patients cared for, handled with 38 fewer beds. The service did not follow procedures to ensure cleanliness as a measure of infection prevention and control. North Bristol NHS Trust values all people as individuals. North Bristol NHS Trust owns the hospital but the adjacent health centre is owned by NHS Property Services. Mental capacity of patients was not clearly recorded in their notes when it was assessed. These included monitoring the waiting list for the newly established central intake team fortnightly. Its a clear signal that the culture has changed when clinicians create initiatives without any central involvement. The Use of Resources reports include a shadow (indicative) rating for the trusts use of resources. The site is to be redeveloped for the first time in 30 years. Staff were supported by their team colleagues and peers, and had access to regular clinical supervision, training and continuing professional development opportunities. Research North Bristol NHS Trust . This was an improvement from 5.6 and 6.8 respectively in 2017. Managers were strong and committed to the patients and also to their staff and each other. The rating for trust level management was rated good and for use of resources it was rated requires improvement. All staff were committed to continually learning and improving services. North Bristol NHS trust is a centre of excellence for health care in the South West in a number of fields, as well as one of the largest hospital trusts in the UK. Its work since and a paradigm shift about health and wellbeing have taken it from below to above average in staff wellbeing terms, saved hundreds of thousands of pounds, and improved performance across the board. The industrial action is a national dispute between the Government and Trades Unions about terms . Text Size. NBT saw a demand increase of 12.2 per cent, with bed occupancy regularly running at 102 per cent, meaning patients waiting in corridors. We observed collaborative working from all staff contributing to patient care. Staff, teams and services worked well together to deliver effective care and treatment. These had been investigated and improvements in cleaning were identified and actioned as a result. Relationships with commissioners had improved and matured. As Chief Executive of UHBW, I believe that diversity is a vitally enriching part of everyday life, including our workplace interactions and decisions. University Hospitals Bristol and Weston NHS Foundation Trust (UHBW) was formed on 1 April 2020 following the merger of University Hospitals Bristol NHS Foundation Trust and Weston Area Health NHS Trust. However, improvements had been made in urgent and emergency care services, which we rated as good. The trust received a HSJ Partnership Award in 2019 as a result of this programme. The Avon Orthopaedic Centre delivers services such as hip and knee surgery, carrying out 1,000 knee replacements a year. Wards created their own wellbeing boards, drop-in events and started boxes for donations of practical things colleagues might need in the middle of a busy shift. Werated North Bristol NHS trust specialist community mental health services for children and young people as requires improvement because: Staff did not consistently complete risk assessments. increased staffing in ED, including mental health, community teams and GP support. The trust performed worse than the England average for most national targets, this included the Admitted Adjusted Referral to Treatment time (where the time from referral to treatment should be less than 18 weeks). On health and wellbeing, it moved from well below average to average, and on staff engagement it is now above average for similar trusts. The specialist palliative care team had worked with the acute medical unit with complex end of life patients to improve patient outcomes. providing Caring, Ambitious, Respectful and Supportive Care. Control of Substances Harmful to Health (COSHH) Policy. Services have been transferred to this provider from another provider, an inspection looking at part of the service, Specialist community mental health services for children and young people, Community health services for children, young people and families. Improve patient flow within the hospital and ensure that there is a robust hospital-wide system of bed management so as to: significantly reduce delays in patient flow through the emergency department; reduce occupancy to recommended levels within medical services; and, ensure that there is capacity within the hospital so that patients can be admitted to and discharged from critical care at the optimal time for their health and well-being. The leadership, governance and culture of the trust promoted the delivery of high quality patient centred care. In the recent case of Yearworth and Others v North Bristol NHS Trust, however, the Court of Appeal for England and Wales revisited the property debate and threw into doubt a number of doctrines with respect to property and the body. In the pre-admission clinic they had a pharmacist working full time who reviewed elective patients. 8>@ There were issues of concern with the availability of medical records and the use of temporary sets of records. Please note that all salary figures are approximations based upon third party submissions to Indeed. We rated well-led as good because: Urgent and Emergency services: (also known as accident and emergency services or A&E) were rated good overall. Cares stands for Caring, Ambitious, Respectful and Supportive: Caring - because it underpins everything we do for our patients and the way we care for one another Young people who were at the beginning of inpatient treatment were not always able to tell us about their care and treatment plan; however, young people further along in treatment had good knowledge of this. Although the NHS may claim to be committed to providing single-sex services, the reality is that both accommodation and care are mixed sex because NHS policies allow transgender people to be included as the sex with which they identify, according to the way they dress, and the name and pronouns they currently use. Patients received the right care at the right time and significant improvements to patient flow had been made since our last inspection, so patients moved through the hospital more quickly and safely.
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