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Healthcare Inspectorate Wales HEALTHCARE INSPECTORATE WALES Annual Report 2018-19 Important Note about Cwm Taf Morgannwg University Health Board and Swansea Bay University Health Board This Annual Report covers the period from 1 April 2018 - 31 March 2019 and the boundaries and names of two of Wales’ health boards changed on 1 April 2019. Following the Bridgend boundary changes, Abertawe Bro Morgannwg University Health Board became Swansea Bay University Health Board; and Cwm Taf University Health Board became Cwm Taf Morgannwg University Health Board on 1 April 2019. For the purposes of this report, we have used the correct names of the health boards during the 2018 – 2019 reporting period. For further details on the new boundaries, please visit the relevant health board websites: www.cwmtaf.wales and www.sbuhb.nhs.wales In Writing Or Via Communications Manager Email: [email protected] Healthcare Inspectorate Wales Website: www.hiw.org.uk Welsh Government Rhydycar Business Park Merthyr Tydfil CF48 1UZ Phone: 0300 062 8163 978-1-78937-514-5 WG38420 Contents 5 Foreword 6 HIW in numbers 8 What did patients tell us? 10 Our work 12 Our Resources 14 Working with others 15 Progress against our Stratgeic Plan 20 National and Local Reviews 26 Inspection Findings 42 Summaries of Local Health Boards and Trusts in Wales 60 Annex A - Commitment Matrix Abbreviations used: Abertawe Bro Morgannwg University Health Board – ABM Aneurin Bevan University Health Board – Aneurin Bevan Betsi Cadwaladr University Health Board – Betsi Cadwaladr Cardiff and Vale University Health Board – Cardiff and Vale Cwm Taf University Health Board – Cwm Taf Hywel Dda University Health Board – Hywel Dda Powys teaching Health Board – Powys Healthcare Inspectorate Wales (HIW) is the independent inspectorate and regulator of healthcare in Wales HOSPITAL PRIVATE CLINIC GENERAL PRACTICE Our purpose To check that people in Wales receive good quality healthcare. Our values Through our work we aim to: We place patients at the heart of what we do. Provide assurance: We are: Provide an independent view on the quality of care. • Independent Promote improvement: • Objective Encourage improvement through the reporting • Caring and sharing of good practice. • Collaborative • Authoritative Influence policy and standards: Use what we find to influence policy, standards and practice. 4 Healthcare Inspectorate Wales - Annual Report 2018-19 Foreword Last year marked the 70th anniversary of the NHS; Our dental inspections were good on the whole founded by Tredegar-born Aneurin Bevan and still with some practices receiving outstanding reports a source of pride to so many in Wales. Healthcare with no suggested improvements at all. However services have changed exponentially in this time with in other dental practices, and indeed in most of advances in medicine, ongoing financial pressures our inspections across all settings, the safe storage and increasing healthcare needs from an ageing and administration of medicines continues to be a population with complex conditions. problem. Care and treatment planning was poor in Balancing these pressures is a challenge for everyone our mental health inspections with improvements working in modern health settings, and patients need needed to risk management in independent settings. to know that the healthcare they receive is safe and Following the allocation of some additional resource, effective. The role of Healthcare Inspectorate Wales we are in a position to increase our core activity has never been more important. within the NHS, enhance our follow up work, In June 2018, we launched our three-year strategic undertake more national and local reviews, and plan Making a Difference which set out our vision better respond to emerging in-year intelligence. and priorities to improve health and wellbeing for We have also embraced the latest digital technology people in Wales and a clear mandate on how we will into our work with the introduction of new electronic play our part in driving up standards in healthcare in inspections and a simpler system of online payments Wales. As I reflect on this first year of our strategic for registration fees. plan, I am proud of the achievements so far as we As we grow and develop as an organisation we strive to increase our impact, take action where continue to focus on delivering an effective service standards are not met, be more visible and be the checking on the quality of care that people receive best organisation we can be. across Wales and taking action where standards are This year we carried out 179 inspections, including not met to support improvement. follow up inspections, of hospitals, dentists, GP If you have any comments on this report, our work practices, mental health providers, independent or your experience of healthcare services in Wales, healthcare and settings using ionising radiation. please get in touch. Overall we saw a high standard of healthcare being delivered to patients, but there are some recurring Dr Kate Chamberlain, Chief Executive themes that must be addressed. It was clear from our hospital inspections that services continue to face significant challenges with regard to staffing levels. At a more local level, issues with appointment booking systems at GP practices were evident in many GP inspections last year with patients reporting long waits and difficulties securing on the day appointments to see a doctor. Healthcare Inspectorate Wales - Annual Report 2018-19 5 10 general hospital inspections HIW 2018 - 19 3 surgical In Numbers inspections Hospitals 120 patient 1803 questionnaires 73 patient dental questionnaires 3 inspections follow up inspections 18 death in custody Dental reviews 1 joint prison healthcare 5 inspection immediate assurance letters issued Offender Healthcare 1 joint youth offending services inspection Concerns 20 GP GP Inspections 37 312 37 were rated concerns from as ‘high’ risk 641 public and staff patient 5 questionnaires immediate assurance letters issued 6 Healthcare Inspectorate Wales - Annual Report 2018-19 18 5 potentially 73 unregistered IR(ME)R providers inspections patient addressed questionnaires 5 4 hospice independent inspections clinic inspections Ionising Radiation (MedicalExposure) Independent Regulations Healthcare Inspections 5 19 independent registered hospitals manager inspections applications 333 29 patient questionnaires inspection of NHS and independent 15 establishments laser 7 inspections inspections of community mental health Mental teams Health and Learning Disabilities 8 National immediate 911 and Local assurance requests letters issued for a SOAD Reviews 1 6 started new national review final reports with CIW published Healthcare Inspectorate Wales - Annual Report 2018-19 7 What did patients tell us? As part of the inspection process we ask patients if Dignified Care they would like to tell us about the care they receive Dignified care includes staff being polite and sensitive by taking part in a questionnaire. to patients’ needs. Last year we received 3106 completed patient • 97% of hospital patients agreed that staff were questionnaires; a small increase on the total number always polite and were kind and sensitive of responses from the previous year (3060). • 91% of hospital patients agreed that staff provided We also invited staff in hospitals and hospices to them with help, in a sensitive way, so they could use complete a questionnaire and we received 327 the toilet completed questionnaires from workers. • 89% of hospital patients agreed that when they used the buzzer, staff came What did patients tell us? • 94% of GP patients felt that staff treat them with We have separated the figures to show patient dignity and respect scores in 2018-19 by the type of setting (for example. hospital, GP, dentist etc.). Communicating Effectively Overall rating This includes how patients communicate with staff and how staff communicate with patients. Patients generally rated their care as good. • 84% of hospital patients said they could • On average, hospital patients scored hospitals communicate using their preferred language as 9 out of 10 • 92% of GP patients said they could communicate • 99% of dental patients rated their dentist as using their preferred language good, very good or excellent • 96% of dental patients said they could communicate • 88% of GP patients rated their experience as using their preferred language good, very good or excellent • 89% of hospital patients said they felt that staff • 97% of patients receiving ionising radiation as always listened to them part of a diagnostic procedure or treatment rated their experience as good, very good or excellent • 90% of CMHT patients said they felt that staff always listened to them • 98% of laser patients rated their experience as good, very good or excellent • 81% hospital patients agreed staff had talked with them about their medical conditions and helped them understand them Cleanliness • 87% of CMHT patients believed staff had enough We also asked patients to rate the cleanliness and time to discuss their needs tidiness of facilities. • 96% of hospital patients agreed the ward was clean and tidy Treatment options • 99.6% of dental patients agreed the surgery was This section covers how well treatments are explained fairly clean or very clean to patients and their understanding and participation in the treatment process. • 99% of GP patients agreed the environment was fairly clean or very clean • 96% of GP patients said things were always explained in a way they understand and 91% said • 99% of independent
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