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Bringing Excellence to Life

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Bringing Excellence to Life Quality Account 2011/12 Barts and The London NHS Trust Bringing excellence to life Quality Account 2011/12 Contents Chief Executive’s statement 3 Looking forward – our priorities for quality improvement 6 Looking back – our assurances about good governance 10 Review of our quality and safety performance in 2011/12 20 Quality dimension one – patient safety 20 Quality dimension two – patient-centered care and acting on patient experience 35 Quality dimension three – clinical effectiveness and efficiency 59 Staff experience and organisational development 73 Third party stakeholder commentaries 81 Appendices 86 Appendix 1: Participation in mandatory national projects in 2011/12 86 Appendix 2: External Auditor’s opinion 91 Appendix 3: Glossary 93 Further information and advice 102 2 Quality Account 2011/12 Chief Executive’s statement Continuous quality improvement at Barts Health I am delighted to introduce the 2012 Quality Account for Barts Health NHS Trust. We are the newest, and the largest, NHS Trust in the country, providing a wide range of general and specialist healthcare services for one million people in the City and east London. Barts Health brings together three former organisations: Barts and The London, Newham University Hospital and Whipps Cross University Hospital NHS Trusts. In one trust we will draw on the immense talent, commitment and expertise within our organisations to create, with our partners, a truly world-class health system. Our vision is to provide the highest quality healthcare that meets the needs of our local population, and to be recognised locally, nationally and internationally for outstanding clinical services, research and education. We want to be known for distinctive quality, safety and consistency in the care we provide and in every setting. We want to be an organisation that all our staff can be proud of, one which they recommend and one in which they feel they are valued in making a huge difference to people’s lives. The organisations that merged on 1 April 2012 have all shown that they, and now we, can deliver excellence in healthcare. The challenge now is to realise the potential of Barts Health for consistent, dependable delivery and for continuous improvement in a very constrained financial climate. Team working within the new organisation is going to be even more essential than ever. Collaboration for higher quality across the NHS system is going to be vitally important too. As an organisation we must listen, learn and act. Only by doing all of these things will we make the most of Barts Health, and play our substantial role in improving healthcare and the health and wellbeing of local people. With our partners, we must also play our part in eliminating inequalities in health that have existed in east London for far too long. Our starting point in Barts Health is a detailed review of quality and safety across the three former organisations using information from the Clinical Due Diligence process and the quality and safety letters of representation from each legacy trust. These findings have assisted us to identify key quality and safety priorities for Barts Health, maintain the progress that has already been made and set our quality improvement actions for the year ahead. All three legacy trusts have made some improvements in the National Inpatient Survey results but further improvements, which are detailed in the Barts Health Patient Experience Strategy 2012, are required. In particular, patient experience improvements will be focused on listening and responding to patient concerns in order to enhance services. In addition the three legacy trusts have a common priority of improving the experience of all staff, specifically making staff feel valued such that they would recommend Barts Health as an employer of choice. Transformational change is already underway. We can see the major investment in our hospitals coming to life. We have the opportunity to build on the work NHS Tower Hamlets previously led in community health services, enabling us to deliver more joined up care for patients along their whole healthcare journey. And we have joined University College London Partners (UCLP), as a founding 3 Quality Account 2011/12 partner of a leading academic health science centre. All of these developments, coming together now, will help us to provide ever higher quality, cost-effective healthcare, at greater pace, for the people we serve. Thank you for the valued contribution that you make in helping us to achieve our aims. I hope you find our Quality Account informative and useful. We want to hear your opinions on how we run our services and any improvements you think we can make. You can get in touch with us by emailing: [email protected] Peter Morris Chief Executive, Barts Health NHS Trust 4 Quality Account 2011/12 About this Quality Account The directors are required under the Health Act 2009, National Health Service (Quality Accounts) Regulations 2010 and National Health Service (Quality Account) Amendment Regulation 2011 to prepare Quality Accounts for each financial year. The Department of Health has issued guidance on the form and content of annual Quality Accounts (which incorporate the above legal requirements). In preparing the Quality Account, directors are required to take steps to satisfy themselves that: • The Quality Account presents a balanced picture of the Trust’s performance over the period covered; • The performance information reported in the Quality Account is reliable and accurate; • There are proper internal controls over the collection and reporting of the measures of performance included in the Quality Account, and these controls are subject to review to confirm that they are working effectively in practice; • The data underpinning the measures of performance reported in the Quality Account is robust and reliable, conforms to specified data quality standards and prescribed definitions, is subject to appropriate scrutiny and review; and the Quality Account has been prepared in accordance with Department of Health guidance. The directors confirm to the best of their knowledge and belief they have complied with the above requirements in preparing the Quality Account. By order of the Board Peter Morris Stephen O’Brien Chief Executive Chairman 5 Quality Account 2011/12 Looking forward – our priorities for quality improvement “I strongly believe that by sharing the expertise that is present in each of our three trusts, we can create a world- class health organisation – one that builds strong relations with our local communities and partners, and which ensures that the needs of our patients always come first.” Stephen O’Brien, Chair, Barts Health NHS Trust For our first year as Barts Health NHS Trust, our quality improvement theme will be ‘People’ – i.e. patients, staff, our clinical partners and the community. People will be put first – and this ethos will underpin our policies and philosophies. Our staff will receive the training and backup that they need to provide world-class clinical care. Our clinical partners will be supported as we pool resources, research and expertise to improve the services that we offer. The communities that we serve will have faster access to high-quality healthcare and more opportunities to work with us to drive our standards up even further. And our patients will benefit from even better facilities, cutting-edge technology and a caring, compassionate culture. Whilst the vision and values of Barts Health are in development, the key words that are defining our emerging approach are value, respect, listen, act and partnerships. These should not be just words – they should come to define how Barts Health will conduct relationships with all our stakeholders. In particular, the words will describe our interactions with: • Our patients - valuing, respecting, keeping them safe from harm • Our staff - valuing, listening, and acting on their concerns • Our clinical partners - valuing, listening, and working together to improve health and services. We are committed to improving care and services so that all patients, and in particular our most vulnerable patients, are kept safe and are always treated with respect and dignity. These are also the principles at the heart of the emerging Barts Health Patient Experience and Engagement Strategy. The strategy will support organisational development and culture, so that patients’ experiences of care and their perspectives will drive up the standard of care and influence the way care is delivered. It will provide the framework for staff to deliver compassionate, respectful, safe and high-quality care. We will continue to develop the delivery framework and then implement it throughout the new organisation. 6 Quality Account 2011/12 The Barts Health quality priorities that will redefine the patient experience The three distinctive Barts Health Trust Board quality priorities for 2012/13 are: • To keep patients (and their carers) better informed about their care and treatment, so that they feel safe and involved before and after they leave the hospital, and able to make informed choices • To improve the feedback given to staff when they report and raise quality and safety concerns • To improve our patient administration systems, with a focus on the quality standard and timeliness of letters and discharge summaries that we send to GPs. We will continue to work in partnership with GPs to deliver a high quality clinical service with the best possible outcome for every patient. Table 1 lists specific improvement projects and developments that the Barts Health clinical teams will lead and implement in collaboration with corporate and clinical colleagues and partners. The teams are currently in divisions and services, but will develop into new Clinical Academic Groups (CAGs) through the integration of our merged organisation. Some of the indicators were agreed with commissioners of the three legacy trusts as part of the Commissioning for Quality and Innovation (CQUIN) schemes. Others derive from intelligence gathered from staff and patient feedback and as part of pre-merger preparation work, such as the Phase 1 and 2 Clinical Due Diligence reviews.
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