QUALITY REPORT 2017/18 Page 2

QUALITY REPORT 2017/18 Page 2 Contents Part 1: Statement on quality from the Chief Executive of Western Sussex Hospitals NHS Foundation Trust 3 What we do 4 Purpose of the Quality Report 4 Statement on quality from the Chief Executive 6 Part 2.1: Priorities for improvement 8 Our Trust approach to Quality Improvement 9 Priorities for improvement in 2018/19 11 Part 2.2: Statements of assurance from the Board 16 Review of services 17 Participation in clinical audits and confidential enquiries 17 Research 26 Goals agreed with commissioners: use of the CQUIN payment framework 26 Statements from the Care Quality Commission (CQC) 27 Data Quality 27 Identifying, Reporting, Investigating and Learning from Deaths in Care 29 Part 2.3: Reporting against core indicators 32 Performance against the 2017/18 core set of indicators 33 Part 3.1: Review of quality performance 40 Performance against 2017/18 quality improvement priorities 41 Reducing preventable mortality and improving outcomes 42 Avoiding harm 55 Improving patient experience 70 Improving staff engagement 74 Part 3.2: Other Information 82 Local quality indicators 83 Single Oversight Framework indicators 87 Annex 1 – Statements from our commissioners, local Healthwatch organisation and Overview and Scrutiny Committee 88 Annex 2 – Statement of Directors’ responsibilities for the quality report 92 Annex 3 – Limited Assurance Report on Quality 94 Glossary of terms and acronyms 98 Quality Report 2017/18 FINAL Part 1: Statement on quality from the Chief Executive of Western Sussex Hospitals NHS Foundation Trust Marianne Griffiths, Chief Executive Page 4 What we do Western Sussex Hospitals NHS Foundation Trust The organisation was created in 2009 by a merger serves a population of around 450,000 people of the Royal West Sussex and Worthing and across a catchment area covering most of West Southlands Hospitals NHS Trusts, and has been Sussex. an NHS Foundation Trust since 2013. The Trust runs three hospitals: St Richard’s Our services are delivered through four clinical Hospital in Chichester, Southlands Hospital in divisions – Medicine, Surgery, Women & Children Shoreham-by-Sea, and Worthing Hospital in the and Core Services – and two enabling ones: centre of Worthing. Corporate, and Facilities & Estates. St Richard’s and Worthing hospitals provide 24- We were inspected by the Care Quality hour A&E, acute medical care, maternity and Commission, the independent regulator of health children’s services, while Southlands specialises in and social care in England, during December day-case procedures, diagnostics and outpatient 2015, and awarded the highest possible rating, appointments. Outstanding. In addition to our three hospitals, we provide a Our ambition now is to build further on this range of services in other community settings, achievement and continue to improve the quality including: Bognor War Memorial Hospital, Crawley of care we can offer our community. Hospital, health centres, GP surgeries, and sexual health clinics. Purpose of the Quality Report Patients deserve to know about the quality of care services we deliver to local communities and they receive, and at Western Sussex Hospitals we stakeholders. aim to ensure that this is the very best quality of The quality of our services is measured by looking care every time. at patient safety, the effectiveness of treatments that patients receive and patient feedback about Our Quality Report is a narrative to patients, the care provided. carers, professionals and the public about the quality and standard of services we provide. It is NHS Improvement requires all NHS Foundation an important way to show improvements in the Trusts to report on the quality of care they provide as part of their annual reports. Foundation Trusts Quality Report 2017/18 FINAL Ten facts about our In 2017/18 Trust the Trust: Treated Saw 132,992 inpatient and day cases 139,430 and held 585,037 patients in outpatient appointments Accident & Emergency Cared for patients in Employed 1000 acute beds 6,958 members of staff across all our sites Benefited from a membership of more than 14,000 staff, patients and members of our community as an NHS Foundation Trust Averaged 240,000 Received around £1 million in donations for hospital public services and equipment from the Love Your Hospital website Received 3,084 charity, Friends of Chichester Hospitals’, The League of page views compliments and Worthing Hospitals & Community Friends and The per month plaudits from League of Friends of Southlands Hospital plus 3,268 patients and Facebook relatives and 2,982 Was supported by around 900 Twitter core volunteers, who help in followers everything from serving meals to performing clerical duties. In addition we also have volunteers supporting our cardiac departments, Delivered chaplaincy team, flower 5,076 ladies, hospital radio, league babies of friends and Samaritans Page 6 Statement on quality from the Chief Executive At Western Sussex Hospitals we are committed to initiate improvement ideas through daily team continually improving the quality of care our huddles and lean projects. Sir Bruce was clear that patients receive and despite many challenges the NHS must mobilise the intellectual capacity of 2017/18 has been another successful year for the those who work for the health service in order to Trust. improve quality in the face of increasing demand, escalating costs and restricted finances. In July 2017 we won the much-coveted Best Organisation prize at the national Patient Safety In February, the Secretary of State for Health Awards in Manchester. The judges commended Jeremy Hunt MP paid his third visit to the Trust the Trust’s stalwart commitment to continuous and reiterated his support for our Patient First improvement and authentic leadership that puts approach while speaking to staff about the patient care, safety and experience at the centre of Department of Health’s ambition to make the NHS everything we do. the safest health service in the world. Mr Hunt championed Western Sussex Hospitals as a Such recognition is also an excellent endorsement leading trust contributing to this ambition and he of Patient First, our ambitious Trust-wide reaffirmed his belief that we are the best example transformation programme which we launched of a learning culture that he has seen anywhere in nearly four years ago in order to help our staff the NHS. always improve patient care and experience with the application of lean management best practice. In March, this year’s NHS Staff Survey results proved a further highlight for our organisation As a result of Patient First, we are now seeing when we were absolutely thrilled to be ranked as fantastic results for our patients. For example, one the very best hospital trusts in the country to with collective focus on the biggest cause of work for. The confidential survey of more than 4,000 patient harm, we have prevented more than 370 members of staff at Western Sussex, and nearly half inpatient falls in the past 12 months. Winning Best a million nationwide, also placed our Trust among Organisation for patient safety is a great mark of the top five trusts in England where employees are confidence in what we are doing and yet more most likely to recommend the care their hospitals evidence that Patient First really is making a provide. For the first time, our Trust was also difference to our patients. ranked in the top 20% of all NHS organisations with the highest levels of staff engagement. In August 2017, Sir Bruce Keogh, who was at the Evidence shows that better engaged staff provide time NHS England’s National Medical Director, better patient care, so our survey results are real visited the Trust and praised both the enthusiasm cause for celebration at a time when engagement of staff as well as the Trust’s commitment to enabling them to solve problems locally and Quality Report 2017/18 FINAL Page 7 scores across the NHS have deteriorated and As we look forward to 2018/19 and the challenges pressure on staff has never been greater. ahead, it is our common values and shared purpose, fostered by our Patient First approach Once again this year, demand for our services has and highly engaged workforce that will ensure we continued to grow and the workload for our staff continue to provide outstanding care. This will of has never been greater, both at the frontline and course be supported, once again, by our for all those who support the delivery of care at commitment to continuous improvement. Western Sussex Hospitals. Our wards, for Pressures of demand, staffing and budgets will example, have never been busier with bed inevitably continue to test us but we are occupancy rates reaching new highs, especially determined to push beyond those barriers and over the winter period when we cared for make further progress on our Quality Priorities and unprecedented numbers of more elderly people True North metrics. In 2018/19 these efforts will with more complex health needs. Despite our very focus on improvement programmes around sepsis, real staffing and bed pressures though, the mental health, orthopaedics, falls, pressure dedication and hard work of our outstanding staff damage and patient experience. ensured the quality of care we provide was maintained. For example, our mortality figures I am pleased to confirm that the Trust Board has continue to improve and we are currently placed in reviewed the 2017/18 Quality Report and confirm the top 17% of hospitals in the country in terms of that it is a true and fair reflection of our Dr Foster’s Hospital Standardised Mortality Ratio. performance. We hope that this Quality Report provides you with a clear picture of what we have Western Sussex staff and volunteers are not only achieved over the past year and how we will hard working, but undertake their work with continually build upon these foundations and exemplary skill, kindness and compassion.

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