A review of nurse staffing had been undertaken across the trust since our inspection in November 2014 and action taken as a result. Our staff are the lifeblood of our Trust. . This was an improvement from 5.6 and 6.8 respectively in 2017. 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. Infection control processes were not always followed. North Bristol NHS Trust is a National Health Service trust that provides community healthcare and hospital services to Bristol, South Gloucestershire, and North Somerset, England. 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. WHAT ITS LIKE TO WORK AT UH BRISTOL & WESTON, Communicate openly, honestly and listen to others, Treat everyone in a friendly, courteous manner, smile and make eye contact, Provide consistently high standards of care and service at all times, Actively seek better ways of working to achieve improvements, Uphold UHBWs values and be proud to work here, Respond promptly to telephones, call bells and other requests for help, Take responsibility and assist everyone who appears lost, Continually moan to others without making any attempt to change things, Appear unapproachable, moody or bad tempered, Being unsupportive of change / new ideas for improvement, Ill treatment or bullying of patients or colleagues. North Bristol NHS Trust values all people as individuals. [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. The letter also suggested that the trust does not require clinicians to disclose their sex. We are OneNBT. 0 The aim is to redevelop the site near Bristol. Overall, there was a 6 per cent increase in patients cared for, handled with 38 fewer beds. The shift to staff health and wellbeing being considered as important as patients health and wellbeing put NBT in a good place to look after its staff during the response to COVID-19. Dr Kate Coleman, founder of Keep Prisons Single Sex, said: At face value, everything Lord Markham says is encouraging. Safe and effective remained the same with a rating of good. 25 September 2019. Video, The secret mine that hid the Nazis' stolen treasure, Explosion derails train in Russian border region, Trump mistrial request denied in NY rape lawsuit, Banana artwork in Seoul museum eaten by visitor, Trump says 'great to be home' on visit to Scotland, NFL player's daughter, aged two, drowns in pool, Father tells how gunman opened fire on Texas home, JP Morgan snaps up troubled US bank First Republic. jobs@uhbw.nhs.uk Create the conditions for them to make suggestions and ensure they can be confident they will be acted on, to lead to effective change. However, improvements had been made in urgent and emergency care services, which we rated as good. Details of free physical and mental wellbeing sessions for NHS staff. This is an organisation that runs the health and social care services we inspect. Relationships with commissioners had improved and matured. People were truly respected and valued as individuals and staff were highly attentive to patients individual needs. Because we rated childrens services as good in November 2014 we did not inspect 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. Take action to improve the safe storage of medical notes. Although training and support had been put in place for staff, some were hesitant and found the system difficult to navigate. The trust employs over 8,000 staff delivering healthcare across Southmead Hospital, Cossham Hospital, and the Bristol Centre for Enablement, as well as the local communities. A dedicated wellbeing message has been sent to all staff every day during the pandemic. 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. We aim to be an anti-discriminatory organisation and are committed to building a team that represents a variety of backgrounds,. It was easy for people to complain or raise a concern and they were taken seriously when they did so. The secret mine that hid the Nazis' stolen treasure. Involvement of woman and their partners in their maternity care at Cossham Hospital. North Bristol NHS Trust owns the hospital but the adjacent health centre is owned by NHS Property Services. Cheltenham, The trust partially met the previous requirement notice. [5] The trial was funded by Parkinson's UK with support from The Cure Parkinson's Trust and in association with the trust. To ensure that any new members of staff understand the cultural wellbeing imperative, the head of people strategy, Guy Dickson, does a slot to set expectations. 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 NBT accelerated its planning ahead of winter 2019/19, developing a strategic plan in consultation with staff. Elective activity increased a sure indicator that the system was coping with winter pressures and able to deal with non-essential activity. Care records were not always managed safely. [25], The trust has welcomed many expansions and successes in clinical services. 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. There was no access to the trusts online records system, for example. The trust was working hard to sure that it included and communicated effectively with patients, staff, the public, and local organisations. Staff explained how they were able to offer extra time to this group of patients to ensure they were well cared for and made to feel relaxed and calm in an unfamiliar environment. ensure the staff attend mandatory training, for example, safeguarding training. The trust's treatments and advances in care have won national and international recognition. 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. Text Size. Like many NHS organisations, patient health had always been the number one success factor, but now NBT positioned staff health as equally important. However, in the theatre department and outpatients areas, some were stored in rooms which were not secured. This was not optimal for patient social and psychological wellbeing. They encompass a desire in all of us to provide the highest quality of care to patients and each other. We aim to be an anti . This rating stayed the same. A development plan had been initiated and coaching was ongoing. Mortality rates were significantly lower than expected when compared with other hospital trusts, as measured by the Hospital Standardised Mortality Ratio and the Summary Hospital-level Mortality Indicator. [27], The trust employs around 8,000 medical and non-medical professionals,[1] supported by volunteers. CCHP started the central intake team (CIT) to manage the risk of service users new to the service and subject to urgent referrals. Staff at all levels were very committed to providing good patient care and frustrated when they felt they could not achieve this. However, improvements were required in end of life care . Bristol, We saw several areas of outstanding practice including: As the major trauma unit for the Severn region the department was required to report all treatment results of major trauma patients to the national trauma audit and research network (TARN). the service is performing badly and we've taken enforcement action against the provider of the service. People have confidence the organisation will look after them. The safe domain was rated good because there were effective systems in place to assess and manage risks to patients. ensure that medicines are stored appropriately and administration is recorded accurately. The 2018 staff engagement survey, conducted in November, also showed an increase in staff engagement from 6.8 to 6.9. GL53 7AN. While leadership and governance within the unit were effective, we found that the service was not as integrated in North Bristol Trust as it could be. Staff monitored the effectiveness of care and treatment, using the findings to make improvements and achieve good outcome for patients. Mental capacity of patients was not clearly recorded in their notes when it was assessed. Children and young people were involved in developing information leaflets and media applications, and the recruitment and training of staff, and have created artwork to make the service environments feel more welcoming. The CCHP worked in partnership with other agencies such as the local authority, education and Barnardos. Staff supported and involved patients, families and carers to understand their condition. [22] On staff engagement there was an improvement in questions on staff feeling their feedback was acted on. +6]`.12UNjxt^aS/7GoXRF[@; ~Y^TC+[AjdX"XVB2E,Ky z7'gP "9$pmt5XW)RvMsM~ We saw evidence that partnership working was routinely included in every aspect of their work. The environment at Monk Park House was not clean and young people had access to hazardous cleaning products and knives. and our acute colleagues in Weston Area Health NHS Trust and North Bristol NHS Trust, Et The work undertaken by the dementia care team within medical services was seen as outstanding. Staff generally were aware of and understood the vision of the Community Childrens Health Partnership (CCHP). M+q}#c{Bo iJ 'xt^ There was good multidisciplinary working across the trust. 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. A culture of wellbeing was encouraged, with organised lunchtime walks to wellbeing from the site twice a week and an emphasis on the importance of taking breaks. People received effective care that met their needs and staff understanding of the Mental Capacity Act and Deprivation of Liberty Safeguards had improved since our last inspection. [20], It ended 20152016 in deficit of 51.6M. Staff were clear about the processes they should follow to risk assess patients and respond to those who may deteriorate. The Avon Orthopaedic Centre delivers services such as hip and knee surgery, carrying out 1,000 knee replacements a year. A childrens and young persons participation strategy (20142016) had been developed. 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. Staff were kind and caring and we observed excellent interactions between them and children and young people and their parents or carers. This work was to be completed in early 2016. The service for young people and their families at Riverside was good. The number of cancelled operations was worse (higher) than the England average and the percentage of patient not treated within 28 days of a cancelled operation was above (worse than) the England average. Every service was found to be caring and we observed positive interaction with patients. Staff appraisals were undertaken across the hospital, but improvements were required within medical and community CAMHS services. In response, NBT enhanced its wellbeing programme to include 16 interventions available for staff to access. Let's make care better together. Well-led and safe improved to good. The trust's treatments and advances in care have won national and international recognition. These reports look at how NHS hospital trusts use resources, and give recommendations for improvement where needed. Responsive at core service level was rated requires improvement. The trust was not meeting its target of 85% for the percentage of staff receiving mandatory training. There was alignment between service and trust plans. Suspended ratings are being reviewed by us and will be published soon. There was strong clinical leadership and direction within the service. Studies have proved a direct link between better staff engagement and improved clinical outcomes for patients. Here we describe our Trust's values and behaviours. A new employee assistance programme was instigated, giving staff access to free financial and legal support, relationship advice and counselling 24/7. We support and care for every member of staff, every carer, every visitor, and will always put the patient first. Our analysts have developed this monitoring to give our inspectors a clear picture of the areas of care that need to be followed up. Staff sickness levels also fell, generating associated budget savings. [1], The trust issued invoices to patients thought to be ineligible for NHS treatment totalling 1.2M in 201819, but only collected 0.2M. BS1 3NU, In Responsive improved to requires improvement. The rate of completion of staff appraisals was inconsistent between teams. The service did not follow procedures to ensure cleanliness as a measure of infection prevention and control. We don't rate every type of service. From April to December 2014, Frenchay Hospital was progressively closed, with the majority of services moving to a new building at Southmead. Did this woman die because her genitals were cut? North Bristol NHS Trust values all people as individuals. Explore in 3D: The dazzling crown that makes a king. the service is performing badly and we've taken enforcement action against the provider of the service. _lvO%x(3yH;< 6={' !)|; W^[}' 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. They are based on assessments carried out by NHS Improvement, alongside scheduled inspections led by CQC. The trust actively sought coaches who represented staff with protected characteristics, to ensure maximum inclusivity of the programme. 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. It comes as the Government is poised to rewrite equality law to protect women by making it easier to bar trans people from single-sex spaces such as wards. 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. There were issues of concern with the availability of medical records and the use of temporary sets of records. The board had developed significantly since our last inspection. In the community services for children and young people such working was excellent, with work with Barnardos Child Sexual Exploitation (BASE) project which focused on young people who were at risk of exploitation being recognised nationally as an area of outstanding practice. As part of each inspection, we look at the way health services provide care and treatment to people. [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. 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). Despite 2,500 more emergency department (ED) attendances and 3,000 more admissions, there were 600 fewer four-hour breaches in 2018/19, with occupancy down by 4 per cent. 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. The success of the programme was recognised with an award for Best Clinical Service and Treatment Pathway Transformation Project in 2019 from the Health Service Journal. End of life care was rated requires improvement overall. The leadership, governance and culture of the trust promoted the delivery of high quality patient centred care. 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. The servicewas working towards Young People Friendly accreditation. The trust ran inpatient geriatric services at Blackberry Hill Hospital until 2005, when it closed activities at the site transferring most services to Frenchay and Southmead, and eventually selling the trust's part of the site. GQ(|T825T2".]]]wuyo=0{@@ @ @ @ @ @ @ @ @ 5U6k}mYN vyF8? Main Duties and Responsibilities Nursing Care (under direct supervision) 1. Our overall rating of the trust improved. Each laboratory features specific reference ranges. vacancies we have across our hospitals and divisions. Staff provided emotional support to patients, families and carers to minimise their distress. For example, we respect their aspirations and commitments, and seek to understand their priorities, needs, abilities and limits. At the heart of the 800 bed hospital is a public concourse which simplifies access to the medical wards and departments. Improvements had been made to the financial governance of the trust, but there was still much to be achieved to bring the trust back to financial balance and address the non-achievement of key operational performance targets. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually. Although bed occupancy remained high within maternity services (excluding the central delivery suite) this had improved flow within the service. There was excellent working with Barnados with a clear ethos of engagement with and involvement of children, young people and their families in developing and delivering services. Read about our approach to external linking. The board and other levels of governance within the organisation functioned effectively and interacted with each other appropriately. The concourse, known as the 'atrium', is naturally lit and ventilated and provides cafes, winter gardens and artwork. The needs of patients with complex needs were well understood within all areas of the hospital. There have been several unsuccessful attempts to upgrade the facilities over the past 30 . Not all areas were following best practice and we were not assured the trust had full oversight of cleaning regimes in some areas. Governance systems had developed since our last inspection. Ensure that the environment at Monks Park is safe for the people who use the service and staff. Research North Bristol NHS Trust . There were 107 operations cancelled on the day of operation in October 2014, 50 of these were due to the lack of a bed due to emergency pressures. There was clear visibility of risks at board level. We carried out this focused inspection of the North Bristol NHS Trust to follow up on the areas that were rated as inadequate and requires improvement in our inspection in November 2014. Leaders had a deep understanding of issues, challenges and priorities in their service, and beyond. At a hearing on November 30, 2021, North Bristol NHS Trust's lawyers asked the tribunal to strike out his case on the grounds that his beliefs are "not worthy of respect in a democratic. The trust had met the previous requirement notice regarding staffing by reviewing the staffing levels and skill balance in the CAMHS teams. Patients should not have to share sleeping accommodation with others of the opposite sex and should have access to segregated bathroom and toilet facilities.. 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 Staffs self-reported happiness scores, using Happy App, improved from 46 per cent (rated a neutral result) in 2017 to 59 per cent (rated a positive result) in 2018. 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. ensure that equipment in theatre is sterile and available for use when required. Here we describe our Trusts values and behaviours. Safeguarding procedures were in place with clear lines of reporting. Records must be fully completed and provide detailed information for staff regarding the care and treatment needs of patients. Actions had been instigated to address both of these. Commitment to quality of care We strive to deliver quality care every time. This equated to a saving of 301,015 on sickness costs. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. 8>@ Governance processes were innovative, and focused on improving safety, quality, and patient experience specifically for outpatients. These replace any issued under embargo or published on this website prior to this time. hko6 Surgery: was rated good overall. As Chair of the Trust I feel passionately that we deliver on this aspiration to ensure that we have a workforce that truly represents the population we serve. This includes bespoke rotations, wellbeing support, personalised travel plans, and a structured preceptorship. BA1 3NG, In Patients felt involved in their care. [2], The Institute of Neurosciences is located in the Brunel building at Southmead Hospital. Inadequate 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. Across the trust there was involvement in audit and benchmarking both internally and externally. Potassium: 3.5-5 mmol/L. Click below to view the Southmead Hospital is host to regular engagement days and study days. Admissions to the unit were appropriate and there was a system in place to triage referrals. There were sufficient staff to ensure outpatient clinics ran safely. Leaders had the integrity, skills and abilities to run the service. This is the South West version of the Department of Health Your Welcome standards. We are the regional Major Trauma Centre, and an internationally recognised centre of excellence in a range of services and major specialities. Is climate change killing Australian wine? There are over 8,000 reasons why North Bristol NHS Trust is a place to be #NBTProud of. NBT created comprehensive plans to address both simultaneously. To do this we must together build and develop the capability of our people, and share common values and behaviours which are transparent and visible in whichever role we play. 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. the service is performing exceptionally well. ensure that all patients medical records are available when the patient is being seen and that the reliance on temporary records is reduced to a minimum. Identify the best time of day/year to hold activities and events, to ensure that all staff groups can access them. 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. )=c,{MyYY> Tier 3 CAMHS were provided by a wide range of professionals, were effective and there was evidence of mutually supportive, multidisciplinary working across all of the CAMHS teams. As much emphasis was placed in the caring for and about those close to patients as patients themselves. Ensure patient information remains confidential through appropriate storage of records in the outpatient clinics and theatre departments to prevent unauthorised people from having access to them. Hospitals are set to be told they must guarantee single-sex care amid a row over hospitals allowing transgender NHS staff to treat patients based on their gender identity. The systems in place to monitor the completion of mandatory training were not effective. A network of champions helped to overcome obstacles. The building, designed by BDP architects, won RIBA South West Award 2018 for its architecture, as well as RIBA South West Client of the Year 2018. In 2017-18, only 77.1% of A&E patients were seen within four hours. Staff supported patients to make informed decisions about their care and treatment. This rating stayed the same. Frontline staff and managers were passionate about providing a high quality service for patients with a continual drive to improve the delivery of care. Although there was a trust wide focus on patient flow within the hospital and improvements had been made this still required improvement. Building wellbeing into the normal working day has also helped staff understand that they are not only able to look after their own wellbeing, they are expected to. Your information helps us decide when, where and what to inspect. Some examples include the use of deep brain stimulation techniques for the treatment of functional disorders such as Parkinsons disease, led by Professor Gill, and developing the use of robotic surgery to deliver drugs directly into the brain.[4]. However, some staff felt unsupported by operational management arrangements and undervalued, and that both service management and the trust did not listen to them. This was the same as our last inspection at Southmead hospital in 2016. A strictly casual dress code helped to level hierarchies and emphasise the OneNBT approach the trust had created. 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. 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. Action to address this was not always timely or effective and had resulted in a high number of complaints. [26], In September 2019, the trust was rated by the Care Quality Commission (CQC) as outstanding for caring, and good overall. #5]%wT$@^@^]H q!zdF*EVUgE. Existing staff may not always be able to respond to urgent referrals or maintain the safety of children and young people receiving services. We rated the responsive domain as inadequate. 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.
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