Bristol CCG in partnership with South Gloucestershire CCG and health and social care partners, have welcomed today’s Care Quality Commission report showing that North Bristol NHS Trust provides good quality care to patients, while noting that the Trust must address a range of internal issues in order to deliver required improvements.
CQC inspectors found every Trust service to be ‘caring’ with high levels of staff commitment and good patient care, but rated the Trust overall as ‘requiring improvement’ with particular emphasis on performance and financial issues and the flow of patients through Southmead Hospital.
GP urgent care lead for Bristol CCG Dr Peter Goyder said: “We recognise the commitment to effective partnership working across all organisations to improve urgent care flow.
“We are also particularly keen to work with NBT to support them in developing a robust workforce to ensure that patient safety remains a high priority.”
High standard of care and staff commitment
Chair of South Gloucestershire CCG Dr Jonathan Hayes said: “There is much to welcome in this rigorous independent report and as co-ordinating commissioner of services from NBT I am pleased that the CQC has recognised the Trust’s high standard of care and staff commitment.
“However there are clearly many internal actions that the Trust needs to take in order to improve patient care and experience as it continues to settle into the new hospital.
“The CQC’s findings relating to ‘flow’ through the hospital are of particular importance to all of those partners who support NBT, including the CCGs, local authorities and our community healthcare providers.
“Partners have been working with the Trust for some time in a joined-up way to ensure that patients don’t go into hospital when they don’t need to, but if they do that they are supported to return home in a safe and timely manner.”
Much to be proud of
Mike Hennessey, Service Director of Care, Support and Provision at Bristol City Council said: “The report highlights that there is much to be proud of within the North Bristol NHS Trust. Every service was found to be caring, there is good multidisciplinary working across the trust and staff at all levels of the organisation are very committed to providing good patient care.
“However, there are clearly improvements that need to be made and Bristol City Council is working closely with the trust to make sure that patients get the right care in the right place, at the right time”
Chief Executive Officer of South Gloucestershire Council Amanda Deeks said: “We welcome the findings published in the CQC report on North Bristol NHS Trust (NBT) which rate maternity services at Cossham Hospital and children’s community health services as outstanding. There are areas within NBT where improvements need to be made.
“We will work with our partners in health to improve the patient journey for South Gloucestershire residents accessing A&E services, this must include the community facilities being developed at sites in Thornbury and Frenchay. The action plan will be scrutinised by our Public Health & Health Scrutiny Committee at a later date.”
Improve the system and patient flow
Examples of recent actions taken by health and social care partners to deliver additional community capacity to support the NBT system and improve patient flow include:
• Direct in-reach and intervention from CCG commissioners and community and social care partners to identify people who are suitable for discharge and support them in returning home;
• Purchasing additional community rehabilitation and reablement support including additional community rehabilitation beds and community services to enable people to return home more quickly;
• All partners have made access to community and social care services available throughout the weekend to help improve flow through the NBT system;
• Providing out-of-hours GP slots for patients in the Emergency Department who could be better dealt with by a GP;
• Increasing the number of people who are supported on discharge from Southmead by community staff so they can leave sooner and increasing the number of people cared for in their own homes to avoid an admission into hospital;
• Developing a “Discharge to Assess” service which means patients who are medically fit but require rehabilitation can be discharged and assessed in their own home on the same day as they assessed as safe for discharge.
• Increasing capacity to provide more Intravenous (IV) therapy at home which also allows early discharge for those in hospital only needing IV antibiotics or other forms of IV therapy;
• Working with patients ready to leave hospital to provide interim placements in nursing homes for their rehabilitation, supported by therapists in-reaching to the homes thereby releasing a bed for someone in greater need.