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Trust performs well in Healthcare ratings

Newsdate: 18th October 2007

Wrightington, Wigan & Leigh NHS Trust has performed well in the majority of the indicators in this year’s Healthcare Commission Performance Ratings.   However, we are very disappointed that we did not fully meet all the required standards.   We are pleased that our overall rating for Effective Use Of Resources has improved from ‘fair’ last year to ‘good’ this year.  However, it is disappointing that our overall rating for Quality Of Services has moved from ‘good’ to ‘fair’ but this change is because of the introduction of some new indicators.  The new indicators cover areas already identified by the Trust Board as requiring improvement and where action plans are already in place.

Andrew Foster, Chief Executive says: “The staff in all of our hospitals work extremely hard for the people of the borough and the range of issues we are measured against get tougher year on year.  Despite the overall result on quality of services being lower than expected, staff should still feel justifiably proud that we have scored well in the majority of the indicators. We fully met and complied with the 44 core standards we are rated on as well as the existing national targets. We were also rated highly for diagnostic services, medicines management and improved our overall rating for financial management to ‘good’.  Where we have scored less well on quality this does not mean that standards have slipped within the Trust but that the Healthcare Commission has set higher standards this year. It is also important to remember that these ratings are for the year up to 1st April 2007 and since then the Trust has agreed a priority to place much more emphasis in quality and safety. We have already developed and implemented initiatives on the areas where we have not performed as well as expected.”

Chris Chandler, Medical Director says: “Naturally, we are disappointed that this years Healthcare Commission rating for quality of service has been scored overall as fair.  This appears to be a consequence of the introduction of new indicators or measures. 

Chris continues: “On all the previously assessed criteria we would have maintained our previous rating of good. The two new indicators, healthcare acquired infection and mortality rates after stroke are aspects of care that we are currently striving to improve”.

The Trust has improved services to patients across a wide range of areas including faster more effective care in A & E and emergency access, shorter waiting lists, quicker in patient referrals, surveying patients views. These are all areas where the Trust performed extremely well.

Andrew adds: “Overall, although we are disappointed with a small number of the indicators we are justifiably proud of our staff and will use the ratings as a benchmark to work on in the coming year but I can assure everyone that we are dedicated to improving even further the quality of the services we provide. 

To further explain the two very concerning areas of mortality rates following stroke and hospital acquired infections we have provided summaries of the way in which the Trust was assessed below.
Mortality following stroke
We believe that the stroke indicator is potentially misleading in suggesting high mortality rates. The objective is to progress towards reducing mortality by 2010 but the indicator actually only measures the proportion of time in hospital that stroke patients are cared for in a dedicated stroke unit. The Healthcare Commission used information from the National Sentinel Audit of stroke care which showed that in 2006, 44% of our stroke patients spent more than 50% of their time in our dedicated stroke unit.

We can confirm that mortality from stroke at Wrightington, Wigan and Leigh NHS Trust is currently comparable with other similar Trusts.

Patients and relatives should be reassured that all our stroke patients receive the best possible care and attention.

Since the review the Trust has implemented a number of initiatives to improve stroke services. The Trust has a dedicated stroke team; which is currently being developed in addition to having a nominated member of staff as an identified lead for stroke.  There are also initiatives for helping the care of patients with this condition such as the “Fast Stroke Patient Pathway” which ensures patients have CT scans within 24 hrs if necessary to aid recovery.

Hospital acquired infection
The Trust is disappointed that we have been unable to further improve our rating in this area despite intensive work to reduce healthcare associated infection. Throughout 2006 & 2007 we have implemented and developed several national and local initiatives with regard to this indicator.

The Trust was aware that achievement of the MRSA target was challenging however through its ongoing infection control work programme we have reduced rates of MRSA. 
Over the last few years the Trust has invested heavily in infection control and cleaning services and will continue to do in an attempt to try and reduce health care associated infection. We have year on year scored green (the highest score possible) following inspections by the Patient Environment Action Teams (PEAT) and are currently in the process of bidding for money from the Strategic Health Authority to further expand our infection control team. The team already have applied robust infection control precautions and policies in place for dealing with infection within the hospital.

The Trust has implemented the Department of Health's "Saving Lives" and "Clean your hands" campaign. In addition, investigations are carried out on all episodes of MRSA positive blood cultures, including detailed analysis using the National Patient Safety Protocol. All members of staff receive induction training on infection control and regular mandatory updates. Standards are monitored by comprehensive internal audit combined with PEAT inspections and patient involvement forum inspections.

 All our dedicated staff are committed to reducing rates of hospital infections.