Response to Duke of Gloucester Patient Group Visit Report

Royal National Orthopaedic Hospital Trust

Thank you Shirley and Marion for your informative visit to the above ward, this was much appreciated. We welcome your input and feedback and will most certainly aim to introduce positive changes where indicated in maintaining high patient standards and overall further improve patient satisfaction.

As Matron for this ward I am reassured by your comments that patients and relatives are expressing confidence in the quality of care they are receiving. This is certainly complementary to the team of nurses and doctors on this ward and therehard work. The ward can be very busy and demanding especially dealing with sarcoma and bone tumour patient who tend to have extended stays more than our routine orthopaedic patients.

In response to points raised I would like to add the following comments:

Long days were rolled out across the Trust having successfully piloted across two adult wards for over two months. In rolling out every staff member had an opportunity to put in writing any concern they had and where possible they were not suitable to work long day’si.e. occupational health reasons, carers and dependants or staff on capability were also highlighted as not appropriate for long days. Management in consultation with HR reviewed all letters. There has since been evaluations completed on long days. We now have a combination of shifts across all wards including Duke of Gloucester. I am happy to address individual circumstances as they arise in relation to suitability of long days. I am, however not aware of any staff who have expressed a wish to change there shift and are unhappy in any way in relation to long days. I would also like to think Ward Managers could raise any concerns with constructive evidence on any concerns they may have in relation to long days.

The issue of long term sickness became an issue on Duke of Gloucester prior to Christmas. It is fair to say Duke of Gloucester has a record of good staff retention and minimum staff turnover. Unfortunately any sickness both short term and long has an impact on remaining staff. Ward Managers do have the option of booking a suitable staff member from the bank consistently over a period to cover long term sickness if they are available and deemed suitable. This has been successfully supported in the past. All staff on long term sickness are being addressed through our Long Term Sickness meetings and to date we have been able to intervene in speeding up the process of consultant referrals and appropriate pain management intervention at the RNOH. One such staff member has already returned to work on reduced hours. All staff returning from long term sickness will work reduced hours if deemed appropriate by our occupation health department.

With reference to alarm cords we will review there accessibility to patients and carry out the necessary changes as highlighted.

The process of discharge planning can be instigated both at the pre –assessment stage and on admission. The aim now is for increasing numbers of our patients to undergo a pre-assessment process and during this process any such potential discharge issues can be raised and facilitate intervention from appropriate multi-disciplinarystaff prior to admission. The involvement of social services can be a timely process and can be very time consuming for nursing staff. Ward staff do not deal with one specific social service group hence it is difficult to build relationships and equally all paperwork varies from one social service department to another. It is correct to say delays around social service referrals, follow up and immediate action can cause bed blocking. We will over the coming year focus on this aspect as part of our discharge processes and establish if further improvements can be made.

Thank you again for your visit and we look forward to you ongoing input and support.

Helen Landers – Flynn

Matron for Adults

10th February 2010