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Royal Bournemouth In For New Inspection
The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust (RBCH) will be one of the first hospitals to be visited as part of the Care Quality Commission's new inspection programme.
The CQC's new Chief Inspector of Hospitals, Professor Sir Mike Richards, made the announcement on Thursday 18 July. It's because the RBCH has been identified as 'high risk' based on death rates data.
Tony Spotswood, RBCH Chief Executive, welcomed the new inspection programme. He said:
"We continually strive to build on the excellent care we provide to our patients which is why we look forward to this inspection by the CQC. The CQC has selected our Trust as it has identified a "high risk" based on some mortality data. It has specifically confirmed however that there is no identified risk associated with the care provided by the Trust, the safety of our hospitals, our responsiveness, or how the Trust is led.
"It is important to look closely at the figures that are used to assess mortality rates and also when these figures were released. Unlike most acute hospitals in the country, the Trust has a specialist palliative care unit - the Macmillan Unit. Locally more patients will appropriately spend the end of their life in our hospital because of the presence of this hugely respected facility. Around 18% of deaths at our Trust last year occurred in the Macmillan Unit.
"There is also a lack of alternatives in our community for patients who do not wish to spend the end of their life in a hospital setting. The Trust has consistently asked for community services and packages of care to be strengthened in order to offer patients a choice. We hope this review will lead to further action being taken to ensure the health system works together to secure patients a genuine choice as to how they are supported in their final days.
"Hospital mortality figures are calculated in two ways. Our SHMI* score is within the expected range, while the HSMR** figures for 2011/12 did flag our Trust as having higher than expected mortality rates at the weekend. However the organisation that publishes these figures - the Dr Foster Intelligence Unit - confirmed our rating was actually within the expected range, once data from the Trust's Macmillan Unit was removed.
"The HSMR figures quoted are now over a year out of date. "Since August 2012 we have increased consultant physician presence on site over weekends so that there is now one consultant physician on site from 8am-8pm Saturday and Sunday as well as on-call cover outside of these hours. This allows immediate senior review of sick patients, as well as the systematic ward rounds of admitted patients and improved continuity of care. It also results in improved supervision and training for junior medical staff. We have also increased nursing staffing levels and continue to look for further changes and improvements across all areas, for example regarding the workload to junior doctors out of hours.
"The Trust is not however complacent and the current indications are that the HSMR data for 2012/2013 will show that our weekend mortality rates are within the expected range.
"However although the numbers are important, we believe the quality and safety of our care is of greater significance and we would like to reassure the public that as part of our continuing efforts to improve patient care we always look for ways we can make changes and improvements. We therefore welcome the input of the CQC and of course should other issues be raised, we will tackle them immediately.
"Many of the recommendations made in Sir Bruce Keogh's report are already being implemented at the Trust.
"We have a real pride in the services and care we provide and would hope that the many aspects of outstanding practice are identified through this work.
"Additionally we caution the interpretation of mortality data, a point reinforced by Sir Bruce Keogh who said in his report 'it is clinically meaningless and academically reckless to use such statistical measures to quantify actual numbers of avoidable deaths'."
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