Sheffield Local Involvement Network

Sheffield LINk is delighted to be able to share some examples of how we have been able to work with the local health and social care providers to bring about a chance that enhances the patient experience.

 Pharmacy delays to discharge

In June 2010, our issue log showed that a number of people had complained about the time it took for them to receive their medication after a stay in hospital, which led to long delays in being discharged. As a first step, the LINk sent a request for information to Sheffield Teaching Hospitals NHS Foundation Trust (STH) to find out exactly how long the pharmacy took to fill these prescriptions. We discovered that pharmacy turnaround times were 95 minutes in the Northern General Hospital (NGH) and 102 minutes at the Royal Hallamshire Hospital (RHH).

We then invited STH to discuss this issue in more detail and more than 20 members attended the meeting in July to hear from those leading this work. The speakers gave an informative presentation about the complexity of the full discharge process and how Trust’s plans to speed this up. One of the speakers was the Chief Pharmacist who talked about the 40,000 discharge prescriptions dealt with each month and the part that pharmacy plays in the discharge process.

STH have continued to share their plans for tackling delays to patient discharge. They are developing a new bed-management system to improve the care pathway, working on an electronic discharge notification system and expanding the number of dedicated discharge liaison teams to support wards with complex cases. The pharmacy has also invested in improving the speed of dispensing with an electronic tracking system in both hospitals, a robotic dispensing system in RHH and having medicines management technicians assigned to particular wards. 

In January 2011, LINk issued a repeat request for information. We were pleased to find that turnaround times at RHH had improved from 102 minutes to 79 minutes and in NGH from 95 minutes to 90, with plans to improve it further. We continue to keep an eye on this issue.

Ward information

Being in hospital or visiting a loved one there can be difficult and anything that gives people the information they need in a stress-free way is a benefit. Sheffield LINk has been responsible for changes to the notice boards’ across all Sheffield Teaching Hospitals wards.

The story began in February 2010, when authorised representatives visited wards to review infection control procedures. One recommendation was to make ward information more accessible. As a result, one of the visitors was invited to join the Patient Environment Group and met with the Patient Partnership Manager about this issue.

Following this meeting, ward boards were completely redesigned to, as benefit patients and their visitors, not the staff. Therefore, the information needs to be relevant, clear and easy to understand. In the process, many notices were removed, technical information was simplified, colours used to separate out information and ‘emoticons’ such as smiley faces, used to show progress on targets, which also helps those who have English as a second language.

The public also want to know who’s who on the ward yet pictures of individuals can soon become outdated. Therefore, they introduced general illustration of the different uniforms in a ward so that people can identify who they need to talk to. The Trust also agreed to check and update the information every three months.

The new style notice board took the form of a poster and was trialled on ward Chesterman 2 at the Northern General Hospital in March 2011. Feedback was positive and, with the support of the WRVS, posters are now up in every ward.

Infection control at local hospitals

In February and March 2010, Maureen Stoneman and Helen Rowe, undertook 'enter and view' visits to the Royal Hallamshire and Northern General hospitals on behalf of the Infection Control Action Group. They made a number of recommendations and Sheffield Teaching Hospitals NHS Foundation Trust (STH) responded in May with a full action plan.

One recommendation was that there should be greater clarity about who can use the sinks on the ward. STH has stated agreed that in future, admission staff will inform patients that they and their visitors can use these sinks to wash their hands. STH has also given the names of those leading on this action and how it will be monitored. Although a relatively small measure, this is just one example of how LINk is working with local trusts to public tackle concerns like hospital-borne infections.

Patient Safety alerts

Earlier this year, it came to light that a number of local trusts had outstanding patient safety alerts (PSAs), for example urgent measures to ensure the safe use of injectable medicines. NHS Trusts are supposed to report to a Central Alert System when the actions recommended by these alerts have been implemented. This implementation was a 'core standard' set by the Department of Health. Sheffield LINk used our 'Request for Information' legal powers to demand an explanation and timescales for when they would comply. We were pleased with how quickly this was resolved once we became involved. 

Quality Accounts for local trusts

LINks members have had an impact on the way in which Sheffield Health and Social Care NHS Foundation Trust presents its annual Quality Account. A draft Quality Account was sent to the LINK who reviewed it and sent a statement that picked up a number of issues including:

• the lack of information about support for carers especially carers of people with dementia

• asking  for additional information on some consultation work that the Trust had done on physical health policy and mental health

• how the report was written and how it assumed knowledge that members of the public don't have. 

The Trust was proactive in receiving feedback on its report and quality objectives for the following year and agreed to the following LINk recommendations:

1.  'Support for Carers'  is a priority area of work for 2010/11  

2 - Acceptance of using service user data as a quality objective  

3 - Including a quality objective on nutrition to address physical and mental health components. 

Washrooms in Huntsman Ward

Patient opinion received some feedback from a patient about their experience in the Northern General Hospital and passed it on to us. Sheffield LINk then contacted Sheffield Teaching Hospital Foundation Trust about the following case.

The patient was recovering from a hip replacement and went to have a shower. While the cubicle was nice and clean, it was very small and difficult to manoeuvre about in due to having a high step and insufficient grab rails. The patient also found that the curtain hadn't kept the water in the shower and so there was water over the floor making it slippery. Although there was a chair in the room, it was an ordinary stacking chair with no armrest and was very low. In the end the patient was forced to call for assistance.

A few weeks later, we received the following response from Sue Butler, Head of Patient Partnership, Sheffield Teaching Hospitals Foundation Trust.

'We acknowledge that the showers on the Huntsman wards could be further improved and we do have plans to convert the showers to "wet rooms".

Over the last couple of years we have been upgrading the Brearley and Huntsman wards. Huntsman 6 and 7 have been upgraded, and this has included changing traditional showers and bathrooms to wet rooms.

This programme is continuing and this year the Trust will complete 3 full ward upgrades - Brearley 4, Firth 2 and L2. The provisional date for further improvements to Huntsman wards is next year.'

Annual Health Checks

As part of the Healthcare Commission (now the Care Quality Commission)'s Annual Health Check, Sheffield LINk agreed to provide a Third Party Commentary on the declarations made by Sheffield Teaching Hospitals, Sheffield Children's Hospital, Sheffield Health and Social Care Trust and NHS Sheffield.

Support Team staff attended training events organised by the Healthcare Commission in preparation for providing support to Sheffield LINk. An Action Group was established to decide the process and ultimately produce Sheffield LINk's commentary.

We ran a series of focus groups with LINk members and the clients of a number of local Voluntary and Community groups. The purpose of these focus groups was to gather evidence of patient experience to form the basis of the commentaries. More than 80 people took part in the focus groups and included representatives of organisations that included Sheffield Society for the Blind, the Pakistani Muslim Centre and Expert Elders.

Members of the Action Group took responsibility for writing the commentaries, and the Support Team gave guidance where needed. We helped the LINk members to write the commentaries and all commentaries were sent to the Trusts in time for inclusion in their declaration.