Our response

Please click here to read the full report by Robert Francis QC, published on 6 February 2013

Mike Pinkerton, Chief Executive of Doncaster and Bassetlaw Hospitals NHS Foundation Trust (until 2017), said: “This is a very important report that marks a watershed for the NHS and contains lessons not just for hospitals but for all involved in healthcare.  We will be studying the report and its 290 recommendations very carefully to learn those lessons and it will be highly influential in shaping the new Quality Strategy that our new executive team has begun to develop.

“One of the recommendations Robert Francis QC makes today is that all NHS organisations should announce at the earliest practicable time the extent to which it accepts his recommendations and how it intends to implement those it accepts.  We confirm that we will do this at Doncaster and Bassetlaw Hospitals.

“As a trust, we are absolutely committed to providing people in Doncaster, Bassetlaw and our neighbouring communities with the highest standard of care.  That includes treating people with dignity and respect and doing all we can to make sure they have the best possible experience of using our services.

“We know we do not always achieve this but we are determined to get as close as we can to doing so 100% of the time.  That’s why it’s crucial that we listen to patients, our staff, relatives and visitors and use this feedback to correct any issues at the earliest possible opportunity, as well as to monitor and continually improve the quality of care.

“There are lots of ways we’re doing this already but our new Board has been looking at how we can improve the way we seek and act on feedback and the Francis recommendations will have a strong influence on the action we take as an organisation and in the way we work with our local commissioning groups in our patients’ interests.

“The Francis report also makes a number of recommendations around training, compassion, performance management and accountability for everyone working in the NHS.  We absolutely agree with the fundamental importance of organisational culture in delivering compassionate, patient-focused care, and in ensuring that we have the right staff with the right skills and the right values.

“Patients quite rightly expect healthcare to be safe, high-quality and focused on their needs.  The Francis review investigated the underlying causes of what happened at Mid Staffordshire and the resulting report makes important recommendations for all NHS organisations.  Doncaster and Bassetlaw Hospitals will be studying these recommendations carefully and we are committed to learning the lessons and putting them into action in this Trust and with our commissioners and regulators.”

Ways we already seek and listen to feedback from patients, staff etc:

  • We encourage staff to report incidents and near misses and to raise any concerns they have so we can make improvements.  Early indications from the latest NHS National Staff Survey, which will be published later this spring, are that our staff do feel able to raise concerns.
  • Our Board members (non-executive and executive directors), Board of Governors and senior staff carry out regular ward visits and safety walk-rounds where they speak to patients and staff to get their views on the care being provided, any issues and suggestions for improvements.  We’ve also begun a programme of mock unannounced inspections to assess the standard of care being provided.
  • We survey a representative sample of 40 patients on each ward every month to get immediate, ‘real-time’ feedback.  This means we can take prompt action to improve any problem areas.  We also take part in all the national patient surveys which include: hospital inpatients, outpatients, A&E patients, people having cancer care, women using maternity services, and children, young people and families using paediatric services.
  • Our Trust Board, Management Board and Board sub-committees receive detailed reports every month on quality of care, scrutinise and discuss them in depth and probe into key issues to identify causes and solutions to any areas of concern.  Our executive team and senior clinicians carry out similar analysis and decision-making on a continuous basis.
  • Senior clinicians play a vital, hands-on role in leading and managing the Trust and its services.  In fact, the majority of our Trust’s Management Board are clinicians.  Each specialty/clinical area belongs to a clinical service unit led by a Clinical Director who is a senior medical consultant or, for pharmacy and clinical therapies, a senior pharmacist/therapist.
  • The new GP-led clinical commissioning groups have begun carrying out regular walk-rounds and inspections/assessments.  We are working with them closely and will continue to do so in our patients’ interests.
  • We held an extensive series of staff engagement roadshows throughout the summer and autumn of 2012 to listen to staff’s views, the issues they face, any concerns they have and their suggestions for improvement.  This provided valuable feedback that has helped us develop our strategy for 2013-17 and we plan to continue holding similar roadshows and events.
  • We have been piloting the new ‘Friends and Family Test’ that will go live from 1 April 2013.  All hospital inpatients and every patient attending A&E will be asked whether they would recommend us to their friends and family, giving the reasons for this.  It will be extended to women using maternity services from October 2013.
  • We invite patients, staff, relatives and visitors to give feedback by completing Your Opinion Counts forms on paper or via our website.  We also read and respond to comments on Twitter and on websites like Patient Opinion.

Steps we have already taken to develop a culture of compassion and quality and that we have the right staff with the right skills and the right values:

  • Our strategy for 2013-17, which will be published later this spring, will set clearly defined organisational values shaped by engagement with our staff, governors and other key stakeholders.
  • We have had very open, honest and valuable discussions across the Trust about our priorities, culture and values through the staff engagement roadshows we began last summer.  These values will be embedded in our recruitment processes, performance management and objective-setting for all staff.
  • For the last two years, all new healthcare assistants go through a formal induction process training them in the fundamentals of care and join an apprenticeship scheme providing recognised qualifications in healthcare, literacy and numeracy.  We are also ensuring that all similar staff have recognised training to NVQ level 2 or equivalent.

Other steps we plan to take, or are considering, once we have been able to study the Francis report fully include:

  • The new Quality Strategy we are developing will set clear priorities, expectations and actions around the standard of care patients and their relatives can expect from us.  There will also be clear lines of accountability and responsibility.
  • We will further develop and build on our existing channels for engaging, involving and communicating with patients, the public and staff so we listen to what they are telling us and use their feedback and suggestions to help us continually improve quality.
  • The Prime Minister has announced a national review of the way the NHS handles complaints.  We will continue the work we have already begun to review and revise the way we handle and learn from complaints and serious incidents to ensure that issues are addressed in an appropriate and effective manner and that the same problems don’t keep reoccurring.
  • We will further develop our systems for rewarding and recognising good practice, whether it’s by individual staff, a team/department or the whole Trust and we will continue to tackle any areas of poor practice and, where appropriate, hold people accountable for their actions.
  • We will further develop the education and training of our staff to ensure they have the right knowledge and skills, understand the priorities and expectations of them and demonstrate the right values.
  • We will look at additional ways of incorporating patient stories, staff stories and other personal feedback into quality reporting to the Trust Board, Management Board, Board of Governors and other similar forums.

Final summary:

Everything we have outlined above has the single, common aim of ensuring we have the right priorities, are assessing and continually improving the quality of our care, and that we are delivering the best possible outcomes for our patients.

Please click here to read the full report by Robert Francis QC, published on 6 February 2013


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Notes to the Editor

Doncaster & Bassetlaw Hospitals NHS Foundation Trust’s vision is We care for you.

The Trust provides a range of acute medical services at three hospitals (Bassetlaw Hospital in Worksop, Doncaster Royal Infirmary, and Montagu Hospital, Mexborough) and in a number of community locations.  In addition, outpatient services are provided at Retford Hospital, and rehabilitation services are provided at Montagu Hospital. The Trust serves a population of over 410,000 people in the areas covered by Doncaster Metropolitan Borough Council and Bassetlaw District Council, as well as from parts of North Derbyshire, Barnsley, Rotherham, and north-west Lincolnshire. It employs 6200 staff.

In 2011/12, there were over 161,355 emergency attendances, including both A&E patients and medical emergencies, over 490,515 new and follow-up outpatients were referred, and over 52,977 inpatients were treated and discharged.

The Trust is registered without conditions with the Care Quality Commission, and maintains compliance with the 16 Essential Standards of Quality and Safety.  In the themed Dignity and Nutrition inspection programme that the CQC carried out in 2011, the Trust was judged to be compliant with the relevant standards.

The Trust was approved as one of the first 10 NHS foundation trusts in March 2004 after receiving the top-rated three stars in the NHS Performance Ratings for five years.  It also won the Top40 Hospitals Award for seven years.

Membership of this NHS foundation trust is open to residents of Bassetlaw and Doncaster, and patients from outside these areas, over the age of 16.  For membership enquiries, contact the Membership Office on 01302 381355 or email foundation.office@dbh.nhs.uk

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