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North Cumbria University Hospitals NHS Trust - 70 years of the NHS

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Improvements to outpatients service

Posted on Monday 2nd March 2015
case notes

North Cumbria University Hospitals NHS Trust has made substantial improvements to its outpatients service, which provides over 250,000 appointments a year across the Trust’s two hospital sites – the Cumberland Infirmary and West Cumberland Hospital, as well as clinics held at Workington Community Hospital.

The service has taken significant strides and is now delivering more consistently safe and responsive care since addressing issues identified by the Care Quality Commission (CQC) inspection in May 2014, which resulted in the service being rated as inadequate.

Nick McDonaugh, deputy director of Emergency Surgery and Elective Care, said: “The response from staff has been exceptional since the Chief Inspector of Hospitals’ report last year and progress has been made not just within the outpatients service but across the whole Trust.

“By overhauling our processes and putting a number of short, medium and longer term initiatives in place since last summer, we are now seeing patients receive a more consistently safe and responsive approach to care. This would not have been possible without the unwavering support and commitment of our staff right across the board.”

The cornerstone to this achievement is the availability and completeness of medical records for outpatient appointments. The Trust is working hard to ensure the completeness and quality of all medical records continues to improve. Part of the CQC inspection involved an audit of case note availability – an individual patient’s medical history to support the doctor or consultant to deliver effective healthcare during clinics.

Only 72 per cent of medical records were available on the day of the clinic during the inspection in April 2014 and since then major improvements have taken place thanks to a number of changes identified by a weekly outpatient improvement group. Since December 2014 clinics at West Cumberland Hospital and Workington Community Hospital have consistently achieved a minimum of 95 per cent case note availability at the start of clinics. The Cumberland Infirmary is also now consistently achieving the target of 95 per cent availability. As a result, only two outpatient appointments have been cancelled since the beginning of December 2014 due to issues around case notes.

The improvement in availability is due to processes being put in place to improve the timely transfer of medical case notes between the Trust’s hospitals, improving the transfer of case notes between departments at least seven days before the outpatient clinic occurs, and delivering systemised and categorised access to case notes.

Nick added: “We are now focussing on maintaining the high standard, ensuring more clinics are running on time and that there are fewer cancellations. We are all committed to improving our patients’ overall experience.”