University Hospitals Birmingham NHS Foundation Trust | 2018

I would like to know as a FOI request to Emergency Departments who are part of a Major trauma centre:

The number of whole time equivalent Emergency Medicine consultants employed by the trust.
The total type 1 ED attendances
The hours per PA working after 7pm, and the overnight consultant shift pattern (ie. Full shift, resident on call, on call from home)

See attached FOI 0602

University Hospitals Birmingham NHS Foundation Trust (UHB) completed a merger by acquisition of Heart of England NHS Foundation Trust (HEFT) on 1^st April 2018. Due to historical differences in data collection/reporting across UHB and the former Heart of England NHS Foundation Trust this response has been provided by hospital site ie. Queen Elizabeth Hospital Birmingham (QEHB) and Heartlands, Good Hope and Solihull (HGS).

Who is the Trust’s current supplier for their Electronic Patient Record?
In-house developed

What is the contract start and end date for the Electronic Patient Record?

Not applicable

Who is the Trust’s current supplier for your Patient Administration System?

HGS – In-house developed
QEHB – Servelec Healthcare Ltd

What is the contract start and end date for the Patient Administration System?
HGS – Not applicable.
QEHB – Start Date: 2017 Review: 2022

When are you due to start looking to re-procure your clinical systems?

Not applicable

Who supplies the Trust’s integration system?

Orion

Please supply a copy of the Trusts latest Informatics Strategy.

See below Q9.

How regularly does the Trust review their Informatics Strategy?

Continuously – see below.

Has the Trust developed a Digital Strategy?

As a Global Digital Exemplar (GDE) the Trust has an agreed strategy via the GDE that encompasses informatics and utilising IT as an enabler to reduce/remove reliance on the physical paper record and enhancing the in-house Electronic Health Records.

How often does the Trust assess their Clinical Systems?

Continuously, iterative development aligned to Trust operational priorities.

Who is the Trust’s current Chief Clinical Information Officer?

We currently do not have anyone in this role; from January 2019 it will be Professor Simon Ball, Digital Director of Health.

Who is the Trust’s current CIO/ IT Director?
Mr Stephen Chilton.

Which member of the board is responsible for IT?

Dr David Rosser – CEO.

Please provide an organisation chart for your IM&T department?

Please see attached.

Which member of the Trust is the SRO for the STP engagements?

Dr David Rosser – CEO.

What proportion of the Trust’s IM&T Department is made up of interim staff and permanent staff?

In general the proportion is 5% interim, 95% permanent. However, this may vary depending on specific projects.

Is the Trust looking to migrate to the cloud in the next 2 years?

Possibly.

Are the Trust considering their options of outsourcing their IT Services in the next 3 years?

No.

How many days has your trust been on Opel 4 (formerly Black Alert) in the last 12 months (September 2017 – September 2018)? Can you please state the dates you were on Opel 4?

Total EMS level 4 days between September 2017 – September 2018

Birmingham Heartlands Hospital: 4 days

Good Hope Hospital: 3 days

Solihull Hospital: 0 days

Queen Elizabeth Hospital: We do not hold this information as it is not recorded or reported for this hospital site.

What was the longest period your trust was on Opel 4/Black Alert in the last five years (up to September 2018)? Can you please state the start and finish dates?

Please note that our recording system changed on 13/12/2016 – we do not hold information prior to this date.

Please see below for the longest period of EMS 4 submissions over the last two years.

Birmingham Heartlands Hospital: 4 days (05/03/18-08/03/18)

Good Hope Hospital: 2 days (30/01/17 – 31/01/17 & 06/03/18 – 07/03/18)

Solihull Hospital No level 4 submissions

Queen Elizabeth Hospital: We do not hold this information as it is not recorded or reported for this hospital site.

Please could you provide the Trust’s Funded Establishment for Qualified Nurses at the end of April 2018, May 2018, June 2018, July 2018, August 2018, Sept 2018 and October 2018, and the number of Qualified Nurses actually contracted to work in the Trust at each of these times.

If possible, please provide a breakdown of each by AfC pay band

Please see attached PDF FOI 0606

Queen Elizabeth Hospital Birmingham

I would like you to send me the locum agency spend for Doctors for the hospital in acute settings as well as the community for each specialism. I would like to know the spend from January 2018 – present, also including the amount of locums that this refers to per month, broken down on a monthly basis. In the breakdown if you could please include the agencies that provide the locums also broken down numerically

Ideally this would read as below –

January 2018 – £80k Community – £200k Acute

A&E

ID Medical – SPR x 2 Consultant x1

Athona – SHO x 2

RIG – Consultant x1

Opthalmology

RIG- Consultant x1

Urology

Your World- Consultant x1

Then a breakdown all the way to as present as possible.

See attached spreadsheet FOI 0589 QE.

Heartlands, Good Hope and Solihull Hospital

Ideally this would read as below –

January 2018 – £80k Community – £200k Acute

A&E

ID Medical – SPR x 2 Consultant x1

Athona – SHO x 2

RIG – Consultant x1

Opthalmology

RIG- Consultant x1

Urology

Your World- Consultant x1

Then a breakdown all the way to as present as possible.

Please see attached spreadsheet FOI 0589 HGS.

Queen Elizabeth Hospital Birmingham

Does your Trust Outsource Radiology Reporting (Diagnosis)? If yes which Reporting Houses do they use?

RIG & In Health Reporting and Medica Reporting.

In the last financial year what % of Radiology Reporting (Diagnosis) has been outsourced to companies such as 4ways, Medica, Everlight and Telemedicine?

What was the total spend in the last financial year for the outsourcing of Radiology Reporting (Diagnosis)?

£101,149.60.

Has the Trust previously used the Health Trust Europe (HTE) Framework to purchase services within the Trust?

Yes.

Heartlands, Good Hope and Solihull Hospital

Does your Trust Outsource Radiology Reporting (Diagnosis)? If yes which Reporting Houses do they use?

Yes, Medica & Inhealth (previously called RIG).

In the last financial year what % of Radiology Reporting (Diagnosis) has been outsourced to companies such as 4ways, Medica, Everlight and Telemedicine?

17.81%

What was the total spend in the last financial year for the outsourcing of Radiology Reporting (Diagnosis)?

£1,122,496.

Has the Trust previously used the Health Trust Europe (HTE) Framework to purchase services within the Trust?

No.

1) Please state the number of deaths in service [ie: during employment, but not necessarily on the premises or during working hours] of nursing staff employed by your organisation since 2012. 20 since January 2012. This includes qualified Nurses and Health Care Assistants.

20 since January 2012. This includes qualified Nurses and Health Care Assistants.

2) (i) Please state how many of the total deaths were recorded, known or otherwise suspected to be suicide?

We do not hold this information. In cases where an individual dies whilst still in employment with the Trust, the Trust records this as a death in service. The cause of death is not recorded.

(ii) Please state what the different categories of cause of death were recorded as, for the purposes of the organisation’s own reporting and recording. For example; cancer, heart failure, suicide etc.

As above.

3) Please include copies of any ‘death in service’ procedure or policy the organisation uses.

Please see attached policies Leaver’s Policy PM Exit Procedure – Amended June 2015 – final.

4) Please describe if there is any work in progress to address mental health needs or suicide risk among your nursing workforce, or alternatively where there have been suicides whether there have been any changes in workplace practices as a result?

The Trust has in place an extensive range of wellbeing support for staff for good mental health, including (but not exhaustively listed) fast track counselling services, mindfulness sessions, sports facilities, spiritual wellbeing services, green spaces and green gym, healthy food options, mental wellbeing resources, self-referral Staff Health and Wellbeing Clinic including a mental health assessment, as well as training in stress management and resilience. A Workplace Wellbeing Strategy has been scoped out to be incorporated in to the newly merged Trust’s overall Workforce Strategy which will progress our work further – the workplace wellbeing agenda includes a focus on mental health and is being worked through collaboratively with staff, trade union representatives and management, and includes mental health awareness and promotion, post-trauma mental health interventions and suicide risks and awareness.

What is the average length of time per patient to assist with a CAUTI?

We do not hold this information. There is no method to measure this as it depends on the patient’s condition, their ability to self-manage any aspect of their catheter managements and other relevant comorbidities.

How many nosocomial CAUTIs were there in your trust last year? What is your position on the safety thermometer for CAUTI?

We do not measure the number of CAUTIs directly; we have indirect measures such as safety thermometer and from mandatory reported E. coli bacteraemia data. We undertake safety thermometer for CAUTI monthly which is published nationally. This information can be found at https://www.safetythermometer.nhs.uk/index.php/classic-thermometer.

What 3 main actions have the trust deployed or is planning to deploy to reduce nosocomial CAUTIs?

There have been a number of interventions to limit the use of urinary catheters and to ensure that if a urinary catheter is inserted it is managed appropriately so as to reduce the risk and incidence of infection:

A multi-disciplinary high impact action group was set up to address urinary catheter issues. This is a group of key stakeholders from continence, education, infection prevention control, nursing and medicine and provides focused Trust activity on appropriate urinary catheter use, prompt removal with the aim to also reduce associated E. coli bacteraemia by 10%.
A catheter review tool is due to be introduced to empower nursing staff to remove urinary catheters in a timely way and to ensure that the use of urinary catheters is appropriately risk assessed.
A urinary catheter passport has been introduced. This is issued to patients who are discharged with urinary catheters. The aim is to involve patients more fully with the care and management of their urinary catheter and improve communication between health care professionals when patients are discharged into the community
Urinary catheter products and equipment have been reviewed and standardised across the organisation.
The saving lives high impact intervention catheter care bundle focuses on the best practice in relation to CAUTI. This is audited monthly by the ward and department areas. As a quality assurance measure the infection prevention and control team carry out random peer audits.
UTI harm post infection reviews are implemented for all UTI harms identified in on the safety thermometer. This is a multidisciplinary investigation to identify lapses in care and quality related to the patient developing a CAUTI.
Launch of new high impact interventions which include urinary catheter insertion and ongoing care. All ward areas are expected to audit catheter care if deemed a risk or requiring improvement each month.
Nurse led decision pathway for the removal of urinary catheter- launched May 2017. A guidance flow sheet was created to encourage timely removal of urinary catheters by empowering nurses. All wards were visited by the infection prevention and control team with the continence educator (an educational stand was also accessible to staff and patients in the main atrium of the hospital) to provide education on the pathway at the time of the launch.

What is the impact on increased length of stay for an average patient in your trust with a CAUTI – how many days on average?

We do not hold this information. There is no accurate way of determining increased length of stay for an average patient in the Trust with a CAUTI as ‘average’ cannot be defined in terms of diagnosis, comorbidities etc.

What is the increased per patient cost of a nosocomial CAUTI? (E.g. extended hospital stay, nursing time, drug treatment, bed blocking, etc.)

We do not hold this information. There is no accurate way of determining increased cost for a patient in the Trust with a nosocomial CAUTI as costs cannot be broken down in terms of diagnosis, comorbidities and functional therapy required by each individual patient.

– In your trust, do you have a guideline/policy/protocol for the use of Oxytocin Or Syntocinon for induction of labour or augmentation of labour or progress in labour? (Maternity Services – Obstetrics)

– Can you provide a copy of the relevant guideline, please?

– In your trust, do you have a guideline/policy/protocol or specific section within the guideline for the use of Oxytocin Or Syntocinon in the Second stage of labour? Is there a specific regimen that is followed? (Maternity Services – Obstetrics)

– If yes, can you provide a copy of the relevant guideline or the relevant section, please?

Please see attached policy Induction of labour including oxytocin infusion 2018 V10.

1. How many patients have been treated in the past 6 months [latest 6 months available] with the following, If possible please split by pediatric (less than 18 years) and adult 18+years;

• Genotropin

• Humatrope

• Norditropin

• NutropinAq

• Omnitrope

• Saizen

• Valtropin

• Zomacton

Please see attached PDF FOI 0503.

Coronavirus information

FOI 0602 Emergency attendances

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