Dorset Healthcare University NHS Foundation Trust

Whenever a Patient Safety Incident occurs the NHS Trust must also record the category (nature) of the incident against a list of 11 defined categories. The same categories of incident apply to acute, community and acute specialist trusts and range from clinical assessment (including diagnosis, scans, tests, assessments) to medical device/equipment or the implementation of care and ongoing monitoring/review. A similar but slightly different list of categories applies to mental health trusts and includes incidents such as disruptive, aggressive behaviour; self-harming behaviour and consent; communication and confidentiality.

Here we show the top 3 most commonly recorded categories by the individual Trust during the six-month time period for which this data relates to.

Patient Safety Incident data, including the list of categories, is published every six months and can be found on the NHS England website at: https://www.england.nhs.uk/patient-safety/national-patient-safety-incident-reports/. This data is public sector information licensed to Blackwater Law under the Open Government Licence v3.0: http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/.

Within England 95% of patients who attend A&E or make an emergency admission should be admitted, transferred or discharged within 4 hours of arrival. This means that depending on the severity of their condition, patients need to be admitted into the hospital for further treatment or observations, transferred into another NHS organisation or separate care (such as social services) or discharged home.

This data includes those who make an unplanned attendance at either a 24-hour A&E department, a single speciality A&E department or a walk-in/urgent care centre. An A&E department must see, on average, more than 200 separate patients each month before it is obliged to provide this data.

A&E attendances and emergency admission data is published monthly and can be found on the NHS England website at: https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-times-and-activity/. This data is public sector information licensed to Blackwater Law under the Open Government Licence v3.0: http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/.

All NHS Trusts must report when an elective operation has been cancelled at the lastminute for non-clinical reasons. For the purposes of reporting, a last-minute cancellation is deemed to have occurred after the patient has arrived at the hospital, or on the day of the operation or surgery. The operation must have been cancelled for non-clinical reasons for it to be reported.

Examples of a non-clinical reason for cancelling an operation include: ward beds being unavailable, equipment failures, administrative errors and emergency cases needing the theatre. This includes all planned and elective operations, including day cases. However, in accordance with the Cancelled Operations Guidance available on the NHS England website, any operation that is rescheduled to a time that is within 24 hours of the original operation time and date is classed as a postponement rather than a cancellation, as long as this only occurs once (any further postponements are then classed as a cancellation).

Cancelled elective operations data is available quarterly and can be found on the NHS England website at: https://www.england.nhs.uk/statistics/statistical-work-areas/cancelled-elective-operations/. This data is public sector information licensed to Blackwater Law under the Open Government Licence v3.0: http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/.

All NHS Trusts have been expected to eliminate all instances of mixed-sex accommodation, unless it is in the best interest of the patient, for instance where there is a need for urgent or critical care. In such cases, mixing may be justified and therefore will not be a breach and will not be counted in these statistics.

Any reported occurrence of shared mixed sex accommodation shown here is classed as an unjustifiable breach and therefore should not be occurring under the NHS guidelines. The Department for Health states:
“There is no justification for placing a patient in mixed-sex accommodation where this is not in the best interests of the patient and better management, better facilities or the removal of organisational constraints could have averted the situation.” Department for Health (2010) Eliminating Mixed Sex Accommodation.

Data is gathered and published monthly to report on any unjustified breaches of NHS sleeping accommodation guidelines. This includes any areas where patients are admitted and cared for on beds or trolleys, even if they do not stay overnight and includes day surgery units as well as clinical decision units; but excludes any areas where patients have not yet been admitted – such as accident and emergency cubicles.

Mixed sex accommodation breach source data can be found on the NHS Improvement website at: https://www.england.nhs.uk/statistics/statistical-work-areas/mixed-sex-accommodation/msa-data/. This data is public sector information licensed to Blackwater Law under the Open Government Licence v3.0: http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/.

Patients who are on a Care Programme Approach (CPA) should, within 7 days of discharge from mental health inpatient services, receive a follow-up. The national threshold for follow-ups within this timeframe is 95% and therefore any trust that has a figure below 95% is falling short of the guidance.

CPA relates to the package of care those with mental health problems may receive.

Follow-ups within 7 days of discharge are viewed as an important step in helping to reduce the number of suicides and cases of self-harm which typically peak immediately after a patient is discharged from a mental health inpatient service.

Mental health discharge and follow-up data is published quarterly and can be found on the NHS England website at: https://www.england.nhs.uk/statistics/statistical-work-areas/mental-health-community-teams-activity/. This data is public sector information licensed to Blackwater Law under the Open Government Licence v3.0: http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/.