James Paget University Hospitals 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/.

The NHS report on bed occupancy rates as an indicator as to what capacity each individual trust is running at.

The figures presented here relate to the overall percentage of beds that are occupied overnight during the reporting period.

It is thought by some commentators that bed occupancy levels greater than 85% can lead to compromised patient safety and higher hospital acquired infection rates (Bagust A et al , British Medical Journal, Vol 319).

Bed occupancy data is available quarterly and can be found on the NHS England website at: https://www.england.nhs.uk/statistics/statistical-work-areas/bed-availability-and-occupancy/. 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/.

The Summary Hospital-level Mortality Indicator (SHMI) compares the actual number of patients who die following hospitalisation against the number of patients who would be expected to die on the basis of average for trusts across England, given the characteristics of the patients treated at that Trust. The SHMI includes deaths that have occurred in hospital or within 30 days of discharge from hospital.

A SHMI number of 1 indicates the observed number of deaths was higher than expected A SHMI of 2 indicates the observed number of deaths was as expected and a SHMI of 3 indicates the observed number of deaths was lower than expected, when compared to the national baseline .

SHMI data is published half yearly by NHS Improvement. The data is calculated using Hospital Episode Statistics (HES) data linked to Office for National Statistics (ONS) death registrations data and is published quarterly using a 12 month reporting period.

With any given number of expected deaths, a range of observed deaths is considered “as expected” however if the number falls outside this range, the Trust is then deemed to have a higher or lower SHMI than expected. A higher than expected SHMI should trigger an investigation by the Trust but cannot immediately be attributed to poor performance.

SHMI source data can be found on the NHS Improvement website at: https://digital.nhs.uk/data-and-information/publications/clinical-indicators/shmi. 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/.

If a Trust cancels a patient’s urgent operation, for a non-medical reason, they must report this. The definition of an urgent operation is determined by the Trust but should include any operation on a patient that is life-saving or limb saving, or where life or limb is threatened. In addition, any operation that requires early intervention but is not yet a threat to survival should also be included according to the Monthly SitReps Definitions v1.07 – Critical Care Capacity document, available on the NHS England website. The Trust should record any cancelled urgent operation, not just those that are cancelled at the last-minute.

Urgent operations cancelled data is available monthly and can be found on the NHS England website at: https://www.england.nhs.uk/statistics/statistical-work-areas/critical-care-capacity/. 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/.