Royal National Orthopaedic Hospital NHS 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/.

In England there are a number of cancer waiting time targets in place to ensure the prompt diagnosis and treatment of those with cancer. The data shown in this section relates to the 62-day cancer waiting time. This means that from the initial urgent GP referral for suspected cancer through to the first definitive treatment of cancer, patients should have to wait no more than 62 days. The target is for 85% of patients to receive their first treatment within this timeframe.

Cancer waiting time data is published quarterly and can be found on the NHS England website at: https://www.england.nhs.uk/statistics/statistical-work-areas/cancer-waiting-times/. 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/.

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/.