Star status does not reflect today’s improved hospital services

27 July 2005

West Suffolk Hospital NHS Trust believes that the performance rating of one star from the Healthcare Commission, which relates to the period 1 April 2004 to 31 March 2005, no longer reflects the improved services currently being delivered at the Bury St Edmunds hospital.

“We knew that we could not retain our three star status because of the financial situation but a rating of one star does not recognise the enormous effort made by every member of staff to improve performance in the areas where we knew we had a problem. The staff have been absolutely fantastic in turning things round and providing quality services in the face of increasing demand, particularly increases in emergency admissions, and problems with winter vomiting virus,” said Chief Executive Chris Bown.

“During the year we have been introducing new ways of working and good practice that has proved to be effective in other NHS Trusts. But changing practice takes time and although we are starting to reap the benefits now the improvements in performance towards key targets came too late to influence the star ratings.

“At the end March 2005 the organisation met four out of the eight key targets, including no patients waiting longer than 9 months for an operation and no patients waiting longer than 17 weeks for an outpatient appointment. Once again we were seeing every single patient with suspected cancer within two weeks of an urgent GP referral to getting a first outpatient appointment. Cancer services are a real success story for the Trust and for patients with breast cancer we are already meeting the next targets to further reduce the time patients wait for treatment, well ahead of the December 2005 deadline.

“Where we were failing against key targets we are now achieving. For example as a result of reviewing and refining the discharge process to improve the flow of patients across the Trust, we are now meeting and sustaining the A&E target.

For the last three months over 98% of patients attending the department have been admitted, discharged or transferred within four hours of arrival compared to 95% at the end March.

“Changes in practice have seen some specialties, including ENT, (Ears, Nose and Throat services) carrying out more procedures in the day surgery unit to take activity out of the main theatres. This coupled with the ‘ring fencing’ or protection of a surgical ward has released beds and resulted in fewer cancelled operations. Last year the percentage of operations cancelled on the day or after admission was 2%, for the three months, April to June 2005 this has fallen to just 0.8%.

“Particularly disappointing was the underachievement for hospital cleanliness which was affected by just one area, A&E where major refurbishment work was taking place at the time of the assessment. However, in the last few weeks the Healthcare Commission has carried out an unannounced inspection of hospital cleanliness on two wards, the outpatient department and A&E. The Assessors found no areas of concern and assessed cleanliness of all the areas as good, scoring over 75%, which is thanks to our cleaners and rigorous cleaning regimes

“The Trust scored poorly against progress towards the target to achieve a maximum wait of 6 months by December 2005, but once again we are turning this round. At the end of June 2005 the Trust had 221 patients waiting over 6 months against a target of 330 and we are confident we will meet the target by the end of the year.

“The indicators make it clear that in a number of areas the quality of care that people receive from this hospital is excellent and the Trust has been placed in the top band of performance for clinical focus. I am very proud of the progress we are making and the local community can be confident they are being cared for by what are in my opinion, three star staff.

“The determination demonstrated by staff to continually improve performance and take on new ways of working is also helping the Trust tackle its biggest challenge - to achieve recurrent financial balance. I am confident, that working in partnership with other stakeholders we can develop new models of affordable and locally accessible services and ensure their sustainability into the future.”

How the Trust is improving performing against the other lower scored targets:

• Waiting times for rapid access chest pain clinic is once again, an example of where the Trust is making continuous improvement. The score of 53% achieved at the end of March 2005 has increased to 85% and is set to increase further in the future.

• The Trust has disappointingly failed to demonstrate achievement of the booking targets and this is as a result of problems with administrative processes. However these problems have been put right and performance is already improving.

• The lower performance rating for Workforce Indicator refers to technical issues around junior doctors hours, which have now been resolved.

Further information: please see the Health Care Commission website