The annual report for Basildon hospital states that Around 3,500 babies a year are born at the hospital’s maternity unit, which has a specialist Neonatal Intensive Care Unit providing a service for the care of ill and very premature babies from across South Essex and beyond, and £168,000 has been paid for a new Children’s Outpatients Department.
(See Appendix 1)
how does Basildon Hospital interact with social services
Basildon hospital interacts with social services in order to co-ordinate with each other which means to work smoothly together, to act upon each other, to communicate their plans and goals with verbal and non-verbal communication. They work together for the best, integrated, seamless service for the patient.
The social workers in the hospital are referred to as medical social workers and they are based at the hospital in their own department known as the Social Work Department.
The interaction between the hospital staff and the medical social workers starts usually within forty-eight hours of the patient’s admission into Basildon hospital.
The medical staff make the referral, however family members or friends can make a referral by completing a referral form and handing it to the medical staff, this is then passed onto the medical social worker. All referrals are treated as a request for an assessment and not as a request for a specific service. A medical social worker would deal with the referral by visiting the patient on the ward where the problem can be dealt with.
If the patient already has a social worker in the community the medical social worker will inform them that the patient is in hospital, to enable them to play a part in planning their discharge.
The patient may be asked to sign a sharing information form which will allow the social worker to contact other agencies involved in the patient’s care in both the hospital and the community, some of the medical staff may include Occupational Therapists, District Nurse and the General Practitioner. If a patient is unable to sign the sharing information document, it will be stated on the form and then a close relative or carer will sign the form on the patient’s behalf.
When the medical social worker has gathered all the information from the patient and relatives, he or she will draw up a list of the patient’s needs with goals they have to meet. If the patient does not agree with these tasks they are able to notify them of their ideas by writing in the boxes provided.
Sometimes a patient’s needs can only be met in residential care. When this happens a medical social worker has to carry out a financial assessment to see if the social services department can assist in funding a residential place. The social worker will advise the patient of the best type of home to meet there needs.
After discharge from the hospital with a package of care there will be a monitoring review after six weeks to make sure the type of care is suitable for the patient, after that they then will be reviewed once a year.
After six weeks of monitoring the medical social worker will withdraw as long as the ongoing problems are sorted out and that is when the community social worker will take over the care. This is when the interaction between the hospital medical staff and the social services staff ends for that patient.
How to gain access to basildon hospital
There are a number of ways in how clients gain access to the service they seek or need:
- Open door
- Referral, recall or recommendation
Open door services: (A+E)
Basildon hospital Accident and Emergency service this is self-referral from the patient
Referral, recall or recommendation: (GP referral)
GP surgeries are the major route to professional hospital and nursing services.
Transport
There is easy access to the hospital for those with a car or without. There are car-parking facilities and there is a bus stop outside the hospital:
A charge is made for parking which contributes to the up keep and security of the car parks as well as to patient services. This is normally £1 a day.
Car parking areas for disabled people are located outside the Outpatient Department and at the main entrance areas.
The buses that stop outside the hospital are:
- Harris Bus Company
- NIBS Buses
- Thamesway Buses
- Arriva Southend
There are also items, which help disabled people to access the hospital, are:
- Access ramps at all the main entrances
- Disabled toilets in all the wards
- Disabled parking near all the main entrances
- Lifts to all floors
- Automatic doors at all the main entrances
- Some information is available in braile
Barriers within Basildon hospital
Even when we have a right to a health care service, we do not always use it. There are several reasons for this. Some of the most common causes are:
Health is a very private thing, and not everyone takes the same attitude towards their own health. People do not like going to see doctors for a variety of causes.
Your guide to the NHS is published in 11 languages as well as English. This is recognition of the fact that Britain is a multi-ethnic society and that not everyone speaks English as their first language, Basildon hospital does not provide leaflets in the hospital for a multi-ethnic society.
Opening times can limit access. This is particularly true for people who have difficulties in getting time off work, those reliant on public transport and those existing in country areas. Basildon hospital Outpatients department opens at 9am and closes at 4pm this may be hard for people to get access, as they may need to get time off work.
People, who are waiting for a surgical operation, may have to wait months or even years at Basildon hospital.
Sometimes Basildon hospital patients no longer need care but are not healthy enough to be discharged without an appropriate care package. The affect of this can lead to other people who need care having to wait for a bed, or their operation may be cancelled.
Own suggestions to improve access
Based on research I have come up with some realistic suggestions on how to improve access to the Basildon Hospital services.
- The ways in which Basildon hospital’s transport access could be improved is by providing the patients with a tram link for the patients (within the Basildon area) who need long term care so they do not have to pay for transport or car parks. They could pay something at the beginning of the year.
- There are not that many buses going to Basildon hospital, the client would have to get the bus to the station then change to get to Basildon Hospital, these buses only come every half an hour. To improve this they could have buses from other towns going to Basildon Hospital e.g from Wickford or Laindon.
- They could lower the cost of car parking at the hospital.
- The bus could stop closer to the hospital's main entrance because if you are a disabled or an elderly person you have far to walk to the main entrance.
- They could also provide more staff in the A+E service on the days when they are likely to be busy which is likely to be at the weekend.
- They also need to provide Basildon hospital with more money to improve the service that is given; the money will have to be provided by the NHS.
- They should also provide information about the hospital in different languages on the stand and not on request.
- They should also try to decrease the waiting times for major operations they could do this by providing more staff and working together with social workers to get care packages organised more quickly which should reduce the bed blocking.
How Basildon is organised at a national level
Basildon hospital is part of the secondary health care setting; it is therefore part of an NHS Trust
Trust
‘’Hospital trusts are found in most large towns and cities, and usually offer a general range of services to meet most people's needs. Some trusts also act as regional or national centres of expertise for more specialised care, while some are attached to universities and help to train health professionals. Trusts can also provide services in the community - for example through health centres, clinics or in individual’s homes. Except in the case of emergencies, hospital treatment is arranged through your GP. This is called a referral. Appointments and treatment are free. Together, NHS trusts employ the majority of the NHS workforce including nurses, doctors, dentists, pharmacists, midwives, health visitors and staff from the professions allied to medicine, such as physiotherapists, radiographers, podiatrists, speech and language therapists, counsellors, occupational therapists and psychologists. There many other staff includes receptionists, porters, cleaners, IT specialists, managers, engineers, caterers, and domestic and security staff.’’
Strategic Health Authorities
Strategic Health Authorities are responsible for developing strategies for the local health services and promising high-quality performance. They manage the NHS locally and are a key link between the Department of Health and the NHS. They will also guarantee that national priorities are included into local plans.
Basildon hospital is involved in a health authority and is apart of the south Essex
The role of the Health Authority is to
Ensure services are planned and delivered logically to meet the health needs of local people
Providing strategic leadership for improving health and tackling health inequalities
Charge specialist health services, such as bone marrow transplantation, haemophilia and genetics
Direct health issues such as infectious disease control
The department of health
This is the Government department responsible for delivering fast, fair, convenient and high quality health and social care services to the people of England. It has offices in Leeds and London and is responsible for:
- Management of the overall health and social care system
- Developing policy and managing major change in the NHS
- Regulation and inspection of the NHS (increasingly at arms length through organisations such as the Commission for Health Improvement)
- Intervention, should problems occur in the running of the NHS at any level
The Department of Health also has four Directors of Health and Social Care who work directly with the NHS and performance manage strategic health authorities
The secretary of state for health is Alan Milburn and his function is to present information to his colleagues in how to enhance the health service. The ways in which he does this is by investigating what he considers is required in the health sector.
For example:
Plans to expand the role of nurses in the NHS have been announced by Health Secretary Alan Milburn.
How basildon hospital is organised at a local level
(See appendix 1)
The staffing structure of Basildon hospital is set up into different sections, these departments are organised into portions all the departments have an area manager such as Mr Mike Imana - Accident and Emergency the structure also includes the Board of Directors and the Chairman the arrangement also includes the role of these people.
NHS funding
The NHS is funded primarily through general taxation, with contributions from National Insurance and charges making up the rest, the amount of money to be allocated each year is decided by the treasury.
How basildon hospital is organised at a local level
(See appendix 1)
The staffing structure of Basildon hospital is set up into different sections. It is set up through the hospital trust, the chairmen of the trust is David Hooper and Sue Jennings she is the commissions for health improvmentef executive. The staff are responsible for the people directly in line to them. These departments are organised into sections all the departments have an area manager such as Mr Mike Imana - Accident and Emergency the structure also includes the Board of Directors and the Chairman the arrangement also includes the role of these people.
How Basildon hospital is Funded at a natonal level
The hospital gets money from four main things:
- The government is the main source of funds for the hospital.
The government’s objective is to build a stronger, more enterprising economy and a fairer society, with opportunities and security for all.
This has been set up to provide £75 billion, which is given to health care
The hospital provides training for those who wish to be apart of the health care sector
Every working person gets deducted NI tax also the hospital gets money from the taxes that workers pay
Where taxes come from Total receipts - £400 billion
How basildon hospital is funded at a local level
Basildon Primary Care Trust has an annual budget of over £84 million. £38m is spent on commissioning hospital services the majority provided by the Basildon and Thurrock general hospitals. In addition, the rest is spent on other specialised services, which may not be located in the Basildon area these specialised services and mental health and learning difficulties or they may not be located in the Basildon general area.
Basildon hospital raises money from
- Staff training and education- they get funds from the people who wish to become part of the health service.
- Selling shares to the board of directors- by selling shares in the hospital they raise money to fund it.
- Paid prescriptions- by charging a small fee to the patients they can fund the hospital.
- Charities- Basildon hospital is funded from an exceeding amount of local charities and individuals who have spent time in the hospital or a member of their family. They may donate items to the hospital, for example in the children’s ward people donate videos or televisions.
The effects of recent government reforms, legislations and polices
In May 1997, the labour government returned to power. They introduced the White Paper, called the NHS-Modern Dependable marks which marked a turning point for the NHS. It replaced the internal market with integrated care. It began saving £1 billion of red tape and put that money into front line patient care. National standards of care were to be guaranteed. There was to be easier and swifter access to the NHS when patients need it. The White Paper began a process of modernisation. The NHS started to provide new and better services to the public, for example, the NHS Direct that is a nurse-led help line to provide advice around the clock. The White paper formed the basis of The Health Act 1999.
A new organisational structure was introduced in this document new initiatives where introduced one of the new initiatives are Saving lives: Our healthier nation.
Our healthier nation
The saving lives: Our Healthier Nation (OHN) White Paper is a complete Government wide public health strategy for England. It was published in July 1999 with double intentions:
- To reduce the health gap (health inequalities).
The strategy aims to prevent up to 300,000 untimely and unnecessary deaths by the year 2010.
The prompt access chest pain clinic pilot showed successful in speeding up diagnosis for patients and is now accessible to for all patients referred directly by the general practitioner.
Our Healthier Nation establishes four national targets for 2010
Every local area is required to address the following priorities:
Cancer – to reduce deaths from cancer by at least a fifth of individuals under the age of 75 years.
Coronary Heart Disease and Stroke – to reduce the death rate by heart disease, stroke and related illnesses by at least two fifths in individuals under the age of 75 years.
Accidents – to reduce the death rate from accidents by at least a fifth and the rate of serious injury by at least a tenth.
Mental Health – to reduce deaths caused by suicide and undetermined injury by at least a fifth.
The targets that are in bold are the local targets that Basildon hospital is considering their main goals and it is improving care for patients with cancer, heart disease and mental illnesses.
‘’Basildon Hospital was recommended as the location for a proposed cardio-thoracic centre for Essex, providing specialist treatment and surgery, including heart bypass and chest operations for around 1,500 Essex people each year.’’
‘’The Secretary of State, it is planned to house the new centre in a state-of-the-art three-storey 14,000 square metre building that will be built between the new ward block and Dry Street. It will have specialist theatres for heart and major chest surgery, over 100 beds including a critical care unit, diagnostic, outpatient and overnight facilities for relatives.’’
Local delivery plans replace Health improvement programmes
South Essex has local targets to achieve through the local Health Improvement Programmes; this has influenced the instruction of Basildon hospital. There is however, no longer a formal obligation, placed on Primary Care Trusts to construct health improvement programmes they can now produce Local Delivery Plans which are more integrated, and link hospitals like Basildon, GP’s and other agencies.
Commission for health improvement
The Commission for Health Improvement's aim is to improve the quality of patient care in the NHS. For the Commission for Health Improvement, the patient's experience of the NHS is at the heart of its work.
The Commission for Health Improvement will raise standards by:
- Assessing every NHS organisation and making its findings public
- Investigating when there is serious failure
- Checking that the NHS is following national guidelines
- Advising the NHS on best practice
Commission for Health Improvement will be autonomous, precise and fair in its work, emphasising best practice in the NHS and encouraging others to adopt it, while not withdrawing from saying clearly where urgent improvement is required.
This affects Basildon hospital because they can provide suggestions on what areas need to be improved.
Acute and specialist trusts
The Department of Health has published two sets of ratings for acute trusts and one set for Specialist Trusts. There are four sections that Basildon hospital gets rated on, which are key targets, clinical focus, patient focus and capacity and capability.
Key targets (some examples are)
- Number of inpatients waiting longer than the standard
Number of patients who were waiting more than 15 months throughout the year, or more than 12 months at end of March 2003, for an inpatient admission
- A&E emergency admission waits (12 hours)
Number of patients waiting more than twelve hours for emergency admission via A&E following decision to admit
Whole hospital score, including cleanliness, formulated against Patient Environment Action Team (PEAT) visits
Clinical Focus (some examples are)
Level of compliance against Clinical Negligence Scheme for Trusts (CNST) risk management standards
- Emergency readmission to hospital following treatment for a stroke
Emergency readmissions to hospital within 28 days of discharge following a stroke, as a percentage of live stroke discharges (age and sex standardised)
- Infection control procedures
Infection control - Self-assessment scores by standard/criteria
Patient Focus (some examples are)
Total number of patients waiting for an inpatient appointment (% of planned target achieved)
Number of patients treated within one month of diagnosis of breast cancer divided by number of patients treated with a diagnosis of breast cancer
Whole hospital PEAT score for hospital food formulated against Patient Environment Action Team (PEAT) visits
Capacity and Capability (some examples are)
Responses from NHS-employed staff opinion survey on satisfaction with employer
The amount of time lost through absences as a percentage of staff time available for directly employed NHS staff
The amount of fires, the fire safety procedures and equipment, the general health and safety of the hospital
This four sections affect Basildon hospital because it gives them an idea on what they will be inspected on, depending on how they do in the inspection is how many stars they get, the more stars the hospital gets the higher the rating. Last year Basildon hospital got three stars.
National service frameworks
National service frameworks set national standards in particular areas of health care. They also define the ways in which the services for particular care groups should be delivered. The four national service frameworks were for coronary heart disease, mental health for older people and people with diabetes. National service frameworks are designed to improve quality and reduce variations in standards of care and treatment. National service frameworks require partnerships with a wide range of organisations. These include NHS trusts, like Basildon Hospital strategic health authorities and local health authorities. The users and carers are also involved. This has affected Basildon hospital because it is designed to improve the quality of the service, and ensure that patients with these health conditions get good treatment and care.
An account of how one aspect of the service offered by basildon hospital has developed in response to changing polices and legislations
Clinical Governance is an important government policy that has affected Basildon hospital
‘’Clinical Governance means doing the right things, in the right way, to the right people and getting it right every time’’
The clinical governance review carried out by the Commission for Health Improvement (CHI) at Basildon and Thurrock General Hospitals NHS Trust took place between January 2001 and June 2003. The review is part of a rolling programme of all NHS organisations to provide robust assessments of their arrangements for clinical governance and it had a major effect on the staff and the work that they do at the hospital.
‘’The hospital had made good progress in reducing and managing waiting lists and has been part of the national booked admissions project. However, there are serious problems of service access through A&E and the medical assessment unit as a result of long standing delays. These delays may have an impact on clinical outcome. In these areas there are also serious breaches of patient dignity, respect and confidentiality. The trust is often operating at full capacity and cannot always guarantee separation of males and females on the wards. Serious problems occur when discharging patients into the community.’’
The trust has summarised the commission’s findings under four main headings and these are reflected in the action plans as follows:
- To deliver specific improvements in the organisation of care recognising that the most pressing area for improvement is the Accident & Emergency Department
- To ensure improvements in the patients’ environment
- To improve the collection and use information
- Processes of quality improvement
- To strengthen the contribution of patients, carers and the local community in trust service delivery
- To consolidate and enhance the management of clinical risk
- To further encourage participation in clinical audit to measure the quality of clinical care
- To improve the use of research and clinical effectiveness information in the delivery of clinical care
- To ensure a consistent approach to workforce development in order to improve the working lives of Trust staff
The main point of the action plan that I am going to investigate further is the first point, which is The Patients’ Experience. This is further divided into A To deliver specific improvements in the organisation of care recognising that the most pressing area for improvement is the Accident & Emergency Department and B To ensure improvements in the patients’ environment.
(See Appendix 2)
This shows how they broke up the action plan into objectives, action required and the date the action was to be finished. It also included who was responsible for carrying out the action.
The Patients Experience consists of nine objectives with action that is required and the time in which Basildon hospital has to complete the action.
The first objective was:
1.1 To improve patient flows through Accident & Emergency and Medical Assessment Unit
It has seven action points some of which are:
Action 2. ‘’Open a new 28/30 bed Medical Assessment Unit. This means that there will be more beds for people that need to be assessed.’’ The timescale for this was December 2001 as this review was taken between January and June 2001 they had 6 months to complete it.
Action 6. ‘’Examine patient flows in A&E to separate flow and management of patients with serious illnesses/injury from those with more minor problems.’’ This means that the patients with major injuries will be seen separate to those with minor injuries. The timescale for this was October 2001 so they had 4 months to complete it.
The last one is a very good point
Action 7. ‘’Pilot a scheme to enable A&E direct booking of GP appointments for patients who present inappropriately to A&E.’’ This means that the people that go into A&E for minor injuries for example a very strong migraine will be able to get a direct appointment from their GP and not wait weeks for an appointment. The timescale for this was October 2001 so this also had 4 months to be completed.
The last objective is connected with B To ensure improvements in the patient’s environment:
1.9 To ensure a review of all office and clinical desk areas is undertaken to guarantee patient confidentiality.
Action 1. ‘’Conduct a review throughout the Trust.’’ This means that the staff is to review the workings/procedures that take place at the hospital. The timescale for this was December 2001 so this had 6 months to be completed.
Action 2. ‘’Develop an action plan through the information Governance group.’’ This means that the hospital has to produce a report through the Governance group. The timescale for this was May 2002 so this had 11 months to be completed.
The one aspect which has changed, that I have investigated was The Patients’ Experience, this is a policy that has been improved because of the government requirements that the clinical governance review has monitored.
Analysis on how Basildon hospital has been influenced by external factors
Basildon hospital has a system in place to help patients, family & friends, and carers regarding the treatment they receive from Basildon Hospital. Basildon Hospital has set up a special Patient Advice and Liaison Service, which will help guide patients, their family, and carers through the different services available within the Trust and help patients sort out any concerns they may have about the care they receive. This service is called PALS
The people who work for the Patient Advice and Liaison Service (PALS) have direct access to the Chief Executive who is Sue Jennings CBE. What this means is that when a situation occurs where the service a patients has received has not gone as it should the case will be brought to the attention of senior executives in order to have it resolved as quickly as possible.
The reason for PALS is not to replace the existing complaints system. The complaints system operates as a separate system. It is hoped that people may choose to speak to PALS first, especially where the concern can be easily or quickly resolved, before making a formal complaint through the NHS complaints procedure. PALS are complementary to existing services. It Provides information and on the spot help for patients, their families and carers. It is also being seen as a powerful lever for change and improvement. PALS can act as the patient’s voice.
A formal complaint can be made direct to the NHS regarding Basildon Hospital but wherever possible patients should tell someone close to, them cause of their complaint - a doctor, nurse, receptionist, or practice manager, for example. In many cases, it should be possible to sort out the problem straight away; this part of the procedure is called a Local Resolution. It is also possible to talk to someone who is not involved directly with the care. In this instance a telephone call or a letter to the appropriate complaints manager can be done. All NHS Trusts have complaints managers, therefore so would Basildon Hospital. The telephone number and address of the trust or health authority is the phone book. In addition, letters can be addressed to ‘the Complaints Manager’, of Basildon Hospital.
Basildon hospital is influenced by the complaints they receive, because they have to try and improve the quality of the service when patients require a change in the way care is given.
If the outcome of the Local Resolution is not successful, then Basildon and Thurrock Trust can be asked to consider taking the complaint to an Independent Review. This should be done within 4 weeks of the date of the letter regarding the outcome of Local Resolution action. This letter will have details on whom to contact regarding an Independent Review. The request will then be considered by a specially trained member of the trust or health authority, called the convener, who will then ask for clarification again about the complaint this, will be asked for in writing. The convener will contact an independent layperson to help him consider the case and will see if another Local Resolution action might resolve the problem. If this is definitely not possible then the convener will decide whether there should be an Independent Review.
The Independent Review Panel will have three people - an independent layperson acting as chairman, the convener, and one other person. The panel will re-examine fully the concerns referred to it by the convener, talking to everyone involved, and getting any specialist advice it needs. It will then prepare a report setting out the results of its investigations, together with its conclusions and any appropriate comments or suggestions. A copy of the report will then be sent to the patient, and the chief executive will write to tell to confirm if any action being taken because of the panel’s recommendations
If the patient is still dissatisfied after the NHS complaints procedure has been completed the next step is to involve the Health Service Commissioner (the Ombudsman) to investigate the case. The Ombudsman is completely independent of both the NHS and of the Government. As well as complaints about NHS services, he can investigate complaints about how the whole complaints procedure.
The local Community Health Council (CHC) can help with complaints. CHCs are independent and can provide information, advice, and support to members of the public who may wish to make complaints. The local Citizens Advice Bureau can also help with advice.
(See Appendix 3,4)
Address and phone numbers.
Complaints Manager
Mrs Jackie Best
Quality Department
Basildon Hospital
Nethermayne
Basildon
Essex SS16 5NL
Tel: 01268 593249
Email: [email protected]
Patient and Public Involvement Team
Room 3E58
Quarry House
Quarry Hill
LEEDS
LS2 7UE
Tel: 0113 254 6103
PALS Office
Basildon Hospital
Room B122
Level B
New Ward Block
Nethermayne
Basildon
Essex
SS16 5NL
Tel: (01268) 598536
Email: [email protected]
Department of Health
Richmond House
79 Whitehall
London
SW1A 2NS
Basildon, Brentwood and Thurrock CHC
67 Southernay
Basildon
Essex SS14 1EU
Email: [email protected]
Tel: 01268 284602
Fax: 01268 527855
The Health Service Ombudsman for England
11th Floor
Millbank Tower
London
SW1P 4QP
Tel: 0845 015 4033
Basildon Primary Care Trust
Phoenix House
Christopher Martin Road
Basildon
Essex SS14 3EZ
Tel: 01268 705000
The Health Information Service (0800 665544) also have up to date information about how the complaints system works.
NHS Direct 0845 4647
Basildon and Thurrock is an Award-Winning Trust it has top 3-stars in the NHS Performance ratings for both years running 2002 & 2003.
It was one of CHKS Top40 hospitals in 2001.
All Basildon and Thurrock Hospital laboratories have CPA (Clinical Pathology Accreditation).
In addition, all its systems and procedures are accredited by HQS (Health Quality Service).
Basildon and Thurrock Hospital has 4 Charter Marks - 1) for Hotel Services, 2) Ultrasound Department, 3) for Endoscopy Departments and 4) for the Day Surgery Unit at Orsett Hospital.
The Sterile Supplies Unit has the EU kitemark and a number of corporate departments, including finance and information technology, have ISO 9002.
The Education & Training Department and the Directorate of Planning & Service Development have achieved Investor in People (IIP).
Basildon and Thurrock Hospital has achieved the Outpatients Directorate for its patient-friendly practices.
The Commission for Health Improvement found the following negative aspects about Basildon and Thurrock Hospital. CHI found “that the long standing delays in accessing services in the A&E and the medical assessment units were a major area of concern requiring urgent management intervention. Conditions in A&E are below acceptable standards for dignity and privacy. There are serious problems with overnight stays and considerable delays for some patients in receiving treatment. The trust is now working with health partners to tackle these issues as a matter of priority."
CHI also recommended the following KEY AREAS FOR ACTION
Improving access to treatment through A&E and the Mary Wright assessment unit should be the trust’s key priority.
Urgent measures are required to improve standards of dignity and privacy in A&E and the medical assessment unit.
Action is required to ensure that social workers and hospital staff work together effectively to improve arrangements for discharging patients.
Urgent action is required to end the use of unsuitable areas for clinical activity.
Action is required to improve feedback mechanisms to staff, to ensure that they hear the outcome of complaints, learn from them and that the information is shared across departments.
The executive team must ensure that all directorates approach the performance review process consistently and that demonstrable progress on action is reported.
The CHI visit Basildon hospital and give them suggested improvements to improve the quality of care given to patients.
The trust needs to develop a patient involvement strategy.
On a final note although Basildon and Thurrock Hospital did gain 3 star rating, work is still needed to improve the Hospital's activities. The CHI report did find both good and bad areas within the hospital and it will not be fair to emphasise the bad points. However, it is possible for a patient to be the result of one of the areas needing improvement and this will not be fair to the individual concerned. A complaints procedure is in place for the individual but this will be at the late stage in the process, and not everyone will follow through with a complaint. It would be recommended that the hospital improves in all areas and treat each case as an individual where possible.
(See Appendix 5)
