Clinical coding error rate

The Trust was not subject to the Payment by Results clinical coding audit during 2013/14 by the Audit Commission.

Prescribed Information Related NHS Outcomes Framework Domain & who will report on them

2013/14 2012/13 Supporting Statement

The data made available to the National Health Service trust or NHS foundation trust by the Health and Social Care Information Centre with regard to—

(a) the value and banding of the summary hospital- level mortality indicator (“SHMI”) for the trust for the reporting period; and (b) The percentage of patient deaths with palliative care coded at either diagnosis or

specialty level for the trust for the reporting period.

*The palliative care indicator is a contextual indicator. 1: Preventing People from dying prematurely 2: Enhancing quality of life for people with long- term conditions

Acute trusts

(a) The SHMI for Wye Valley NHS Trust for the period July 2012 to June 2013 was 1.1516. This gave the Trust a banding of 1 (higher than expected). (b) Wye Valley NHS Trust scored 18% for this indicator.

(a) The SHMI for Wye Valley NHS Trust for the period of April 2012 to March 2013 was 1.1257. This gave the Trust a banding of 2 (as expected).

(b) Wye Valley NHS Trust scored 17% for this indicator.

Wye Valley NHS Trust considers that this data is as described for the following reasons;

Please see section 2.2.11

Wye Valley NHS Trust has taken the following actions to improve this rate and so the quality of its services, by

Prescribed Information Related NHS Outcomes Framework Domain & who will report on them

2013/14 2012/13 Supporting Statement

The data made available to the National Health Service trust or NHS foundation trust by the Health and Social Care Information Centre with regard to the trust’s patient reported outcome measures scores for— (i) groin hernia surgery, (ii) varicose vein surgery, (iii) hip replacement surgery, and

(iv) knee replacement surgery,

during the reporting period. 3: Helping people to recover from episodes of ill health or following injury

All acute trusts

Wye Valley NHS Trust scored 01.28 for groin hernia surgery for the time period September 2013 to February 2014 compared to 0.086 nationally. There was no data available for this time period for varicose vein surgery, hip

replacement surgery and knee

replacement surgery on the Health and Social Care

Information Centre Indicator Portal

Wye Valley NHS Trust scored the below; Groin hernia – 0.115 Varicose vein – No data available. Hip replacement – 0.484 Knee replace – 0.328 For 2012/13 compared to national scores of; Groin hernia – 0.085 Varicose vein – 0.093 Hip replacement – 0.438

Knee replace – 0.319

Wye Valley NHS Trust considers that this data is as described for the following reasons:

 For the vast majority of measures levels of improvement for the Trust are above the national averages. However, the Health & Social Care Information Centre results shown are based on provisional data only and are subject to change until the publication of finalised data,

expected later in 2014. All finalised data was reviewed when published. No concerns have been raised.  The data shown are only for

procedures where the Health & Social Care Information Centre is in receipt of a pair of linked pre-

operative and post-operative questionnaires containing valid entries on specific key items within the questionnaire. Thus numbers available for analysis may be lower than overall numbers of procedures or questionnaires.

Prescribed Information Related NHS Outcomes Framework Domain & who will report on them

2013/14 2012/13 Supporting Statement

following actions:

 Robust processes are in place to ensure that all eligible patients are given the opportunity to participate in the national PROMs programme. Participation rates for the Trust are very good and have continuously been above national averages.

 If any eligible patients are not invited to participate, reasons are explored and relevant actions taken to reduce the risk of this happening again.

 Routinely monitors and reports national and locally calculated participation rates to ensure that we continue to achieve the very good participation rates.

 Outcome scores are sent to the Clinical Directors in Surgery and Trauma & Orthopaedics, and feedback requested.  Participation rates and outcome scores

are routinely reported to the Trust’s Clinical Effectiveness & Audit Committee and the Quality Committee.

The data made available to the National Health Service trust or NHS

3: Helping people to recover from episodes of ill

Not available on Health and Social Care Information

(i) 10.14 for

2011/12 compared to

Wye Valley NHS Trust considers that this data is as described for the following reasons;

Prescribed Information Related NHS Outcomes Framework Domain & who will report on them

2013/14 2012/13 Supporting Statement

Health and Social Care Information Centre with regard to the percentage of patients aged— (i) 0 to 14; and (ii) 15 or over,

Readmitted to a hospital which forms part of the trust within 28 days of being discharged from a hospital which forms part of the trust during the reporting period.

following injury

All trusts

Portal West Midlands

(ii) 8.8.1for 2011/12 compared to 11.45 for the West Midlands.

Please see section 2.3.1

Wye Valley NHS Trust has taken the following actions to improve this rate and so the quality of its services, by

Please see section 2.3.1

The data made available to the National Health Service trust or NHS foundation trust by the Health and Social Care Information Centre with regard to the trust’s responsiveness to the personal needs of its patients during the reporting period. 4: Ensuring that people have a positive experience of care

All acute trusts

Not available on Health and Social Care Information Centre Indicator Portal

Wye Valley NHS Trusts score against this indicator was 67.9 for 2012/13 compared to 68.1 for England.

Wye Valley NHS Trust considers that this data is as described for the following the inpatient survey.

Wye Valley NHS Trust has taken the following actions to improve this score, and so the quality of its services, by;

Please see sections 2.1.6 and 2.1.7

The data made available to the National Health Service trust or NHS foundation trust by the Health and Social Care

5: Treating and caring for people in a safe environment and protecting them Wye Valley NHS Trust achieved 95.2% for quarter 3 of 2013/14 against this indicator

Wye Valley NHS Trust achieved 92.5% for quarter 4 of 2012/13 compared to 94.2% for England.

Wye Valley NHS Trust considers that this data is as described for the following reasons;

Prescribed Information Related NHS Outcomes Framework Domain & who will report on them

2013/14 2012/13 Supporting Statement

Information Centre with regard to the percentage of patients who were admitted to hospital and who were risk assessed for venous

thromboembolism during the reporting period.

from avoidable harm

All acute trusts

compared to 95.8% for England.

completion of VTE risk assessments in 2013/14

Wye Valley NHS Trust has taken the following actions to improve this percentage and so the quality of its services, by;

 Service Unit Managers and Service Unit Directors are notified on a weekly basis of any areas that have been identified as non-compliant. This enables the relevant managers to make a targeted approach in reinforcing the need for VTE risk assessments to be completed in a timely manner. This has been in place for a number of months and has proved positive in reacting to any areas of non- compliance.

 The completion of VTE risk assessments continues to be incorporated into Service Unit KPI dashboards. These dashboards and the relevant supporting information, i.e. details of areas of non- compliance against VTE risk assessment, are reported through Service Unit Governance meetings and Service Unit Performance meetings to

Prescribed Information Related NHS Outcomes Framework Domain & who will report on them

2013/14 2012/13 Supporting Statement

continue emphasising the need to have 100% compliance with completion of VTE risk assessments.

The data made available to the National Health Service trust or NHS foundation trust by the Health and Social Care Information Centre with regard to the rate per 100,000 bed days of cases of C difficile infection reported within the trust amongst patients aged 2 or over during the reporting period.

5: Treating and caring for people in a safe

environment and protecting them from avoidable harm

All acute trusts

Not available on Health and Social Care Information Centre Indicator Portal

Wye Valley NHS Trust had a rate of 15.5 for 2012/13 compared to 17.3 for England.

Wye Valley NHS Trust considers that this data is as described for the following reasons;

The Trust has a robust programme of C. difficile prevention. This includes use of the most sensitive PCR test for primary diagnosis.

Wye Valley NHS Trust has taken the following actions to improve this rate, and so the quality of its services, by;

Wye Valley NHS Trust has purchased

hydrogen peroxide fogging technology and is the process of implementing it use. For 2014/15 it is introducing a new root cause analysis approach which will involve the lead nurse in infection prevention and control from Herefordshire CCG being an active participant in all toxin positive case RCAs.

Prescribed Information Related NHS Outcomes Framework Domain & who will report on them

2013/14 2012/13 Supporting Statement

The data made available to the National Health Service trust or NHS foundation trust by the Health and Social Care Information Centre with regard to the number and, where available, rate of patient safety incidents reported within the trust during the reporting period, and the number and percentage of such patient safety incidents that resulted in severe harm or death

5: Treating and caring for people in a safe environment and protecting them from avoidable harm All trusts Not available on Health and Social Care Information Centre Indicator Portal

Wye Valley NHS Trust scored 7.9 for the rate of patient safety incidents reported for October 2012 to March 2013. There was no national comparable data.

Wye Valley NHS Trust scored 0 for the in relation to the rate of patient safety incidents that resulted in severe harm or death for October 2012 to March 2013.

Wye Valley NHS Trust considers that this data is as described for the following reasons

 The Trust encourages open and honest reporting of any incidents or near misses.

Wye Valley NHS Trust has taken the following actions to improve this rate and so the quality of its services, by the

completion of the roll out of electronic web based incident recording to ensure real time reporting.

Friends and Family Test - Question Number 12d – Staff – The data made available by National Health Service Trust or NHS Foundation Trust by the Health and Social Care Information Centre ‘If a friend or relative needed treatment I would be happy with the

4: Ensuring that people have a positive experience of care

All acute trusts

Wye Valley NHS Trust scored 54% in relation this indicator for 2013 Staff

Survey compared to 67% for all acute organisations.

Wye Valley NHS Trust scored 53% in relation this indicator compared to 65% for the Staff Survey 2012 for all acute organisations.

Wye Valley NHS Trust considers that this data is as described following the staff survey results.

Wye Valley NHS Trust intends to take the following actions to improve this

percentage, and so the quality of its services, by;

The NHS friends and family test came into force on 1st April 2014 and requires the

Prescribed Information Related NHS Outcomes Framework Domain & who will report on them

2013/14 2012/13 Supporting Statement

by this organisation' for each acute & acute specialist trust who took part in the staff survey.

quarters 1,2 and 4 (quarter 3 is covered by the staff survey). The questions are pre-set. In March 2014 the staff Friends and Family Test was discussed at staff partnership, i.e. how to collect the information and this will be rolled out will be rolled out May and June 2014 across the Trust.

Friends and Family Test – Patient. The data made available by National Health Service Trust or NHS Foundation Trust by the Health and Social Care Information Centre for all acute providers of adult NHS funded care, covering services for inpatients and patients discharged from Accident and Emergency (types 1 and 2) 4: Ensuring that people have a positive experience of care This indicator is not a statutory requirement.

All acute trusts

Wye Valley NHS Trust scored 25.8% for this indicator in March 2014

compared to 23.7% nationally.

Friends and Family data was reported nationally from April 2013.

Wye Valley NHS Trust considers that this data is as described for the following reasons;

The Trust has actively promoted responses to Friends and Family Test throughout 2013/14.

Wye Valley NHS Trust has taken the following actions to improve this percentage and so the quality of its services, by;

Appendix 1:

Thank you for allowing Healthwatch Herefordshire the opportunity to comment on the Wye Valley NHS Trust Quality Accounts.

After consideration Healthwatch Herefordshire would like to give the following feedback: 1) Priorities (Page 5)

HWH noted that the improvement plans only have three objectives, one of which implies that it will be acceptable for WVT to harm 6 out of every 100 adult in- patients. We would recommend 100%, as the key performance indicator. 2) Patient Safety (Page 6)

In the subsequent Rationale section on patient safety, the proposed action plans seem to address only some of the four bullet points. We would recommend addressing all points.