Archived: Sunderland Eye Infirmary

Sunderland Eye Infirmary is one of two acute hospitals forming City Hospitals Sunderland NHS Foundation Trust.

The trust provides acute hospital services to a population of around 350,000 people across the Tyne and Wear and Durham area. In total the trust has 855 beds across two hospitals and employs around 4,923 staff. Sunderland Eye Infirmary has 22 beds.

Sunderland Eye Infirmary provides ophthalmology care and treatment in surgical, accident and emergency (A&E) and outpatient services for people living in the Tyne, Wear and Durham area.

We inspected Sunderland Eye Infirmary as part of the comprehensive inspection of City Hospitals Sunderland NHS Foundation Trust, which includes this hospital and Sunderland Royal Hospital. We inspected Sunderland Eye Infirmary on 16 and 19 September 2014.

We carried out this comprehensive inspection because the Care Quality Commission (CQC) had placed City Hospitals Sunderland NHS Foundation Trust in risk band 2 in the CQC Intelligent Monitoring system.

Overall, we rated Sunderland Eye Infirmary as good. We rated it as good for being safe, effective, caring, responsive and well-led across each of the acute services they provide within the hospital.

Our key findings were as follows:

• Processes were in place to implement and monitor the use of evidence-based guidelines and standards to meet patients’ care needs.
• Patients were provided with care in a compassionate manner and treated with dignity and respect.
• Arrangements were in place to manage and monitor the prevention and control of infection, with a dedicated team to support staff and ensure policies and procedures were implemented. All areas we visited were clean. Methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile (C. difficile) rates were within an acceptable range for the size of the trust.
• Patients were able to access suitable nutrition and hydration, including special diets. Patients reported that, on the whole, they were content with the quality and quantity of food.
• We had no concerns about staffing at this hospital. Staffing establishments and skill mix were maintained and regularly reviewed to maintain optimum staffing levels.
• We had no concerns about mortality rates at this hospital.
• The importance of patients’ and public views were recognised and mechanisms were in place to hear and act on patients’ feedback.

We saw an area of outstanding practice:

• The enhanced recovery pathway for cataract surgery and the role of the primary nurse were viewed as an excellent development of the service and resulted in individual surgeons’ cataract audits showing consistently higher visual acuity outcomes compared to benchmark standards (UK Cataract National Dataset audit).

However, we found that there was an area of poor practice that was a trust-wide issue resulting in a compliance action at trust level. This is reported in the trust provider report, which states:

The trust must:

• Ensure that patient group directions (PGDs), which are written instructions for the supply or administration of medicines to groups of patients who may not be individually identified before presentation for treatment, are updated and monitored in line with trust policy

The trust should:

• Review the storage of medical records within this hospital.

• Develop mechanisms for reviewing and if necessary updating patient information, particularly in the outpatient department.
• Introduce patient surveys specific to the outpatient department.
• Review the participation in audits, including clinical audits in the A&E department.
• Review the arrangements for the role of the Eye Infirmary when dealing with major incident/events across the trust.
• Review the practice of recording patient concerns in the electronic nursing evaluation, in line with best practice guidance.

Professor Sir Mike Richards

Chief Inspector of Hospitals