Wansbeck General Hospital

Wansbeck General Hospital is one of the acute hospitals providing care as part of Northumbria Healthcare NHS Foundation Trust. This hospital provides emergency care from an emergency care centre, medical and surgical services, a limited maternity service which included a pregnancy assessment unit, ante natal clinics and elective gynaecology, end of life care and a range of outpatient and diagnostic imaging services. Wansbeck General Hospital does not provide critical care and children and young people's services. Services had been reconfigured in June 2015 when the Northumbria Specialist Emergency Care Hospital (NSECH) opened. The opening of NSECH had resulted in a new model of care and different patients pathways in emergency, medical and surgical care and maternity services.

Northumbria Healthcare NHS Foundation Trust provides services for around 500,000 people across Northumberland and North Tyneside with 999 beds. The trust has operated as a foundation trust since 1 August 2006. Wansbeck General Hospital has 207 beds.

We inspected Wansbeck General Hospital as part of the comprehensive inspection of Northumbria Healthcare NHS Foundation Trust, which included this hospital, Hexham General Hospital, North Tyneside General Hospital, Northumbria Specialist Emergency Care Hospital, and community services. We inspected Wansbeck General Hospital between 10 and 13 November 2015.

Overall, we rated Wansbeck General Hospital as outstanding. We rated it outstanding for being caring, responsive and well-led, and good for being safe and effective.

We rated end of life care, medical and surgical services, and outpatient and diagnostic imaging services as outstanding. Urgent and emergency care and maternity and gynaecology services, we rated as good.

Our key findings were as follows:

• The opening of NSECH had resulted in a new model of care and different patient pathways in emergency, maternity and medical and surgical care at this hospital. This had resulted in different ways of working for some staff.

• Staff felt fully informed about all the changes which had taken place and were proud of the hospital and the care it provided to the local community and beyond.

• Strong governance structures were in place across the hospital and there was a systematic approach to considering risk and quality management. Senior and site level leadership was visible and accessible to staff. Leadership was encouraged at all levels and staff supported to try new initiatives.

• Managers at all levels understood the challenges of the new model of care and were actively addressing any issues that this had presented, specifically around nursing and medical staffing and patient acuity.

• Staff and patient engagement was seen as a priority with several systems in place to obtain feedback.

• When we spoke with managers and staff throughout the hospital, the “Northumbria Way”, which incorporates the trust’s values, behaviours and culture, was evident.

• Staff delivered compassionate care, which was polite and respectful and went out of their way to overcome obstacles to ensure this. All patient feedback was extremely positive.

• There were processes to ensure patients were cared for in the right place at the right time. Patient flow was a priority, and the hospital proactively managed this.

• For all performance measures relating to the flow of patients the hospital was performing the same or better than the England average.

• The transfer of patients between NSECH and the ‘base’ hospitals was still being embedded at the time of inspection and staff were working flexibly to accommodate patient needs.

• The hospital had infection prevention and control policies in place, which were accessible, understood and used by staff.

• Patients received care in a clean, hygienic and suitably maintained environment.

• There was adequate personal protective equipment (PPE) such as aprons and masks available to staff. We routinely saw staff using this equipment during our inspection. Patients told us that staff washed their hands and used gloves and aprons.

• The hospital routinely monitored staff hand hygiene procedures and at the time of inspection, compliance was high.

• Between April and October 2015 there had been no cases of methicillin resistant staphylococcus aureus (MRSA) at this hospital.

• In the same time period, the hospital had reported very low numbers of cases of c-difficile and MSSA.

• Nurse staffing was maintained at safe levels in most areas. The hospital had implemented a ‘Safer Nursing Care Tool’ (SNCT) to assess the staffing requirements across wards.

• The proportion of consultants and junior doctors at this hospital was very similar to the England average.

• The hospital utilised advance nurse practitioners to support doctors.

• Mortality and morbidity meetings were held at least monthly and were attended by representatives from teams within the clinical business units.

• Patients were assessed regarding their nutritional needs using the Malnutrition Universal Screening Tool (MUST).

• Nutritional assistants were employed to provide patients with eating and drinking assistance if required.

• Most wards followed the ‘well organised ward’ model to ensure that equipment storage was standardised and consistent across the trust.