North Bristol NHS Trust’s conditional registration from the Care Quality Commission (CQC) is driven by the recent receipt of an improvement notice, and we take this very seriously. We are therefore deeply disappointed at this result. It follows an inspection from the former Healthcare Commission (HCC) in February.
The notice specifies two areas:
1. The adequacy of corporate records to record that all relevant staff have received infection control training. For example, in the improvement notice it states 85 percent of staff in neurosciences have not received mandatory training in the last year. In fact, according to directorate paper records, this number is 20 percent. Obviously what we have to do is ensure that all training carried out is also appropriately recorded on the Trust’s computer system.
2. The Trust Board does not have an appropriate assurance framework to secure the prevention and control of healthcare-acquired infections. This means that the Board is not receiving adequate information on all the actions that we know are being taken across the Trust to protect patient care. Training records and cleaning scores are some of the examples given.
With all the focus and attention infection has received at this Trust, these failures are deeply disappointing.
To put this into context, this Trust has been driving down infections and we now stand below the regional and national rates for MRSA and C. difficile. For example we have recorded 14 cases of MRSA against a reduction target for this year of 29 cases – this is 75 percent less cases than last year. In addition there have been 181 cases of C. difficile – around 70 percent less than recorded last year for the Trust as a whole.
For neurosciences – where training is specifically mentioned – we have had no MRSA infections for more than a year and less than two cases of C. difficile a month in the last year making it one of the best performing directorates in the Trust in terms of infection control.
I am also conscious that people will be aware of the recent publicity regarding Mid-Staffordshire NHS Foundation Trust. The standardised mortality ratio, during the three years it was investigated, varied from 127 and 145. The mortality ratio here at North Bristol NHS Trust is 80 – well below the national average of 100.
The NHS Litigation Authority inspects Trusts routinely and this year we have reached CNST level two for general services and level three for maternity. This included our governance systems where we scored nine out of ten.
I am not complacent but I want the public to be reassured that this is one of the safest NHS Trusts in which to receive care. What the improvement notice shows is that we have work to do in demonstrating our systems in some of these areas. I would be very sorry if the public gain the picture that North Bristol NHS Trust is a hospital where a patient is now likely to acquire an infection – this is not the case.