Changes to outpatient services at WCH and Carlisle

North Cumbria University Hospitals NHS Trust has made substantial changes designed to improve care provided by outpatients service at  the Trust’s two hospital sites – the Cumberland Infirmary and West Cumberland Hospital, as well as clinics held at Workington Community Hospital. The service provides a quarter of a million appointments each year.
    
The Trust says that service is now delivering more consistently safe and responsive care since addressing issues identified by the Care Quality Commission (CQC) inspection in May 2014, which resulted in the service being rated as inadequate.
   
Nick McDonaugh, deputy director of Emergency Surgery and Elective Care, said:

“The response from staff has been exceptional since the Chief Inspector of Hospitals’ report last year and progress has been made not just within the outpatients service but across the whole Trust.

“By overhauling our processes and putting a number of short, medium and longer term initiatives in place since last summer, we are now seeing patients receive a more consistently safe and responsive approach to care. This would not have been possible without the unwavering support and commitment of our staff right across the board.”

The cornerstone to this achievement is the availability and completeness of medical records for outpatient appointments. The Trust is working hard to ensure the completeness and quality of all medical records continues to improve. Part of the CQC inspection involved an audit of case note availability – an individual patient’s medical history to support the doctor or consultant to deliver effective healthcare during clinics.
    
Only 72 per cent of medical records were available on the day of the clinic during the inspection in April 2014 but since then major improvements have taken place thanks to a number of changes identified by a weekly outpatient improvement group.

Since December 2014 clinics at West Cumberland Hospital and Workington Community Hospital have consistently achieved a minimum of 95 per cent case note availability at the start of clinics. The Cumberland Infirmary is also now consistently achieving the target of 95 per cent availability. As a result, only two outpatient appointments have been cancelled since the beginning of December 2014 due to issues around case notes.

The improvement in availability is due to processes being put in place to improve the timely transfer of medical case notes between the Trust’s hospitals, improving the transfer of case notes between departments at least seven days before the outpatient clinic occurs, and delivering systemised and categorised access to case notes.

Nick added: “We are now focussing on maintaining the high standard, ensuring more clinics are running on time and that there are fewer cancellations. We are all committed to improving our patients’ overall experience.”

There are many excellent staff at our local hospitals and I know the trust is quite right when it says they are all working hard to deliver better care. If anyone reading this has had experience of a recent outpatient appointment and would like to leave a comment - positive or negative - I'd be most interested to hear it.