You said, We did 2016-17

 The car park at North Devon District Hospital is too expensive.

 The option to purchase more cost-effective 5 or 7 day passes has been made more visible following the installation of new car park pay machines. The options are now integrated in the payment process.

The starting point for serving ward meals at North Devon District Hospital should be alternated.

Staff have been reminded of the procedure to rotate the starting point for the delivery of meals on a daily basis so that it is not always the same patient who is served last. This also helps with food temperature even though the meal trolley is maintained at the correct temperature.

The delivery of some distressing news was given to a patient by a consultant in not a private or appropriate way on a ward at North Devon District Hospital.

The lead consultant was contacted and asked to share the feedback with the teams.

In the acute inpatient survey, patients are asked if the side effects of their medication have been explained to them. This question had been scoring lower than the other questions in the survey.

As result of enhanced communication of this aspect of care, in the year ending Mar-17, the Trust achieved target in 11 out of the 12 months

 More simple food choices at North Devon District Hospital, particularly in respect of sandwiches i.e. the provision of plain sandwiches with condiments provided separately in sachets.

 Simpler sandwich options were introduced with sachets of condiments provided separately for patients to add as required.

 The physiotherapy outpatients department at North Devon District Hospital could be nicer and more private.

 The department has been refurbished and now has individual clinic rooms to improve privacy and dignity.

 It would be better to be able to attend physiotherapy appointments before and after work.

 The Trust’s flexible working policy has been used to allow clinicians to alter their working hours to offer early and late appointments for patients.

 Improve the level of avoidable missed doses of medication for inpatients at North Devon District Hospital.

 In respect of newly-admitted patients, pharmacy technician ward sweep has been introduced daily at 9am with the aim of getting any missed doses of medication back on the ward by 10am. Additionally, pharmacy communication books and dedicated pharmacy trays for drug charts with missed doses needed have been introduced onto each ward. A downward trend in missed doses of medication has resulted.

 Prevent avoidable inpatient readmissions by improving communication on discharge.

 A medicine support service has been established. Subject to patient consent, a copy of the patient’s discharge summary is sent to the designated community chemist so that the next prescription received from the GP can be checked to ensure the changes made during admission are followed up in the community. The focus is currently on patients requiring blister pack medication.

 There is a delay in accessing medication from pharmacy.

 A sufficient number of bleeps has been purchased so that each ward has a dedicated pharmacist and ward-based technician to contact should they require a discharge prescription processing or an urgent/newly-prescribed medication supplied.

 The facilities for parents on Caroline Thorpe Ward require improvement.

 The parents’ small kitchen area has been redecorated and enhanced, funded by the ward’s charity ‘Care for kids’. Parents are able to make themselves beverages and heat snacks in an uplifting environment featuring a coastal theme.

 Mums who have had a difficult delivery are not always able to visit their babies on SCBU e.g. if they are in intensive care.

 SCBU has purchased two dedicated iPads which link up mum to baby via Skype, enabling mum to see baby in real-time even when she cannot be present.

 Families said that they are often unable to visit babies in the SCBU due to the visiting times.

 Staff asked parents by questionnaire what they would like. As a consequence, SCBU has changed its visiting times in line with the feedback received. Visiting times are now more family-friendly.

 Mums often have to wait for their baby’s milk to be warmed.

 SCBU has introduced a second milk warmer so that babies can get their feeds without waiting.

 Mums have had difficulty expressing their milk due to a lack of breast pumps.

 SCBU has now purchased enough breast pumps for there to be a dedicated pump per cot. In addition, the delivery suite will have one to enable mothers to express within two hours of delivery, according to best practice guidance.

 Parents would like more involvement in their baby’s care. They do not want to miss their baby’s ‘firsts’.

 SCBU is working towards delivering ‘Family Integrated Care’. Parents will be encouraged to stay in and taught how to care for their baby. This will enhance parental bonding, satisfaction, breastfeeding and ownership. New documentation and booklets are being created. Parents will involve themselves collaboratively with staff in care planning and informed decision-making.

 Parents would like more information while they are on SCBU.

 The ward welcome leaflet has been updated to include the information that is required quickly. SCBU staff have made up baby friendly packs of parent information specific to the length of stay and gestation of the baby. All parents now receive an admission pack, a day 2 pack and a discharge pack tailored to the requirements of their baby. In addition they are given a special bag for their baby’s cot in which to store mementos to take home.

 Parents said that once their baby was discharged they felt ‘abandoned’ with no one to turn to who had expertise in preterm infants.

 SCBU saw the need for a community service as required for service standards. A neonatal outreach team has been created linked to the Children’s Community Nursing Service. All babies who reach an agreed criteria are visited at home. This is enhancing parental satisfaction and confidence and babies can be discharged home earlier.

 Patients were concerned that on returning home they would have no ongoing point of contact.
(Pathfinder Urgent Care)

 A follow-up phone call to all patients discharged by the urgent care stream has been introduced. This has reassured patients that they will be supported when their care is transferred from the acute hospital to the community and has also led to reduced readmissions.

 There is insufficient patient parking at Barnstaple Health Centre.

 Car parking machines have been installed and patrols introduced from Monday to Friday for 20 hours a week at peak times.

 Toys for younger children are needed in the waiting area at Litchdon House.

 A wooden toy table to entertain the children in the predominantly paediatric waiting area has been introduced.

 Conversations in the consulting rooms at Litchdon House can be overheard.

 Music has been introduced so that conversations in consulting rooms cannot be overheard and to try to make the atmosphere in the waiting areas more relaxing/comfortable.

 More patient-friendly chairs are required in the main waiting room at Litchdon House.

 New chairs which are firmer, higher and have arms for assistance have been introduced

 The waiting room at Bideford Minor Injury Unit is dull and needs repainting

 The reception hatch area has been painted and a new sign clearly identifying where to go on arrival has been installed.

 Patient information leaflets are not easily accessible at Bideford Minor Injury Unit.

 Funded by the League of Friends, the patient information leaflets have been relocated from behind the nursing station to the main corridor.

 A patient received a waiting list letter with the wording ‘if you improve and no longer need our intervention etc.’ when the patient was palliative. (Barnstaple Community Rehabilitation Team)

 The wording on the letter was changed to reduce the risk of upsetting patients or their families.

 The patient environment in the physiotherapy outpatient department at Ilfracombe Community Hospital is poor.

 A temporarily-available area is being used on a trial basis to provide an improved patient environment. Work with the locality and senior management to improve privacy and dignity is continuing.

Last updated: October 30, 2018