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									        COMMENTARY BY


           Submitted for the Final Declaration
         For the period April 2007 – March 2008.

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This document is the independent view of the York Health Services NHS
Trust Patient and Public Involvement Forum and forms part of their work-plan
for 2007-08. With the abolition of PPIfs taking place on the 31st March 2008,
this assessment covers the forum‟s work up to December 2007, as the
remaining months are a period of “winding down” and completing outstanding

This document has been completed using the “Criteria for Assessing Core
Standards – Information for Acute Services” as produced by the Healthcare

There are 24 core standards in total. These have been further broken down
into seven more detailed domains that are listed below:

      1.     Safety
      2.     Clinical and Cost Effectiveness
      3.     Governance
      4.     Patient Focus
      5.     Accessible and Response Care
      6.     Care Environment and Amenities
      7.     Public Health.

The forum was not expected to comment against each standard but where
comments have been made evidence has been gathered by the Forum.
Members have no reason to believe that the evidence provided by the Trust is
not accurate on standards where comments have not been provided by the

The Forum has commented against Core Standards:

             C4                          C16
             C13                         C17
             C14                         C20a

York Health Services NHS Trust is required by the Healthcare Commission to
include this commentary verbatim in their declaration.

In responding to the Core Standards, the PPI forum gives below information
that it has gathered from its work. Comments in quotation marks are taken
from visit reports and represent the views of the forum and patients at the time
the visit was carried out.


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C4 Healthcare organisations keep patients, staff and visitors safe by
having to ensure that:
      (a)   the risk of healthcare acquired infection to patients is
            reduced, with particular emphasis on high standards of
            hygiene and cleanliness, achieving year on year reductions
            in MRSA.

         “The area was very clean and well organised. Hand washing
          notices clearly displayed near the cleansing gel at the entrance of
          the wards and bays. Wards secure. No opening. Babies tagged and
          kept with their mothers all the time.” (Visit to Maternity Dept)
         “The ward and outpatients departments were very clean and safety
          appeared to be good. Hand washing notices in place with
          machines. Very clear sign posting. All surfaces very clean, toilets
          and showers were spotless. No mess visible. There was plenty of
          space to move around and the ward looked as though it was
          running in a very efficient manner.” (Visit to ENT)
         “Standard of cleanliness and safety for patients and visitors was
          good.” (Visit to OT)
         “All areas were very clean; cleaning machines are able to access
          many areas.” (Visit to A&E Dept)


C13. Healthcare Organisations have systems in place to ensure that:
      staff treat patients, their relatives and carers with dignity and

         “The area was quiet and felt calm and safe, with caring staff.
           “Special rooms are available for the use of bereaved parents.
           “There is a separate entrance to the hospital for parents in labour
          and for parents visiting the Special Care Baby Unit” (Visit to
         “Patients spoken to agree they were treated with dignity and
          respect, including one person spoken to in outpatients. One patient
          was distressed by two younger patients who had their TVs on all
          day. Although they have earphones there is an amount of sound
          outside these. A member spoke to one patient who had travelled
          form Harrogate who was very impressed with the ward.” ( Visit to
         “Staff attitudes were very good and the noise level was acceptable.
          The staff seemed to work very well together and the care they gave
          the patients we saw was good. Staff were very caring and coped
          very well” (Visit to OT)
         “From our observations staff were excellent in treating patients and
          carers with dignity and respect. The Department had a quiet and
          calm atmosphere. Staff were kind and helpful. Patients are given a
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          leaflet on „ See and Treat‟ which explains how the department
          manages all patients within the Department” (Visit to A&E)
         “It was very evident that the Catering Team take great pride in their
          work and every effort is made to assist with any request made by
          patients.” (Visit to Catering Dept)
         “There were mixed gender wards but these had single sex bays.
          Patients spoken to said they had been treated very well and with
          dignity and respect. Staff attitudes are excellent and all staff were
          welcoming.” (Visit to Acute Stroke Unit)
         “All patients were seen to be treated with respect and care.
          Patients have separate rooms, which were very clean, bright and
          welcoming” (Visit to St Helen‟s Unit)
         From our observations staff were excellent in treating patients and
           carers with dignity and respect. The department had a quiet and
           calm atmosphere, there are separate treatment rooms, Staff were
           very kind and helpful. (Visit to Podiatry Clinic, Diabetes Dept)

C14. Healthcare Organisation have systems in place to ensure that
patients, relatives and their carers;

      (a) have suitable and accessible information to, procedures to
          register formal complaints and feedback on the quality of

         “Information in leaflets supplied to patients to give feedback on
          services received.” (Visit to Maternity)
         “Information is available in side rooms for visitors and patients in
          leaflet form. Also a mobile trolley with feedback forms and literature
          is moved around from ward to ward.” ((Visit to ENT)
         “Leaflets were available in many areas of the Department on “How
          to Complain” as well as throughout the hospital. PALS leaflets were
          also on display. On display also was a leaflet „How to make a
          suggestion, comment or say thank you‟ on services received.
          Leaflets were easy to understand.” (Visit to A&E Dept)
         Leaflets were available in many areas of the department on “How to
          Complain” as well as throughout the Hospital, Patient dietary
          leaflets were on available in the department and leaflets on the
          Hospital Services were also accessible. (Visit to Podiatry Clinic,
          Diabetes Dept)

C.15 Where food is provided healthcare organisations have systems in
place to ensure that:

      (a) patients are provided with a choice and that it is prepared
          safely and provides a balanced diet:
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      “Special clients catered for. There is a serving room where food is
       available and where patients may collect their meals.” (Visit to
      “Dietary needs are met.” (Visit to ENT)
      “Members were informed that there is a very close working
       relationship with the Nutritional Department, to ensure that correct
       meals are delivered to the wards.” (Visit to Catering Dept)

      (b) patients individual nutritional personal and clinical dietary
          requirements are met, including any necessary help with
          feeding and access to food 24 hours a day:

      “Patients‟ dietary needs are met. Assistance for helping patients to
        take food is available…Family members of patients are welcomed
        into the ward to assist patients with food…protected meal times.”
        (Visit to Acute Stroke Unit)
      “Patients individual dietary needs are met. The dining room is bright
        and friendly. Staff look out for patients and ensure that they receive
        the portions of food that they feel happy with. Meal times are
        protected.” (Visit to St Helen‟s Unit)

C.16 Make information available to patients and the public on their
services, provide patients with suitable and accessible information on
the care and treatment they receive and, where appropriate, inform
patients on what to expect during treatment, care and aftercare:

         “A booklet giving details of all services in the maternity unit is given
          to each patient. There are details about screening tests, antenatal
          care and newborn screening programme, also information about
          breastfeeding support groups in Selby and York area.” (Visit to
         “All those booked to come in receive information beforehand.
          Accident and Emergency do not but would be provided if asked for.
          We were told a booklet was in process of being designed which
          would eventually be available at each bedside.” (Visit to ENT)
         “PALS information on notice boards provides patients with clear
          instructions on how to give feedback about the services they have
          received. PALS forms were also available.” (Visit to Acute Stroke
         “There were notice boards, which provided leaflets and information
          on other services available.” (Visit to St Helen‟s Unit)
         Leaflets were available in many areas of the department on “How to
          Complain” as well as throughout the Hospital, Patient dietary
          leaflets were available in the department and leaflets on the
          Hospital Services were also accessible.” (Visit to Podiatry Clinic,
          Diabetes Unit)


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C.17 The views of patients, their carers and others are sought and taken
into account in designing, planning, delivery and improving healthcare

             “There are details in the leaflets on how to make a complaint”. (Visit
              to Maternity)
             “Information available on notice boards.” (Visit to ENT)
             Following the publication of “Maternity Matters” members met with
              Trust staff to discuss the contents of the report and its implications
              for the Trust. The Trust spent sometime with Members, answering
              their many questions and giving information on how the Trust will
              implement the recommendations made in “Maternity Matters” as
              well as giving information on patient satisfaction surveys etc.”
              (Maternity Fact Finding visit)
             Following two visits to the A&E Department during May 2007,
              Members suggested that panic alarms be fitted to all rooms and
              staff be issued with personal alarms. The Trust responded to these
              recommendations by informing the forum “that discussions were on-
              going re: installation of panic alarms and that personal alarms have
              been purchased and staff made aware that they are available.”
             Copies of the Trusts Leaflets on “How to make a suggestion” were
              on display. (Visit to Podiatry Clinic, Diabetes Dept)

C.20 Services are provided in environments which promote effective
care and optimise health outcomes by being:

(a)       a safe and secure environment which protects patients, staff,
          visitors and their property, and the physical assets of the

         “Wards secure. Babies tagged and kept with their mothers at all times.”
          (Visit to Maternity Unit)
         “Safety appeared to be good.” (Visit to ENT)
         “Cleanliness in all areas was very good; it was comfortable and felt
          safe” (Visit to A&E)
         “A high standard of cleanliness was observed in both units. Cleaning
          was ongoing and in progress during the visit.” and “…there were plenty
          of hand gel machines with notices advising people to use them” (Visit
          to Acute Stroke Unit)
         “Members observed a very good standard of cleanliness and safety.
          There were hand gel dispensers and the corridors were clear of
          obstructions and very clean” (Visit to St Heln‟s Unit)
         “Cleanliness in all areas was of an excellent standard; it was
          comfortable and felt safe.” (Visit to Podiatry Clinic, Diabetes Dept)
         “The reception area is clean, bright and comfortable. The treatment
          rooms were clean and well provided with up to date equipment.” (Visit
          to Podiatry Clinic, Diabetes Dept)

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      Forum was pleased to welcome the Head of Security to their December
       2007 meeting to hear of the procedures put in place to ensure the
       safety of patients, staff, visitors and property.


On behalf of the York Health Services NHS Trust PPI Forum, we confirm that
this commentary is an independent, open and transparent view of the Trust‟s
performance against the Healthcare Commission core standards.

Signed at a meeting of the PPI forum held in York at the Priory Street
Centre, on 13th February 2008.

Richard Smith, Chairperson.
Date: 13th February 2008.

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