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					            PATIENT AND PUBLIC INVOLVEMENT IN HEALTH FORUM
                                  FOR
                     BASILDON & THURROCK HOSPITALS

    VISIT TO BASILDON HOSPITAL ON TUESDAY 27th JULY 04 AT 12.15 PM

       PRESENT:              Mrs S. Nelson
                             Mr J. Chew
                             Mr S. Wynne
                             Mrs M. Moura

The Forum were met and escorted by Debbie Crisp, PALS Manager.

FRANK AHRENS WARD.

The group were shown around the ward by Jackie Smith, Ward Manager.

This is a 31 bedded ward, incorporating a 9-bedded Coronary Care area and the provision to
monitor an additional 4 via telemetry.
The staff offers continuity of care for patients suffering acute coronary problems, from
admission through to discharge, along with patients admitted with a wide variety of acute
medical conditions.

2 Consultant Cardiologist and 3 Medical Consultants, manage the care of medical and elderly
patients within this speciality including junior medical staff.

Staffing Establishment, 35.19. (Includes Physicians assistant & Ward clerk)

Qualified      22.91.
CSW            10.28

In Post, 31.13.               Ward Manager                                1.0
                              F Grade/ Cardiology NP.                     3.28
                              E Grade                                     7.15
                              D Grade                                     9.00.
                                                                    =     20.43

Vacancy’s Qualified, 2.48.

Clinical Support Workers                                    8.70.

Vacancy’s CSW, 1.58

Use Bank Staff to cover vacancies usually own staff.

Physicians Assistant                                        1.00

Ward Clerk                                                  1.00

Cardiac Rehabilitation / Support terms                      4.86
The ward is split into two, Acute one end and Rehabilitation the other.



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Ward appeared bright and fairly clean, the main entrance is dismal and uninviting, the ward is
in the original part of the hospital and as yet as not been upgraded or refurbished, shower
rehab end is being upgraded and is a great improvement on what was available.

Some patients spoken to complained that they had been without shower facilities for two
weeks and although they were using the shower it was not complete, there were some small
problems, the ward manager informed that the problems were minor e.g. no soap dish, hooks
to hang clothes these were in the process of being sorted.

Some patients said that the ward was cleaned more thoroughly at weekends than in the week,
this the manager told the Forum was, because there were less interruptions for domestic staff
with ward rounds etc.

There are no television or telephones by each bed, but there is a day-room that the patients use
to watch television or generally chat. They appreciate having the day-room because they do
not have to sit by their beds for days/weeks on end.

Patients commented on the kindness of staff and the quality of care was considered excellent,
there were no adverse comments about food.

Some elderly visitors mentioned the difficulty they had with visiting the hospital at evenings
and weekends due to the poor availability of bus services at these times, and that a taxi from
Grays costs £17.00, which is a requirement sometimes when the bus doesn’t turn up
especially during winter.

No patients on the ward with MRSA.


Few concerns - Drug cupboard on the main ward corridor requires a swipe entrance
because it gives open access, light-shades in sluices dirty, and no aprons or gloves outside
rehab sluice




MEDICAL ASSESSMENT UNIT.

The group were shown around by Lorna Pudney, Unit Manager.

This is a 28 bedded ward consisting of 12 assessment beds, 14 short stay beds and 2 self-
contained assessment rooms. There are 4 side-rooms 2x 4 bed bays and 2 x 8 bed bays,
patients are mixed due to the high turnaround between 30/40 patients per day, (some
inappropriate.)

One 4 bedded bay is used for Cardiac patients that require monitoring.

Patients are referred directly by their GP to the General Medical and Elderly On-Call
Speciality teams by telephone, the patient is then sent in with letter from GP.
The ward has links with the Community Crisis Support and Anticoagulant services.

There are 3 doctors based on the ward between 10 am and 6 pm, 2 Senior House Officers, and
1 Senior Staff Grade, outside these hours On-Call Teams cover the unit.
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Staffing Establishment:        22.08 Qualified, 10 CSW.

1, E Grade Vacancy to be filled in September 04

G Grade                                       1. 08
F Grade                                       6.00
E Grade                                       7.00 + 1 Starts Sept
D Grade                                       7.00.
                                      =       21.08 in post
CSW                                           10.00

Department Assistants (porters)               3.00 (07.30 to 9.00pm )

Ward Clerks                                   4.00 (07.30 to 9/10 p.m.)

Between 07.30 and 9pm.

2, Nurse Practitioners.
3, Qualified Staff.
3,CSW.
2 Dept Asst.
2 ward Clerks.
2 Domestic staff 7am to 3 p.m. and 1 from 4pm to 8pm. (Tea & Sandwiches available for
patients a hot meal can be given if required.)

Night Cover.

2, Qualified Staff.
2 CSW.

During evening/ night hours from 9pm to 7 am there can still be an admission of
patients, there is no Department Assistant, Ward Clerk or Domestic available, all their
work is covered by the 2 CSWs and Nursing Staff.

The unit appeared bright and clean, no notices stuck on walls, curtains matching.
Few patients require feeding, little complaints about food.
Staff are trying to set-up a room for relatives where they could be spoken to in private.

No patients on ward with MRSA.

Few concerns.

Cardiac Arrest Trolley needs cleaning.

Assessment room on regular basis is used for patients when there is a shortage of beds
this not only cuts down the turn around of patients who sit and wait at the ward
reception area (except patients brought in by Ambulance) but the assessment room
doors have key pad entrance these could put patients at risk in an emergency if staff are
delayed entering the room.

There is a lack of storage on the unit therefore items are stored in the assessment rooms.

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At the entrance there were 4 patients waiting who complained they had been waiting
over an hour since being seen which wasn’t a problem, what they were concerned about
was they didn’t feel they were being kept informed of any developments.

One patients husband said that his wife had been in three times over a few weeks and
had recently been discharged and to report back to unit if worried he did not see why
his wife had to go through the same procedure as a new patient each time especially as
there was such a short space of time between attendance.

These conversations were reported to the Ward Manger by Debbie Crisp, who said the
Manager would speak to the patients.

The patients were also given a leaflet on PALS and were recommended to raise their concerns
with PALS.



WILLIAM HARVEY WARD.

The group were shown around by Alan Coyle, Ward Manager.

This is a 30 bedded (some times 31) Acute Medical ward that takes medical patients of all
ages mainly from Accident and Emergency and Medical Assessment Unit, this ward was set
up 12/18 months ago to allow patients to be cared for while the are waiting to be placed on a
specialised ward.

Consultant / Doctors do ward rounds daily.

Staff Establishment: 12.68 qualified staff and 15.75 CSWS.

G Grade                                      1.00
F Grade                                      2.00
E Grade                                      4.00
D Grade                                      5.68
                                          = 12. 68
Some up grading of staff to take place.

CSWs                                         15.75

2 with NVQ 3, 1, NVQ 2 and 2 more NVQ 3 start September 04


There are some vacancies that are covered by Agency staff
4 Qualified shifts per week and 1 CSW shift per day.

The ward has

1 Ward Clerk
1 Discharge Co-ordinator.
Home assessment Co-ordinator.
1 Ward Hostess who helps patients with feeding and any dietary needs.


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DERMOTOLOGY DAY UNIT is situated on this ward off the main ward corridor it is about
to move into the new unit, staff are unaware what will replace that area, the waiting room is to
be given back to the ward use as a relatives room.

Ward appeared bright and clean, no notices stuck on walls, curtains matched and kitchen in
good repair.

Patients spoken to were happy with the way staff cared for them, also food was found to be
reasonable.

Patient are not mixed on ward

2 Patients nursed in side rooms with MRSA.

Some Concerns, ONE Major

Drug room off main ward corridor requires a lock.

Sluices both ends grills and lights dirty

Shower male and female ends unpleasant, again in need of upgrade

Cardiac Arrest Trolley dirty. (cleaned weekly )

Female 4 bedded bay had 5 patients who were very upset that they had been cared for in
this manner since Saturday evening 24th when they had all been admitted, they had
complained at the time but there was a bed shortage.

Forum members requested that Debbie Crisp informed the Director of Nursing, the
Deputy Director of Nursing assured the Forum that within 2 hours a patient from the
ward would be moved to a specialised ward so that the additional bed could be moved to
an appropriate place.


A letter to the Trust was sent to raise the concerns of patients and Forum members that
patients in future should NOT be place in situations where their dignity, privacy and
confidentiality cannot be maintained, exception would be for a shot space of time during
a Major Emergency only.



Forum members have concerns re staff uniforms on wards and that Doctors do not
wear white coats, it is very difficult for patients and the public to distinguish whose who.

Nurse Practitioners wear maroon uniforms but NVQ 3 male Clinical Support Workers
have maroom epilets this leads to confusion, they all say they wear name badges but they
are not always visible, Forum members are aware that the Trust is reviewing uniform
policy and hopefully it will be improved in the near future.


Members would like to thank staff for their time and patience during visits.



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           PATIENT AND PUBLIC INVOLVEMENT IN HEALTH FORUM
                                 FOR
                    BASILDON & THURROCK HOSPITALS


          QUESTIONS ARISING FROM VISIT TO BASILDON HOSPITAL
                           ON 27th JULY 2004.

FRANK AHERNS WARD.


1. Does the Trust have any plans to up grade this ward?

2. Are vacancies being advertised?

3. Could the Drug room have a door lock?

4. Could shades in sluices be cleaned, and gloves and aprons replaced?

MEDICAL ASSESSMENT UNIT

1. Would the Trust review the staff numbers required for evening/night hours?

2. Could the Trust review the amount of times the Assessment rooms are used as
   patient accommodation, and the possibility of removing the key pads?

3. Could patients waiting for treatment be kept more informed of why they are
   waiting?

4. What is the reason for patients who return to the unit after a short time from being
   discharged to be treated like first time attendee’s?


WILLIAM HARVEY WARD

1. Can the Trust arrange for the drug room to have lock fitted?

2. Grills and lights in sluices require cleaning, can this be arranged?

3. Is there any possibility of the shower rooms being improved?

4. Should Cardiac Arrest trolleys be cleaned more regularly than weekly?

5. Could the Forum have assurance from the Trust that patients will not be placed in
   areas where their Dignity,& Privacy cannot be maintained?

6. Is there any progress on the Trust uniform policy?



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