Delivery of Same Sex Accommodation

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					                                                             Agenda Item: 8

Title of Report Delivery of Same Sex Accommodation
Executive       This report confirms the Trust’s progress towards improving
Summary         patient perceptions of same sex accommodation through the
                delivery of several projects funded via Dignity Challenge monies. It
                outlines a further work schedule between April 2010 and June
                2010 and to approve the Trusts declaration of compliance with the
                national standards for SSA as required by the DoH by the 31st
Actions         To note the ongoing work plan but to approve the declaration of
Requested:      compliance of the national SSA standards.
Corporate objectives supported by this paper:

No 5 - Improving the patient experience, privacy and dignity

Reputation of the Trust and to patient experience

Public and/or Patient Involvement:

Involved in patient perception audit

Resource Implications:

Up to 2% of contract value if not compliant with same-sex accommodation

Performance measures are publicised through Trust communication channels.

Have all implications been considered?                         YES     NO     N/A
National policy / legislation                                  
Local Delivery Plan                                            
Contract                                                       
HR                                                                            
IM&T                                                                          
Equality and Diversity                                                        

Name                    Marian Carroll
Job Title               Executive Director of Nursing/DIPC
Month and Year          March 2010
                      Delivery of Same Sex Accommodation

1      Introduction
This report updates the Trust Board on progress in respect of delivering same-sex
accommodation and confirms further action required in the coming months. Trust
Board approval of the declaration of compliance with the national SSA standards is
also required by the 31st march 2010.

A working definition of same sex accommodation is that patients should not normally
have to share sleeping accommodation or sanitary facilities with members of the
opposite sex. This applies to all areas of hospital care. There are some exceptional
circumstances (such as where the patient needs level 3 intensive care), where
providing fast effective care for the patient may take priority over ensuring same-sex
accommodation. Where mixing does occur, it must be in the interest of all the patients

Following a peer-review visit on the 11th. March 2010, the Trust can declare
compliance with the same sex expectations extant in recent national directives.

2      Policy background
The Operating Framework required PCTs to work with provider units to publish plans
to deliver substantial and meaningful reductions in the number of patients who report
that they share sleeping or sanitary accommodation with members of the opposite sex.

   Privacy and Dignity Challenge Fund
    PAHT will receive a non-recurrent allocation of £670,000 against the successful
    delivery of a number of projects.

   Measuring Improvement
    Delivery against the Privacy and Dignity Fund Delivery plans continues to be
    monitored through reports to the SHA and through monthly patient experience

3      PAHT’s current position
The Trust undertook a full assessment of all inpatient clinical areas and completed
several extensive estates diagnostic surveys. This information formed the basis of bids
that were submitted to the SHA in March 2009 and £670,000 will be received by PAHT
on the delivery of the proposed changes.

The Trust can declare compliance with the same sex expectations extant in recent
national directives.

4      Patient Experience of Same Sex Accommodation
The key performance measure for the Trust regarding same sex accommodation is the
patient experience and all wards offer a questionnaire to all patients who are
discharged on the third Friday of each month regarding their experience of
accommodation as inpatients. The results to February 2010 indicate that there has
been a marked improvement in patient perceptions of same sex accommodation since
May 2009. Currently, about 10% of patients still report that they share sleeping areas
with patients from the opposite sex on admission, this figure falls to about 7% after
being moved to another ward. About 13% of patients report that they shared
bathroom/toilet facilities with patients of the opposite sex:
Delivering same sex accommodation - Patient Satisfaction Questionnaire results                      Feb-10

            Q1                       Q2                      Q3                Q4                   Q5                      Q6                Q7
            When you were first      When you were           When you were     If you moved to      If you moved, did you   If you moved,     While staying in
            admitted to a bed on a   first admitted, did     first admitted,   another ward (or     mind sharing a          was the ward's    hospital, did you
            ward, did you share a    you mind sharing a      was the ward's    wards), did you      sleeping area, for      standard of       ever use the same
            sleeping area, for       sleeping area, for      standard of       ever share a         example a room or       cleanliness       bathroom or
            example a room or bay,   example a room or       cleanliness       sleeping area, for   bay, with patients of   acceptable to     shower area as
            with patients of the     bay, with patients of   acceptable to     example a room       the opposite sex?       you?              patients of the
            opposite sex?            the opposite sex?       you?              or bay, with                                                   opposite sex?
                                                                               patients of the
                                                                               opposite sex?

                    % No                    % No                  % Yes              % No                    % No                % Yes              % No
NMGH                        86.7%                  90.9%             100.0%              90.9%                      87.5%            100.0%                93.3%
ROH                         87.8%                  60.6%              97.6%              97.4%                      52.9%            100.0%                78.0%
RI                         100.0%                  68.2%             100.0%              62.5%                      50.0%             90.0%                96.0%
Fairfield                   88.5%                  66.7%             100.0%             100.0%                      83.3%            100.0%                92.0%
Total                       90.4%                  67.9%              99.0%              93.1%                      64.1%             98.6%                87.0%

4      Project delivery arrangements
The Director of Operations, the Director of Estates and the Director of Nursing/DIPC
established a small project delivery team to ensure that the 18 individual schemes that
constituted the single-sex accommodation strategy were delivered within the agreed

5     Peer review
On March 11th 2010, the Trust participated in a peer review of same-sex
arrangements. 17 colleagues from the Department of Health, the SHA, the Countess of
Chester Hospital and Commissioners visited the 4 trust sites. They visited all mixed-
sex wards and departments including critical care areas and day surgery units.

Following the visit, it was confirmed that the Trust could declare compliance with
national standards for same-sex accommodation.

During the feedback, a number of suggestions were offered where the patient
experience could be further enhanced and these have been incorporated into a work
plan for delivery in the next 3-to-4 months. The work plan is appended.

6      Conclusion
The work being undertaken reflects the critical importance of privacy and dignity as
factors influencing the patients’ perception of the quality of care that they receive. The
eradication of mixed sex accommodation is crucial to improving patients’ experience,
and will be one that will feature prominently in our ongoing performance management
discussions for 2010 and beyond.

The Nursing, Operations and Estates teams will continue to work with Divisions to
build upon the good practice to date to create a better patient experience. The board
is requested to approve the declaration of compliance with the national SSA standards
in which the external peer review undertaken on the 11th March 2010 provides further
confirmation of compliance.

Marian Carroll
Director of Nursing/DIPC
March 2010
                                                                                                                               Appendix 1

Interim Work Plan Pending Formal DSSA Peer Review Report 11th. March 2010

Theme             Actions                                                                               Lead Director     By when
Patient            Develop bedside information/patient leaflets for use in general and critical care   Nursing           June 2010
Experience           areas
                   Replace traditional open-backed gowns with more modern patient gowns                Facilities        Ongoing
                   Work with LINKS groups to improve the patient experience of single-sex              Nursing           May 2010

Estates              Review toilet provision in ROH Discharge Lounge                                   Facilities        June 2010
                     Consider use of more obvious signage/colour coding for designated male or         Nursing           June 2010
                      female areas on mixed wards
                     Source and supply curtain clips and signs for all ward areas                      Nursing           June 2010
                     Revisit estates strategy to make intent regarding single-sex accommodation        Facilities        June 2010
                      more prominent, particularly on NMGH site

Systems and          Clarify definition of “breach” within policy and escalation arrangements          Nursing           April 2010
Processes            Include single-sex arrangements in Trust Privacy and Dignity policy               Nursing           April 2010
                     Formally confirm areas where single-sex wards cannot be provided                  Operations        May 2010
                     Use productive ward techniques to map gender split/breaches                       Nursing           June 2010
                     Include explicit reference to breach prevention and rectification in all Bed      Operations        April 2010
                      Management processes
                     Develop RCA process for breach investigation                                      Nursing           May 2010
                     Revisit patient flow arrangements in all DSU and Endoscopy units                  Operations        May 2010

Culture              Include single-sex accommodation reference at Trust induction days                Human Resources   April 2010
                     Develop and deliver an explicit communications strategy around single-sex         Nursing           April 2010