Good Hope Hospital

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We reviewed equity in access under the responsive key question. As we only looked at 1 quality statement, the ratings for responsive did not change. We found responsive remained requires improvement.

Patients were not able to access the services they needed due to the demands on the hospital. This meant patients from other specialties were often provided a bed within surgical wards resulting in cancellations of surgery at times.

This service scored 46 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Person-centred Care during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Providing Information during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Listening to and involving people during this assessment. The score for this quality statement is based on the previous rating for Responsive.

Two patients we met had experienced their planned operations being cancelled previously and described how this was both disappointing and costly. One had arranged for others to care for their pets, and both had been at the hospital when the procedure was cancelled. Another patient found the elective surgery process as a whole had been responsive and efficient in terms of getting their tests and operation done.

There was anxiety among some of the nursing team about cancellations of elective (planned) operations. On the orthopaedic wards, nursing staff recounted how patients’ procedures were cancelled most days due to a lack of a bed for their recovery. They reported how these were patients who were often already at the hospital waiting to start the process but had to be sent home when a bed could not be allocated to them. Nurses recognised how distressing this could often be for patients who had planned for their operation and the necessary recovery time only to be cancelled at the last moment.

There were extensive numbers of medical patients at the hospital being cared for in designated surgical wards. Staff felt this was a major issue. This resulted in some staff caring for them who, as they told us, did not have the experience or skill set for the differing needs of medical patients. Some of these patients had a high level of clinical need, and staff found they struggled to keep on top of their tasks due to greater need of medical patients, and without the extra staff needed to provide the higher level of care required. During our assessment, there were 12 medical and 1 general surgery patient on the 26-bed gynaecology ward. We heard there were sometimes as few as 2 gynaecology patients, and there had been 3 or 4 only one day the week before inspection. They said a lot of medical patients were waiting for a package of care for weeks. Sometimes gynaecology patients had to go on trolleys in GAU due to a lack of available beds.

Staff raised concerns patients may sometimes be discharged from the ward too early, due to the pressure for beds. However, the service had not audited the number of failed discharges so was unable to confirm or refute this.

The processes did not ensure patients had equity in accessing the service. There were issues with medical outliers within the surgical service which resulted in elective patients being cancelled due to unavailability of beds. Information provided after the onsite assessment did not identify any cancellations due to no surgical beds, however there were cancellations due to the lack of intensive care beds being available. In the 6 months prior to the onsite assessment, there were 10 cases where operations were cancelled due to a lack of ITU beds, 7 of these were for trauma and orthopaedic patients.

The service did not gather data on all failed discharges (discharges where patients were re-admitted due to ongoing concerns). However, the chief medical officer for the trust had requested that services collect this data for future reports to the trust board. Information shared after the onsite assessment showed trauma and orthopaedic services collated information on their re-admission rates. During the 6 months preceding the onsite assessment, the re-admission rate was 4.4%. This information was collated as part of the clinical pathways within this specialty; however, this was not used to inform the service of any failed discharges.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.