Francis Inquiry Report

Position statement on Agreed action Plan from Emergency Department.

Clinical Care and Effectiveness Emergency department at DBH is working to full fill clinical standards set out by the college of Emergency Medicine. Current practices are regularly measured against these standards and action plans generated for impro ement. !n "ear #$%# are #$%& 'ollowing audits were completed and action plans generated Head injury in Children Spontaneous pneumothorax Fever management in Children Missed X-rays audit NHSLA case notes audit Minor head injury audit rauma Audit !ain management in children Management o" Asthma Fracture nec# o" Femur $enal Colic% &acterial Meningitis and meningococcal septicaemia% Consultant sign o"" Sa"eguarding Standard 'uestionnaire Monthly Audits% 'uarterly Handover process Audit Appropriate re(uest o" Coagulation

Ne) N*C+ guidelines are regularly revie)ed and discussed in C, group meetings and recommendations made "or implementation% o achieve the uni"ormity in providing high standards o" care locally developed guidelines are in place and are readily availa-le "or clinicians to vie) "or guidance% *!.Cs are in place "or eam distri-ution is implemented in +/ "or e""ective clinical care% +/ is divided into $ed0 &lue and 1ello) teams )ith allocated doctors and Nurses to loo# a"ter the patients% High Level riage is in place "or all the patients Attending +/ at /&H% here is mental health availa-le "or all mental health pro-lems% All cu-icles in +/ are "itted )ith Monitoring e(uipment "or patient care%

Training and Education /epartment is committed to education and training% here is a continuous education programme "or -ot junior doctors and Middle grade doctors% All o" the consultants are A LS0 ALS and +!LS providers% Majority o" middle grade doctors are A LS0 ALS and +!LS providers rest are encouraged and supported to achieve the competencies% here is a named supervisor o" all middle grade and junior doctors )ho is responsi-le "or overloo#ing the training re(uirement% All middle grade doctors are encouraged to pursue the career in +mergency Medicine% Spea#ers are invited regularly to teach on teaching sessions "or junior and middle grade doctors% Complaints and serious Incidents. there is a ro-ust process "or ans)ering the complaints and /epartment "ully complies )ith the trust procedures to respond to the serious incidents% o learn "rom the mista#es0 serious incidents and Complaints in"ormation gets disseminated through clinical governance group meetings%

Miscellaneous
here is a (uarterly environmental audit in place% here is a monthly hand hygiene audit that ta#es place in the department and action plan generated% /epartment )or#s to achieve all targets set out -y department o" health "or +mergency /epartment%

Challenges and Actions.

Challenges .vercro)ding is the -iggest challenge in the +/ at the moment0 )hich has man-"old percussion and leads to a lot o" pro-lems )hich lie at the -ase o" clinical care% Actions /epartment )ould -ene"it "rom expanding the /epartment to increase the capacity -y at least 234% rust is currently )or#ing to increase the num-er o" -eds -y 56% /epartment is currently see#ing to increase the capacity o" C/7 Middle grade doctors recruitment is a continuous challenge in +/% Currently there is 8-5 vacancies in +/ "or middle grade doctors% /epartment is )or#ing actively "or "illing these vacancies% /epartment actively see#ing to increase the num-er o" nursing sta""0 )hich has -een approved -y the trust% /epartment )ould -ene"it "rom seconding Middle grade doctors to Acute medicine and * 7 )hich )ill )or# to improve the competencies% CS7 is to adapt compassionate care as a continuous item on the agenda and )ill )or# actively to develop the culture o" compassionate care%

Medical Sta""ing

Nursing sta""ing raining and +ducation

Compassionate care