An independent review of an audit of patient transfers between West Cumberland Hospital and the Cumberland Infirmary has found that all transfers had a positive impact on the patient, but found that more needs to be done to ensure better communication and co-ordination.
North Cumbria University Hospitals NHS Trust (NCUH) carried out an audit of 85 cases – equivalent to 10 % of transfers between April and September 2015. It found that while some cases were not on a specifically agreed clinical pathway, the decisions to transfer were ‘clinically understandable’.
NHS Cumbria Clinical Commissioning Group (CCG), following advice from the Northern Clinical Senate, asked the North East Quality Observatory Service (NEQOS) to review this audit. They carried out an in depth review of a random 14 % sample made up of 12 cases.
It found ‘the significant majority of transfers were clinically appropriate and unavoidable. However, it has been identified that there are patients who are being transferred between sites without appropriate adherence to Trust policy on communication and co-ordination.’
In response to audit findings the Trust has been working to implement a number of actions and has agreed to a re-audit in 6 months’ time. A previous patient experience survey carried out in 2014 which showed good levels of satisfaction with the service received for those transferred from one hospital site to another is also planned to be repeated within the next few months.
Dr David Rogers, medical director of NHS Cumbria CCG, said: “We know there is a lot of concern in the community about transfers between the West Cumberland Hospital and the Cumberland Infirmary and we wanted to commission this review to independently assess if the numbers being transferred were clinically appropriate.
“We know that of the 12 cases considered in the random sample all 12 of the transfers had a positive impact on the patient’s quality of life – the vast majority considered unavoidable. But there are improvements that need to be made to the process, the documentation and communication with patients and their families. The Trust is already working on this and I anticipate a re-audit later this year would show that improvement.”
Dr Derek Thomson, medical director for North Cumbria University Hospitals NHS Trust, said: “Following concerns raised regarding patient transfers from West Cumberland Hospital to the Cumberland Infirmary, the Trust undertook a number of pieces of work including a review of all complaints, claims, inquests and incidents since May 2013 in order to establish whether any patients were harmed or died as a result of a transfer. The review found that there have been no patient deaths as a result of a transfer.
“A clinical audit of transfers, was also undertaken in agreement with the CCG on the introduction of some new pathways in 2015, and has been independently reviewed by NEQOS. This has shown that in all cases, the transfer had a positive impact on the patient’s life which is an extremely encouraging finding for patient care in our Trust.
“However, we recognise that use of documentation and communication can be improved and we have already taken a number of actions as a result. We have redesigned and are now piloting our transfer documentation to be more ‘user-friendly’ for all Trust and North West Ambulance Service staff involved, and will be monitoring its use closely once fully introduced.
“We will continue to improve management of transferred patients in line with our action list are confident that improvements will be visible in the re-audit later this year.”