5 April 2022
The Northern General Hospital, situated in the north of Sheffield, is home to the city's adult accident and emergency department and major trauma centre.
The Northern General is the largest hospital campus within Sheffield Teaching Hospitals NHS Foundation Trust spanning 100 acres. The hospital has over 1100 beds and employs more than 6,000 staff. It provides a wide range of specialist services including orthopaedics, renal, heart and lung services and has a purpose-built spinal injuries unit. There are a general and cardiac intensive care services onsite.
Sheffield Teaching Hospitals NHS Foundation Trust provides acute and community services to an estimated population of 694,000. The trust provides specialist services for the populations of Yorkshire & Humber, parts of Mid-Yorkshire and North Derbyshire.
9 June 2016
Performance showed a good track record and steady improvements in safety. Staffing levels and skill mix were planned and reviewed to keep people safe. Systems, processes and standard operating procedures for infection control, medicines management, patient records and the monitoring and assessing and responding to risk were mostly reliable and appropriate.
Patients had comprehensive assessments of their needs. Staff worked collaboratively to understand and meet the range and complexity of patient’s needs. Staff were qualified and had the skills they needed to carry out their roles effectively. Information about patients care and treatment, and their outcomes, was not routinely collected or monitored in within the cardiac intensive care unit therefore the service was unable to benchmark itself against other similar services.
Patient’s emotional and social needs were highly valued by staff and were embedded in their care and treatment. Feedback from patients who used the service was continually positive about the way staff treated them. There was a strong, visible patient centred culture. Services were tailored to meet the needs of the individual patient. There was a proactive approach to understanding the needs of different groups of people.
Leaders prioritised safe, high quality person-centred care. There was a clear statement of vision and values, driven by quality and safety. There was a strong focus on continuous learning and improvement.
14 November 2018
Our rating of this service improved. We rated it as good because:
- We rated safe, effective, caring and well led as good. We rated responsive as outstanding.
- The service managed patient safety incidents well. Staff knew how to report incidents and gave examples of recent incidents they had reported.
- The service provided care and treatment based on national guidance and evidence of its effectiveness. For example, the ‘guidance for the care of the person who may be in the last hours to days of life’ document, which reflected ‘Five priorities for care of the dying person’, and rapid discharge pathways for general wards.
- Staff ensured patients received pain relief appropriate to their needs. Where patients had complex pain, staff ensured they were reviewed regularly, and that pain was brought under control using a range of analgesia.
- The service undertook local audits, such as the DNACPR forms, assessment of the use of intravenous/subcutaneous fluids in patients in the last days of life and the whiteboard e-handover process and compiled achievable action plans and implemented standard operating processes (SOPs) to improve performance and services offered.
- Staff involved patients and those close to them in decisions about their care and treatment. Patients, families and carers gave positive feedback about their care.
- The mortuary had a dedicated viewing room for recently deceased patients and staff told us they could facilitate requests to wash and prepare the body in line with religious, spiritual and cultural beliefs.
- There was a multi-faith chaplaincy department who could provide support to patients, relatives and staff regardless of their faith or belief.
- The service took account of patients’ individual needs. We were inundated with outstanding examples of staff meeting patients’ individual needs.
- The service treated concerns and complaints seriously, investigated them and learned lessons from the results, which were shared with all staff.
- The service had managers at all levels with the right skills and abilities to run a service providing high quality sustainable care.
- The department had an end of life strategy with a focus on educating, developing and growing a strong and competent nursing workforce with the right skills to deliver quality end of life care.
- The service engaged well with patients, staff, the public and local organisations to plan and manage appropriate services and collaborated with partner organisations effectively.
- Whilst mandatory training compliance had improved we found low compliance amongst some staff groups for some subjects. Staff reported delays obtaining pressure relieving equipment.
- The trust had processes in place to ensure patients care preferences at the end of their life were documented. However, they were unable to evidence improvements for patient outcomes because they were not auditing outcomes. The trust did not have gold standards framework accreditation and did not provide any indication this was planned.
- Despite implementing positive initiatives to ensure patients preferred place of care was achieved there were 259 delayed fast track discharges at this hospital.
- The trust performance in the national End of life care Audit: Dying in Hospital 2016 was worse than the England average for three of the five agreed clinical indicators and the trust answered no for five of the eight organisational indicators.
9 June 2016
The services had a positive safety culture; there were clear management responsibilities and accountability for safety and governance. The services promoted continuous quality improvement.
There were enough qualified, skilled and experienced staff to meet people’s needs. Staff received good support, staff appraisals, and mandatory training was up to date. Radiology services provided well-established, highly regarded training programmes for medical staff at every stage of their five-year programme and for student radiographers from local universities.
All of the staff were passionate about their work and staff teams worked well together to provide an excellent experience for their patients. All of the patients and relatives we spoke with gave positive feedback about the staff, care and the treatment they received.
Space was limited in the fracture clinic and was not designed to meet the needs of patients.
Staff were aware of the trust values; there was good staff engagement and an open culture. Staff participated in research activities and there were numerous examples of innovation and improvement.