North Bristol NHS Trust

North Bristol NHS Trust is a National Health Service trust providing community healthcare and hospital services to Bristol, South Gloucestershire and North Somerset, England. The trust has over 8,000 staff delivering healthcare across Southmead Hospital, Cossham Hospital and the Bristol Centre for Enablement, and the local communities.[2] Medical teaching facilities are provided in association with the University of the West of England, Bristol University and the University of Bath.[3]

North Bristol NHS Trust
TypeNHS foundation trust
HeadquartersSouthmead Hospital, Southmead Road, Westbury-on-Trym, Bristol, BS10 5NB
Hospitals
ChairMichele Romaine
Chief executiveAndrea Young
Staff8,000[1]
Websitewww.nbt.nhs.uk

Healthcare and clinical specialties

North Bristol NHS trust is a centre of excellence for health care in the South West in a number of fields, as well as one of the largest hospital trusts in the UK. As a centre of excellence in a range of services and major specialties, the trust's pioneering treatments and advances in care have won national and international recognition.[4]

Neurosciences

The Institute of Neurosciences is located in the Brunel building at Southmead Hospital. The institute is the regional centre for neurological services serving the South West of England.[5]

Since the 1940s, the institute has consistently been at the forefront of technical advances. The service has a national and international reputation, with patient referrals from across the South West, throughout the UK and worldwide.[6] Using the latest techniques, the Neurosciences team treat a wide range of conditions, Some examples include the use of pioneering deep brain stimulation techniques for the treatment of functional disorders such as Parkinson’s disease, led by Professor Gill, and developing the use of robotic surgery to deliver drugs directly into the brain with pinpoint accuracy.[7]

In February 2019, a BBC documentary filmed over six years, The Parkinson's Drug Trial: A Miracle Cure followed a group of volunteers with Parkinson's disease as they take part in a groundbreaking medical trial.[8] The trial was funded by Parkinson's UK with support from The Cure Parkinson's Trust and in association with the trust.

Orthopaedics

The Avon Orthopaedic Centre delivers services such as hip and knee surgery, carrying out 1,000 knee replacements a year.[9]

Plastic and reconstructive surgery

The trust is a regional centre of excellence in plastic and reconstructive surgery. The co-location of regional specialties of neurosurgery and orthopaedics alongside plastics makes Southmead Hospital a key centre for trauma with access to experts in complex cases.

Renal and transplant

The Richard Bright Renal Service at Southmead Hospital carries out more than 100 kidney transplants every year and has led the way with laparoscopic transplants (keyhole surgery), spousal donation and non-heart beating donor transplants.

Severn Major Trauma Network

The Severn Major Trauma Network was set up to manage and influence care for seriously injured patients from injury to rehabilitation. The network serves both adult and children's major trauma and has an adult population of around 2.3 million and children's population of approximately 810,000.[10]

Bristol Urological Institute

Bristol Urological Institute (BUI), based at Southmead Hospital offers care for urological conditions.

Vascular services

The trust delivers the vascular service for the 1.12 million people of Bristol, North Somerset, Bath, North East Somerset, South Gloucestershire and Wiltshire. Formed in 2014, the major arterial centre (MAC) for the network is Southmead Hospital. The network is responsible for the delivery of both elective and emergency vascular and arterial surgery and care.

Facilities and services

Until 2014, both Southmead and Frenchay were large hospitals with major Accident and Emergency (A&E) facilities, but the trust decided to centralise activities at Southmead. From April to December 2014, Frenchay Hospital was progressively closed, with the majority of services moving to a new building at Southmead. A&E was transferred on 19 May 2014. A few services relating to brain and head injuries remain at Frenchay after December 2014.[11][12] The first patients moved into the new Brunel building at Southmead in May 2014.[13]

The trust ran inpatient geriatric services at Blackberry Hill Hospital until 2005, when it closed activities at the site transferring most services to Frenchay and Southmead, and eventually selling the trust's part of the site.

In August 2015, the trust announced that they were not bidding for the contract to continue providing their current Children's Community Health Partnership services which they won in 2009, because of the "non-core nature of the service", a "lack of management capacity" and "financial pressure".[14]

It was scheduled to be the first trust to go live with Lorenzo patient record systems, but as of November 2015 are experiencing problems in transitioning from the old Cerner system.[15]

Brunel Building, Southmead Hospital

The trust opened the doors of its new building, Brunel, at Southmead Hospital, in 2014.[16] Andrea Young, chief executive of North Bristol NHS Trust, said the handing over of the hospital was the "pinnacle of 10 years of hard work".

At the heart of the 800 bed hospital is a public concourse which simplifies access to the medical wards and departments. The concourse, known as the 'atrium', is naturally lit and ventilated and provides cafes, winter gardens and artwork. Bedrooms have large areas of unobstructed glazing and are naturally ventilated, providing the patient with control of their own environment. The bedroom wings are located on the eastern side, naturally shaded from the afternoon sun by the mechanically ventilated clinical block which houses 24 state of the art operating theatres, intra-operative MRI suite, 48 critical care bedrooms, advanced imaging suites, cardiac catheter labs and endoscopy unit. Of the 800 beds, 75% are single en-suite rooms, aiming to improve patient dignity and privacy.

The trust's Brunel Building has been honoured with two RIBA awards, an internationally-recognised mark of excellence. The building, designed by BDP architects, for North Bristol NHS Trust, scooped a RIBA South West Award 2018 for its architecture, and RIBA South West Client of the Year 2018.[17]

The hospital recruited a group of volunteers, known as 'Move Makers', to aid the transition from Frenchay. The volunteers proved to be so popular with people coming into the new building it was decided to keep them on indefinitely, and in 2019 were awarded the Queen's Award for Voluntary Service.[18]

Performance
Four-hour target in the emergency department quarterly figures from NHS England Data from https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-times-and-activity/

Between July and September 2014, the trust had the third worst performance in the country against the requirement to treat and discharge or admit 95 per cent of A&E patients within four hours. It produced an operational resilience and capacity plan, envisaging the trust would achieve performance of 92 per cent against the A&E four-hour standard by April which was rejected. The biggest reason for avoidable breaches of the target was said to be the availability of suitable beds to admit patients. The trust had a deficit of £20.1 million at the end of August, £6.7M worse than planned.[19] An unnamed whistleblower claimed a lack of beds was putting patient safety at risk because small rooms designed for minor procedures, such as injections, were being used to keep patients in overnight. The trust claimed these single rooms were entirely appropriate for safe and dignified patient care.[20]

In February 2015, it was reported that the trust had 247 patients who had waited more than a year for elective treatment, 201 of them waiting for spinal surgery.[21] It spent £20.8M, 7.1% of its total turnover, on agency staff in 2014–2015.[22] In February 2016, it was expecting a deficit of £33.7M for the year 2015–2016.[23]

It ended 2015–2016 in deficit of £51.6M.[24]

In December 2017, the trust reported 122 breaches of the 12-hour target in A&E – the worst performance in England and only 70.3 per cent of patients were seen within the four-hour target.[25] 122 people at Southmead Hospital were left on trolleys in corridors for more than 12 hours during December.[26] In 2017-18, only 77.1% of A&E patients were seen within four hours.[27]

PwC partnered with the trust to introduce Perform, a behavioural change methodology to reduce outliers, bed occupancy and rising demand. They deployed patient flow transformation discharge teams to help staff at all levels. The impact of the programme included releasing 50 beds, reducing length of stay by 13 per cent and enabling a 10.2 per cent increase in the four-hour performance. The trust received a HSJ Partnership Award in 2019 as a result of this programme.[28]

The trust has welcomed many expansions and successes in clinical services. Neuromuscular services at the trust and University Hospitals Bristol and Weston NHS Foundation Trust have been recognised by Muscular Dystrophy UK for providing outstanding care for people with muscle-wasting conditions.[29]

In September 2019, the trust was rated by the Care Quality Commission (CQC) as outstanding for caring, and good overall.[1]The trust was also rated outstanding for well-led.[1]

Overseas patients

The trust issued invoices to patients thought to be ineligible for NHS treatment totalling £1.2M in 2018-19, but only collected £0.2M. [30]

Working for the trust

The trust employs around 8,000 medical and non-medical professionals,[1] supported by volunteers. It takes a progressive approach to staff wellbeing.[31] The Wellbeing Programme is funded by their charity, Southmead Hospital Charity, and is made up of a range of physical, psychological and lifestyle support. This includes a free over-the-phone physiotherapy assessment service, bespoke psychological support sessions, Arts on Referral and the Mental Health First Aid network. Staff also have access to a 24/7 free, confidential helpline offering counselling about financial, legal, relationships and more, provided by partner organisation Health Assured. This programme was recognised by the NHS Parliamentary Awards in 2019.[32]

Professional development and healthcare careers

Learning and development at the trust is based in the Learning and Research Centre at Southmead Hospital. The trust has links with University of the West of England and University of Bristol who support undergraduate and postgraduate education and work placements across many professions.

Nursing recruitment

Southmead Hospital is host to regular engagement days and study days. Nurses across the region are welcomed into the trust for professional development seminars, and clinical teams provide an insight into clinical developments, give attendees a chance to network with senior and staff nurses and access to complimentary CPD hours towards revalidation.

This continues on appointment to a role at the trust, as the trust offers a wide range of benefits. This includes bespoke rotations, wellbeing support, personalised travel plans, and a well structured preceptorship.[33]

In February 2019, the trust held a recruitment event, with over 100 student, newly-qualified and experienced nurses registering their interest in working for the trust.[34]

See also

References
  1. "North Bristol NHS Trust Inspection Report". Care Quality Commission. 25 September 2019. Retrieved 19 December 2020.
  2. "About Us". North Bristol NHS Trust. 10 February 2012. Retrieved 2 October 2019.
  3. "About Us". North Bristol NHS Trust. Retrieved 21 November 2011.
  4. "Major Specialties". North Bristol NHS Trust. 17 February 2012. Retrieved 2 October 2019.
  5. "Neurosciences". North Bristol NHS Trust. 29 February 2012. Retrieved 2 October 2019.
  6. "Neurosciences". North Bristol NHS Trust. 29 February 2012. Retrieved 2 October 2019.
  7. "Clinical trial of GDNF | Parkinson's UK". www.parkinsons.org.uk. Retrieved 2 October 2019.
  8. Lewin, R (12 June 1987). "Drug trial for Parkinson's". Science. 236 (4807): 1420. doi:10.1126/science.3109033. ISSN 0036-8075. PMID 3109033.
  9. "Orthopaedics". North Bristol NHS Trust. 8 March 2012. Retrieved 2 October 2019.
  10. "Severn Major Trauma Network". North Bristol NHS Trust. 21 March 2016. Retrieved 2 October 2019.
  11. "Frenchay-to-Southmead hospital move for A&E cases". BBC. 19 May 2014. Retrieved 29 May 2014.
  12. "Frenchay Hospital Site Redevelopment FAQs". North Bristol NHS Trust. Archived from the original on 30 May 2014. Retrieved 29 May 2014.
  13. "First patients to move into new Bristol hospital". ITV. 1 May 2014. Retrieved 4 May 2014.
  14. "Investigation: Bristol's most vulnerable children face sell-off threat to services". Bristol Cable. 11 August 2015. Retrieved 22 August 2015.
  15. "North Bristol live with Lorenzo". digitalhealth.net. 17 November 2015. Archived from the original on 23 November 2015. Retrieved 23 November 2015.
  16. "City's £430m hospital completed". 27 March 2014. Retrieved 2 October 2019.
  17. "Southmead Hospital's Brunel Building wins two coveted awards". Business Leader. 18 May 2018. Retrieved 2 October 2019.
  18. "Southmead Hospital Move Makers receive the Queen's Award for Voluntary Service". North Bristol NHS Trust. 30 May 2019. Retrieved 2 October 2019.
  19. "Trust's winter cash withheld until it has 'believable' A&E plan". Health Service Journal. 27 October 2014. Retrieved 24 November 2014.
  20. "Lack of beds at Bristol's new Southmead Hospital 'is putting patients' lives at risk'". Bristol Post. 29 October 2014. Retrieved 24 November 2014.
  21. "200 North Bristol patients still waiting over a year for spinal surgery". Health Service Journal. 20 February 2015. Retrieved 15 March 2015.
  22. "Agency spending: the real picture". Health Service Journal. 26 November 2015. Retrieved 23 December 2015.
  23. "One in four trusts plunge deeper into the red". Health Service Journal. 25 February 2016. Retrieved 22 March 2016.
  24. "Analysis: The trusts whose finances fell furthest despite 'urgent action'". Health Service Journal. 2 June 2016. Retrieved 31 July 2016.
  25. "Blowout in 12 hour waits at 'extremely pressured' hospital trust". Health Service Journal. 15 January 2017. Retrieved 15 February 2018.
  26. Meek, James (5 April 2018). "NHS SOS". 40 (7). London Review of Books. Retrieved 31 March 2018.
  27. The 10 worst A&Es for waits revealed BBC
  28. 2019-03-21T00:01:00+00:00. "HSJ Partnership Awards 2019: Best Clinical Service and Treatment Pathway Transformation Project". Health Service Journal. Retrieved 2 October 2019.
  29. A Rahman, Ishtiaq; Vohra, Hunaid (16 April 2018). "Non vitamin K antagonist oral anticoagulation- The future of anticoagulation following mitral reparative surgery". International Journal of Innovative Surgery. 1 (1). doi:10.33582/2639-9229/1001. ISSN 2639-9229.
  30. "Trusts missing out on tens of millions from overseas patients". Health Service Journal. 19 November 2019. Retrieved 9 January 2020.
  31. "NBT Staff Wellbeing Programme named regional champions for wellbeing in NHS Parliamentary Awards". North Bristol NHS Trust. 24 June 2019. Retrieved 2 October 2019.
  32. "NBT Staff Wellbeing Programme named regional champions for wellbeing in NHS Parliamentary Awards". North Bristol NHS Trust. 24 June 2019. Retrieved 2 October 2019.
  33. "Staff Benefits". North Bristol NHS Trust. 27 November 2014. Retrieved 2 October 2019.
  34. "Major recruitment drive to reopen Cossham Birth Centre as soon as possible". North Bristol NHS Trust. 31 January 2019. Retrieved 2 October 2019.

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