Barking

“the Trust has put mitigations in place. The Trust provides mandatory training for all staff including both nursing and medical staff related to the care of patients with a Learning Disability.”

“BHRUT plan to recruit more learning disability nurses in 2025. They have created pathways to encourage and upskill existing staff due to the shortage of nurses going into learning disability training (RNLD).”

“be able to check the wording in their specific product information to ensure the appropriate advice on checking for leaks is present.”

“The CQC has confirmed that they are reviewing this case, and will consider what further action should be taken, and whether any monitoring of the trust, or regulatory response, is required.”

“no patients that are currently on a Patient Tracker List for any cancer diagnosis can be removed or deferred without approval of the responsible consultant”

“Critical Care Outreach Team (CCOT) model since April 2024.”

“Patient Safety Investigation Response Framework (PSIRF) which uses multidisciplinary investigations and reviews with multiple responsible authors.”

“An Internal Alert has been shared with staff via email, Alert reference Issued Date 9 November 2023 which details good record keeping standards that should be adhered to by all staff.”

“A video has been developed and was placed on the Trust intranet 27 November 2023 which shows - Medical Director (Patient Safety and Patient Experience), explaining the importance of good record keeping.”

“A screen saver was agreed and appeared on all Trust computer screens week commencing 4 December 2023”

“All medical staff must complete a record keeping module on the Trust BEST learning management system that allows staff to undertake e learning module on their first day working at the Trust.”

“The Trust sepsis education programme is essential for all clinical staff and has recently been updated. This is supported by additional face to face training for doctors and nurses.”

“The Trust has adopted the UK Sepsis Trust`s adult screening tool and the use of this is audited by the Lead Nurse for Sepsis. Audits include patients who have scored over 5 on the National Early Warning Score to ensure that Sepsis was considered. In addition, all positive blood culture cases are audited to ensure compliance with the Sepsis 6.”

“The Radiology department will alert/notify the referrer's/requesters to all imaging with: a. Expected, Unexpected, or Newly Detected Cancer b. Unexpected Critical or Significant Non-Cancer Findings. The referrer/requester will be notified with either a CANCER alert for the expected, unexpected, or newly detected cancer and cancer recurrence, or CRITICAL alert for expected or unexpected findings. This will be sent electronically via Aptvision2 to the referrer/requester (*Verbal Escalation is”

“Aptvison Radiology Referral System - this new Radiology Requesting System is planned to live week commencing 30 October 2023. 2. Acknowledgement Feature - Following a finalised radiological report, alongside any urgent notifications produced by radiology, an”

“Viewable WorkLists - It is planned that a viewable worklist of requested imaging and radiological report by referring location /area will be available in the initial release of the referral portal. A secondary release is planned to allow consultants/referrers to view a worklist based who was involved in the requesting process e.g., individual consultant or a group of named team members. 4. Oversight of Reporting - Speciality Specific Reports - Requesting Specialties will be provided with direct”

“Speciality Specific Mailboxes - will be created by the Specialties. This is as an additional safeguard where the notification of imaging report will be sent to a group email in addition to the named consultants individual worklist. Access to shared mailbox will be agreed by the Specialty. 6. Chief Medical Officer [name redacted] - To facilitate prompt review, acknowledgement, and action on all imaging reports by referrers. The CMO (or nominated deputy) will inform each CG of the requirement that each of”

“The Radiological Requesting, Review and Expectation process as detailed in this response will be added to the New Consultants 3-day Induction programme run by the CMO. 7. Collaborative Working - On 04 July 2023 Dr [name redacted], Consultant [name redacted] and Clinical Lead for Radiology, presented the BHRUT's Policy on Incidental Finding at the North-East London (NEL) Clinical Leadership Group for peer review. This group's membership comprises of the Quality and Safety Leads (Consultant grade) from Whipps”

“Cross site audits have been completed on COTE (Care of the Elderly) wards on a random basis to understand a cross section of compliance with fluid management with no notice given to the ward in advance of the audit. The audits capture patients who are on fluid restriction, patients requiring oral and intravenous hydration, parenteral nutrition and output monitoring, whether the intake and output is entered on Careflow Vitals and appropriate action taken as necessary. The audits were completed by”

“has completed all the actions assigned to the department within the Trust's SI recommendations and subsequent Action Plan. If any scan is mis- reported, the Department uses it as a learning opportunity, and it is reviewed at the Departmental Radiology Event and Learning Meeting (REALM) and undertakes a process of peer review. The Radiology Department has reviewed Mr [name redacted] scans through its Governance process.”

“The Trust's Radiology Department has carried out an audit of Visipaque Swallows from May 2016 - June 2017 and will conduct a further audit three months after the revised Protocol (attached) has come into use to ensure understanding and compliance. If any issues are identified by the audit, the staff concerned will have 1:1 conversations with one of the Clinical Leads for Radiology and be required to undergo an observed procedure for assurance of skill.”

“The Trust's new policy is for a weight based bolus and then a weight based infusion the latter within weight ranges. Even with a patient of 25kg the infusion would be at 20iu/kg/hr which is a very reasonable infusion rate and in line with recognised dosage rates even at this weight. The APPTR must be checked at 6hours and this allows the dose to be adjusted within recognised time intervals. We therefore feel that the safeguards are,in place as we have moved to an entirely weight based formulati”