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Cambridge University Hospitals NHS Foundation Trust

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The Cambridge University Hospitals NHS Foundation Trust is one of the United Kingdom's NHS foundation trusts.[1] It was originally named Addenbrooke's NHS Trust. It became a foundation trust and was renamed in 2004.

The Trust provides healthcare for people in the Cambridge area, in southeast England, and specialist services such as transplantation, treatment of rare cancers and neurological intensive care for a much wider area.[2] It runs Addenbrooke's Hospital, the Rosie Hospital, and Saffron Walden Community Hospital. It is one of the Shelford Group an informal organisation of ten leading English University Teaching Hospitals and part of the Cambridge Biomedical Campus.

The Trust is part of the UnitingCare Partnership, a consortium with Cambridgeshire and Peterborough NHS Foundation Trust. In September 2014, the Cambridgeshire and Peterborough clinical commissioning group announced that the partnership was the preferred bidder for an £800 million contract to deliver older people’s health services in Cambridgeshire beginning in April 2015. The goal is for a single lead provider to be responsible for older people’s healthcare services and adult community health services, to better coordinate and improve this aspect of healthcare throughout the region.[3]

Keith McNeil the chief executive is a one-time special forces sniper and a former transplant physician, who moved to the hospital from Brisbane.[4] He resigned in September 2015 following a Care Quality Commission Report which put the hospital into special measures.

Computerisation

As part of its eHospital transformation, the trust installed an Epic Systems electronic health record system in 2014, which together with a Hewlett-Packard infrastructure transformation, will cost the Trust £200 million over 10 years. The Epic implementation is the first end-to-end deployment of Epic in Europe, as well as the first Epic implementation in the UK. 2.1 million records were transferred to it and it went live on 26 October. In the weeks after Go-Live, it experienced significant teething problems.[5] There were particular problems with communicating pathology results with both the new Epic system and the system used by The Pathology Partnership, the newly formed joint venture pathology provider. The trust reported ongoing issues with pathology codes and reporting leading to difficulty matching test results to patients, requiring re-checking. “GPs were asked to stop all routine blood tests at short notice; patients were attending their GP surgery for blood tests and had to be turned away. Some tests that had already been taken had to be discarded and GPs had to repeat them. The trust has apologised to GPs’ patients and The Pathology Partnership has written to GPs giving details of the 200 patients affected".[6] Chief information officer, Dr Afzal Chaudhry, said "well over 90% of implementation [had] proceeded successfully".[7]

Dr Chaudhry has described the difficulties of computerising clinical practice in some detail. "If you take some of the senior consultants who'd never left notepad and books. They'd trained as a student, used them as junior doctors all the way through and some of these people, they'd been there for years. Then overnight we took everything that they knew, then threw it away." The trust has installed 6,000 new PCs and 395 workstations on wheels with a battery pack and 24 inch widescreen monitors capable of moving all around the hospital.[8]

It was the first Trust to receive the Healthcare Information and Management Systems Society Stage 6 Award in November 2015 for the effective use of technology in providing high quality patient care within a year of going live, the fastest in the UK.[9] [10]

Research

Cambridge University Hospitals sits in the heart of the Cambridge Biomedical Campus and is part of the internationally renowned research campus which has seen a huge expansion over the last 20 years. The hospital is a partner in one of 8 designated Academic Health Science Centres (AHSC) Cambridge University Health Partners, formed with Papworth Hospital Trust, Cambridgeshire and Peterborough Foundation Trust and the University of Cambridge. Research is central to the role and function of this specialist teaching hospital. In 2017 it was awarded £114 million from the National Institute for Health Research to the Cambridge Biomedical Research Centre, a research partnership with the University of Cambridge. There are approximately 1,000 research studies underway at one time covering a range of health conditions including common conditions like diabetes and heart disease, through to specialist research in rare dementias and rare cancers. The hospital has a number of high specification facilities, equipment and resource to support of all of this activity, including the recently expanded Cambridge Clinical Research Facilities offering 24/7 clinical beds to support Phase I and Phase II studies. In addition there is support to set up and initiate studies from the Cambridge Clinical Trials Unit, the Research & Development Department, the Cambridge BioResource and in processing and managing studies an onsite pharmacy and BioRepository. Cambridge is one of 13 Genomic Medicine Centres and the lead site for the East of England Genomic Medicine Centre, part of the 100,000 Genomes Project which is sequencing whole genomes of people with rare diseases and cancers.

Performance

The trust was one of 26 responsible for half of the national growth in patients waiting more than four hours in accident and emergency over the 2014/5 winter.[11] The trust spent £13.2 million on agency staff in 2014/5.[12]

The Care Quality Commission placed the trust in special measures in September 2015. This was a surprising move and generated considerable publicity and controversy. The chief executive, Dr Keith McNeil and the finance director resigned. Its sudden failure has been blamed on shortages of staff and an increased use of agency staff, which increased costs and reduced quality and on the new Epic electronic health record system.[13] Waiting times for treatment increased and as many as 200 beds were occupied by patients who were medically fit for discharge, so that the hospital was repeatedly unable to admit patients. It projected a loss of £64 million for 2015/6.[14]

In December 2015 staff were told payment of their salaries was dependent on a loan from the Department of Health.[15] In February 2016 it was expecting a deficit of £39.7 million for the year.[16]

In September 2015, the trust was placed in special measures after Care Quality Commission inspectors deemed it inadequate.[17] It was taken out of special measures in January 2017, following a visit from inspectors the previous September. The Care Quality Commission has since given the Cambridge University Hospitals Trust a rating of “good”.[18]

At the end of March 2017, the trust was confirmed as one of four additional NHS Global Digital Exemplars; joining the twelve announced in September 2016.[19]

Whistleblowing

Dr Narinder Kapur, consultant neuropsychologist and head of neuropsychology was sacked in 2010. The trust claimed there had been a breakdown in their relationship because of his management style and working methods. He said he had raised concerns about staff shortages and the impact on patient care several times to his line managers. In July 2013 an employment tribunal ruled that he had been unfairly dismissed.[20] Dr Kapur subsequently set up a website for whistleblowers, providing resources and advice on whistleblowing, patient safety and professionalism. [21]

Private Finance Initiative

The trust made a Private Finance Initiative deal in 2007 for the building of a £76 million elective care centre. It is required to pay £9 million a year for 30 years to Key Health Services (Addenrookes) Ltd. which is owned by 3i and NIBC Bank.[22]

See also

References

  1. ^ NHS foundation trust directory, Monitor — NHS Foundation Trusts, UK.
  2. ^ "Addenbrooke's hospital boss on a mission to improve NHS leadership". The Guardian. 5 March 2014. Retrieved 16 March 2014.
  3. ^ "CCG appoints NHS-led consortium for £800m flagship contract". Health Service Journal. 1 October 2014. Retrieved 26 October 2014.
  4. ^ "Addenbrooke's hospital boss on a mission to improve NHS leadership". Guardian. 5 March 2014. Retrieved 21 December 2014.
  5. ^ "The NHS's chaotic IT systems show no sign of recovery". Guardian. 21 December 2014. Retrieved 21 December 2014.
  6. ^ "'Major incident' declared for flagship IT project". Health Service Journal. 25 November 2014. Retrieved 23 December 2014.
  7. ^ "Addenbrooke's Hospital paperless system's 'significant problems' reported". BBC News. 24 November 2014. Retrieved 21 December 2014.
  8. ^ "'We took everything they knew and threw it away,' says Cambridge University Hospitals NHS Trust". Computing. 23 June 2015. Retrieved 26 June 2015.
  9. ^ http://www.hitcentral.eu/healthtech-wire/himss-award-cuh-stage-6-status-international-electronic-medical-record-adoption
  10. ^ http://www.ehealthnews.eu/development/4578-himss-awards-cambridge-university-hospitals-stage-6-status-of-the-international-electronic-medical-record-adoption-model
  11. ^ "26 trusts responsible for half of national A&E target breach". Health Service Journal. 1 April 2015. Retrieved 3 May 2015.
  12. ^ "Agency spending: the real picture". Health Service Journal. 26 November 2015. Retrieved 23 December 2015.
  13. ^ "What Addenbrooke's tells us about state of NHS". BBC News. 22 September 2015. Retrieved 3 October 2015.
  14. ^ Toynbee, Polly (22 September 2015). "Jeremy Hunt's hit squad is a danger to our national health". Guardian. Retrieved 3 October 2015.
  15. ^ "NHS Hospitals Forced To Take Out Emergency Loans To Pay Doctors And Nurses, HuffPost UK Reveals". Huffington Post. 15 December 2015. Retrieved 17 December 2015.
  16. ^ "One in four trusts plunge deeper into the red". Health Service Journal. 25 February 2016. Retrieved 22 March 2016.
  17. ^ Care Quality Commission
  18. ^ "Addenbrooke's out of special measures due to staff 'dedication'". BBC News. 18 January 2017. Retrieved 18 January 2017.
  19. ^ Stevens, Laura (31 March 2017). "Four more acute global digital exemplars confirmed by NHS England". Digital Health. Digital Health. Retrieved 12 May 2017.
  20. ^ "Protect NHS whistleblowers urges consultant who lost job and home after raising concerns". Daily Telegraph. 26 May 2013. Retrieved 26 December 2015.
  21. ^ "ABetterNHS.com".
  22. ^ "Medicine Balls". Private Eye. 2 October 2015. p. 17. {{cite news}}: |access-date= requires |url= (help)
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