Thornbury Hospital

I visited Thornbury Hospital on 10 March and was taken around by Maggie Sullivan the Matron. Maggie trained as a nurse at King's College Hospital in London. She has worked in various places throughout the UK. She has been at Thornbury for the last 12 years.

Thornbury Hospital was apparently originally established in the mid-1880's in a workhouse. The present wards date from the beginning of the last century. The Out-Patients buildings are prefabricated.

The hospital is currently part of North Bristol NHS Trust. It seems that before long it may become the responsibility of South Gloucestershire PCT.

There are currently 23 beds in a single brick built ward. Most of the patients are looked after in 4-bedded bays. As far as possible there is no mixing of the sexes in each bay.

In-Patients and their problems

Most patients are elderly. The majority of admissions are from home and occur as the result of a General Practitioner's home call. However, some beds are used for intermediate care mainly for patients who have been in Southmead Hospital for surgery or some other reason. They go to Thornbury Hospital if they require further rehabilitation or if they require further time in hospital before going home. The average stay in Thornbury Hospital is 23 30 days.

Some patients have respiratory infections. There are a few patients with leg ulcers (less than previously). Occasionally it is possible to offer respite care, but in general, the hospital does not have enough beds for this purpose. There are some stroke patients.

There are two side rooms for terminal care. The staff have been trained in palliative care. Rooms are large and one has been renovated by Friends. There is room for an extra bed to be put up in each room so that a relative can stay overnight.

The hospital does not have any x-ray facilities. Patients requiring a chest x-ray have to go to Southmead Hospital or elsewhere.

There is an ultrasound.

There is no video link.

It is not possible to undertake endoscopies (sigmoidoscopies are undertaken).

Physiotherapy there are two part-time Physiotherapists.

Occupational therapy there is one full-time and one part-time Occupational Therapist. Some of the staff have duties in Thornbury Hospital and outside in the community.

There is no Casualty Department. Patients with minor problems can be dealt with at the Thornbury Health Centre which is adjacent to Thornbury Hospital.

There is an Out-Patients Suite with several Examination Rooms. The following specialities are represented the number of clinics per month is given in brackets.

Dermatology (2)

Surgery (2 or 3)

Orthopaedics (1)

Paediatrics (2)

Paediatric Diabetic Specialists (1 every 3 months)

General Medicine (2)

Gynaecology (2)

Urology (1)

Audiology (1)

Dietician (1)

In addition there are three Ante-Natal Clinics per week.

There are no ENT Clinics.

Up to now recruiting staff has been relatively easy. It seems that many people like to work near to there own homes.

At the moment there is no major problem as far as recruiting nurses is concerned. However, a problem is looming largely due to the fact that the work force is getting older and many nurses will be retiring shortly.

1. Patients are admitted under the care of their own General Practitioner. However, GPs do not visit regularly, but will do so by request.

2. Emergencies Emergencies are dealt with by the General Practitioner on call (there is a local co-operative of General Practitioners who run an out of hours service at the moment, but this may change shortly).

3. Consultants do not have any in-patient responsibility, but visiting Consultants will always see patients on the ward.

There is a very active League of Friends. They have bought a lot of equipment. For instance, they have supplied 24 electrically controlled beds which can be operated by the patients. They have, also, bought a ceiling hoist so that the staff do not have to lift patients manually. They buy the flowers for the ward. They provide a trolley service. They pay for the newspapers and magazines for the ward. Presents are given to patients at certain times e.g. at Easter.

1. Social workers visit from time to time.

2. There are close links with the District Nursing Service. There are regular meetings with community staff including District Nurses. This allows for exchange of information.

3. As indicated above some of the staff have shared hospital and community responsibilities. The hospital is regarded as being very much a community facility.

4. At one time there were some maternity beds at Thornbury Hospital, but this is not now the case. However, ante-natal clinics are run by midwives.

5. Attached to the medical block is an additional ward for EMI patients (elderly mentally infirm). They have a small day room. There are 14 in-patient beds and a small out-patient hospital. The hospital is used partly for assessment and it is the responsibility of the Mental Health Trust.

6. A particular problem is that there is frequently a significant delay in getting people out of hospital and back either into their own homes or into nursing homes. This is a considerable problem and is responsible for the rather long average stay in hospital.

7. Patients come largely from Thornbury. However, some patients come from Almondsbury and Bradley Stoke. A handful of patients come from Berkeley.

8. There are apparently plans for rebuilding the hospital, but these are dependent to some extent upon the sale of land adjacent to the hospital.

Again, I was impressed with this hospital. It, also, has a friendly feel about it. The Matron is very much in charge and clearly has an excellent grasp of what is going on and what needs to be done. Again, the hospital is well supported by the local community. The number of Consultants visiting is rather small and it seems that there is scope for increasing the number of Out-Patient Clinics. There is, also, a need for extra facilities particularly x-rays. It may well be that a small Casualty Department should be set up here in conjunction with the adjacent Health Centre. A very positive point is that there is plenty of car parking space.

Overall another worthwhile visit to a unit that appears to be undertaking good work. Planners please note!

RLH

10^th March 2004