Enter and view: The Musculoskeletal Service at Jubilee House

This is an Enter and View report by Healthwatch Portsmouth. Healthwatch representatives visited the Musculoskeletal service at Jubilee House to assess the care delivered there.

Our visit held three main purposes. 

1. Opportunities to observe and showcase best practice in musculoskeletal (MSK) rehabilitation at Jubilee House. 

Although we found incomplete aspects to the premises, there were many striking examples where the refurbishment works have delivered high quality facilities. 

Overall, we were reassured to find that all staff with whom we spoke appeared passionate about their role and highly informed about their service in the new premises. They expressed a strong and tenacious commitment towards continuously developing the service. They shared ideas that focus on ‘prevention of physical deterioration’.

However, IT and concerns about equitable access by GPs to refer patients to the service present challenges within the service and strategically to the Trust. This presents a ‘digital exclusion risk’ to some patients and we have noted this within our recommendations.

2. We sought also to understand if the new and much enlarged Healthcare Trust has had real benefits for patients experiencing frontline services.

We were impressed by the service’s leadership team who collectively voiced a belief in openness and accountability with a desire to reach out and engage patients within their communities, including those from "harder to reach" groups. They mentioned plans to hold community assessment & engagement days and ‘Better Health MSK’ days. The clear intent and vision of the leadership team bodes well for future delivery of the excellent service to patients.

3. Crucially, we wanted to hear how patients (and where possible, carers and family members) experience the service, its facilities; accessibility; referral timescales and pathways; information; specialist services; and their overall experiences of treatment and engagement by the Trust.
We found from talking to staff and patients and from performance data confidence in the building and the quality of care the MSK Service provided by The Trust.

There are recommendations in this report:

1. That priority is given to the provision of suitable secure bike storage to support greener travel for both staff and patients.

2. The positioning of the bell push by the front door is lowered to allow access for patients using wheelchairs.

3. Simple and consistent signage is provided, and temporary signage is replaced with permanent signs where applicable to external parts of the building. 

4. Access to the building via the side entrance to the building could be clearly signposted in the car park as well as on/by the door.

5. Shelter (weather protection) should be given priority above the side entrance door.

6. The name of the Trust (in full) replaces the legacy Trust’s name (Solent NHS Trust).

7. The service operates up to 6.30pm. We would like to recommend that for patient and staff safety improved lighting levels at the front of the building is addressed. 

8. That suitable, practicable and cost-effective options (e.g. privacy screens) should be considered to improve privacy and confidentiality for patients and visitors when speaking with the Receptionist.

9. That access to basic refreshments in the waiting room is addressed and that this is regularly checked.

10. That toilet doors are fitted with appropriate means to let patients know if a toilet is in use or not.

11. That texts to patients should use a patient’s preferred language.

12. A multi-organisational review of appropriate/timely engagement in multi-disciplinary meetings to enable support for patients on the pelvic health pathway to optimise outcomes, equity of access and support for community staff.

13. That efforts by the Trust to work with others towards a streamlined IT solution (including provision of printed service information) to manage referrals should be a matter of priority. 

14. That a printed leaflet or easy-read booklet about the MSK service is made available to patients in the reception area and via GP practices or community hubs who wish to refer patients to the service.

15. Plans to ensure information and communication with patients whose needs fall within the scope of the Accessible Information Standard are prioritised and embedded as a Standard Operating Procedures within the service.

There are no follow up actions in this report. The provider has responded.