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Achieving clinical negligence scheme for trusts standards improving documentation standards – experience at Royal Bolton Hospital
  1. N Katakam,
  2. E Church,
  3. S Sasson,
  4. J Mechery,
  5. S Das
  1. Royal Bolton Hospital, Bolton, UK


Background Clinical negligence scheme for trusts (CNST) provides a means for NHS organisations to fund the cost of clinical negligence claims. It is designed to ensure high quality is embedded in organisational governance, patient care and safety. Achieving level three of the CNST standards (March 2009) requires intensive monitoring of every aspect of organisation and clinical care.

Method Retrospective audit was performed on documentation for Caesarean Section (CS), Operative vaginal Delivery (OVD) and perineal trauma (PT) in January 2009. All CNST criteria were included in the audit. Documentation standard was found to be varied and failed to meet CNST standards. Preprinted, carbonised documentation proformas were developed for CS, OVD and PT. Re-audit was done in October 2009.

Results Dramatic improvement in documentation was noted. Proformas ensured uniformity, easy completion; ease of use and made it easy to audit.

CS – Improved from a range of 40–100% in various criteria to 79–100% in all the criteria. OVD – Improved from a range of 42–92% in various criteria to 100% in all the criteria. PT – Improved from a range of 75–100% in various criteria to 100% in all the criteria.

Conclusion Continuous audits are ongoing on a two monthly basis and are presented at our Perinatal Care Forum and departmental teaching sessions. This exercise highlights trends that may need addressing. It provides opportunity for trainee doctors and midwifery staff direct involvement and ownership of CNST in routine practice.

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