1. Institution details
2. Institution name
3. Number of hospitals in institution
4. Total number of inpatient beds in institution
5. No of Critical care or level 3 beds in institution
6. No of HDU or level 2 beds in institution
7. No of operating theatres in institution
8. Last CQC fundamental standard rating for Safety (pick from list)
9. Last CQC fundamental standard rating for Premises and Equipment (pick from list)
10. Are computerised systems for recording patient vital signs in use? (E.g. Heart rate, respiration rate, temperature, SpO2)
a. System status (pick from list)
b. Total number of beds in institution covered by computerised systems for recording vital signs (or NA if not implemented)
c. Supplier name(s) and system name(s) of most significant systems (or NA if not implemented)
d. Year of first implementation Actual or planned (or NA if not implemented)
e. Patient monitoring (approx. number of devices or connected beds)
Capital programmes
11. Does the institution have a planned capital replacement programme for IT systems and IT equipment? (pick from list) Yes
a. Total capital spend for IT in year (software, hardware, project management), nearest £100K
b. Approximate capital spend on networking to improve WiFi coverage and performance (core systems, edge systems, cabling, access points, controllers and software), nearest £100K
2017-2018
2018-2019 (planned)
2019-2020 (projected)
2021-2022 (projected)
12. Capital spend on clinical software applications used for direct patient care at the bedside by nursing and medical staff (i.e. recording vital signs, medical and nursing notes, medications, care record) EXCLUDING imaging systems
a. All systems, nearest £100K
b. Of which, patient at risk applications (e.g. for NEWS), nearest £5K
2017-2018
2018-2019 (planned)
2019-2020 (projected)
2021-2022 (projected)
13. Does the institution have a planned capital replacement programme for Medical Equipment? (pick from list)
a. Capital spend in year, nearest £100K. NB Medical equipment including portable medical equipment for diagnosis, therapy or treatment. Excluding large scale installed equipment such as radiotherapy, CT, MRI
2017-2018
2018-2019 (planned)
2019-2020 (projected)
2021-2022 (projected)
14. IT Networking Infrastructure
a. Wired network access at the bedside (pick from list)
b. Wireless access coverage for suitable medical software applications (pick from list)
Level 1 beds
Critical care level 3 beds
HDU level 2 beds
Operating theatres
A&E
15. Ration of handheld devices per bed i.e. smart phones, tablets (approx.)
16. Ratio of bedside PCs to beds (approx.)
17. Do the PCs in this area comply with the IEC6061 standard for medical equipment (pick from list)
Level 1 beds
Critical care level 3 beds
HDU level 2 beds
Operating theatres
A&E
18. Early warning scores (NEWS, NEWS2 etc.)
19. Which early warning score for the deteriorating patient is in use in the institution?
20. No. of admissions to level 1 care per year (latest figure available)
21. Number of level 1 patient bed days per year (latest figure available)
22. % of level 1 patients monitored using a patient at risk scoring system such as NEWS
23. Standards operating in the Trust (pick from list)
24. Is the network run to the ISO80001 standard ?
25. Does the IT department operate to the ITIL standard?
26. Does the Trust operate a formal bring your own device policy regarding smartphones or tablets?
27. Does Clinical Engineering (BME) hold ISO9001?
28. Does Clinical Engineering (BME) hold ISO13485?
