Part A
Answer the following questions:
1. In what areas has the hospital done well?
2. What areas does the hospital still have to improve?

Dialogue

Dr Iloabachie: Have you seen the latest trust report?

Dr Jones: Yes, doesn't make for very happy reading. Does it?

Dr Iloabachie: No, we've only achieved 4 of our 9 targets, what are the management going to do about this?

Dr Jones: Who knows? We're alright though; the clinical focus was rated highly. Our deaths within 30 days of selected surgical procedures is low as is our emergency readmission.

Dr Iloabachie: True, but our infection control procedures are in the lowest band.

Dr Jones: Unbelievable when you think of how much money this hospital has spent on training.

Dr Iloabachie: Maybe it's not effective training.

Dr Jones: The high staff turnover makes it ineffective.

Dr Iloabachie: I agree. I notice our patient focus was not too bad, our privacy and dignity were in the highest band.

Dr Jones: That's all very well, but waiting times are in the lowest band, what's more important? It's difficult to have dignity when you have been waiting 6 months for an operation.

Dr Iloabachie: Did you also notice that staff opinion is in the lowest band, I wonder what was in all those questionnaires they sent round?

Dr Jones: Yes, that's why personnel are changing all the time; If only this hospital would address this problem immediately.

Dr Iloabachie: Have you read the website; it goes on about how much staff are valued and what a nice place it is to work.

Dr Jones: Usual reality verses fiction.

Dr Iloabachie: The accident and emergency department comes out pretty badly.

Dr Jones: I know, over 25% of patients have to wait more than four hours. 9 people had to wait more than 12 hours.

Dr Iloabachie: Maybe they didn't really need to be there, in the past people would never come if it wasn't a real emergency.

Dr Jones: That's hardly the point; we don't have the resources to see people quickly and efficiently. I don't think the trust is entirely to blame; they aren't getting enough financial support from the government.

Dr Iloabachie: Well how do other hospitals manage? They have the same resources and don't make patients wait so long.

Dr Jones: We don't have the most efficient managers.

Dr Iloabachie: You can say that again. They've cut almost every medical post they can and the management department keeps on growing. Did you see they're advertising for a newly created post as we speak?

Dr Jones: It's beyond belief. A few more doctors in A and E would do much more to cut waiting times than another manager telling the existing staff how to do it.

Dr Iloabachie: And they're still below average on the number of hours worked by Junior Doctors. My team walk around like zombies half the time.

Dr Jones: The problem is that they don't involve us in the problem solving. They sit upstairs devising new ways to meet targets without ever asking us if they are realistic.

Dr Iloabachie: Didn't they ask you to join the performance improvement panel?

Dr Jones: Yes, but how much time would it take - all unpaid?

Dr Iloabachie: I see your point, but if we don't do anything, nothing will change.

Dr Jones: I suppose I could reconsider my decision.

Dr Iloabachie: It could make all the difference.

Glossary:
trust - zarząd powierniczy
readmission - ponowne przyjęcie
band - pasmo, przedział
effective - skuteczny, efektywny
privacy - prywatność
dignity - godność
personnel - personel
accident and emergency - oddział ratunkowy
hardly the point - nie o to chodzi
efficient - wydajny
performance improvement panel - zespół (komisja) do spraw podnoszenia jakości pracy
unpaid - niepłatny

Part B

Complete each of the statements below by choosing A, B or C according to the text and what is correct in English. All of the language in these items has been presented in the last 11 lessons.

1. Dr Jones ___________ with Dr Iloabachie that high staff turnover has made infection prevention training ineffective.

A. agreed to B. agreed with C. agree to

2. Dr Jones wishes the hospital ______________ high staff turnover.

A. had addressed B. would address C. is addressing

3. Dr Iloabachie thinks in the past patients didn't __________ to A and E unless they really needed to.

A. use to come B. like to come C. want to come

4. The hospital, _________ has too few doctors, is advertising for a new management post.

A. who B. where C. which

5. A ____________ patients had to wait more than 12 hours in A and E.

A. few B. lot C. little

6. Dr Iloabachie says the hospital still has a poor record when it comes to ___ number of hours worked by junior doctors.

A. - (no article) B. the C. a

7. Dr Iloabachie decides he ____________ the performance management team.
A. joins B. will have joined C. will join

Part C

Write the questions do the following answers.
1. 25%
2. more doctors
3. the highest band
4. the website
5. almost every medical post possible

Key

Part A
1. The hospital has high clinical focus and high patient focus.
2. The hospital needs to improve; infection control, staff morale, waiting times in A and E and reduce the working hours of junior doctors.

Part B
1. B
2. B
3. A
4. C
5. A
6. B
7. C

Part C
1. How many patients had to wait more than 4 hours in A and E?
2. What would cut waiting times in A and E?
3. How was patient privacy and dignity rated?
4. Where does it say how much staff are valued?
5. What has been cut?