28.07.15
New trust that took on Stafford hospital must improve – CQC
The University Hospitals of North Midlands NHS Trust ‘requires improvement’, particularly its ‘unacceptable’ waiting times, according to the CQC.
Following an inspection in April, the trust was rated as inadequate in the ‘responsive’ category because services “are not planned and delivered in a way that meets people’s needs”, according to the report.
They were found to have a “constant struggle” with capacity issues, which meant people were often unable to access services quickly.
CQC’s chief inspector of hospitals, Sir Mike Richards, said: “People were frequently experiencing unacceptable waits and unable to access services in a timely way. There were not enough beds for critical care patients and high numbers of patients were cared for in the recovery unit.”
It also was rated as ‘requiring improvement’ in terms of whether services were safe, effective, and well-led.
The only category in which it received a ‘good’ rating related to whether its services were ‘caring’.
Overall the inspection team determined that the trust should review arrangements for patient flow through the emergency department and ensure there are enough resuscitation trolleys available. They must also work with local stakeholders to reduce the number of patients waiting for follow-up appointments.
Additionally staff should be ‘trained and knowledgeable’ about the Mental Capacity Act 2005 and relevant responsibilities related it.
However at the time of inspection the trust was undergoing a ‘significant’ programme of change and relocation of services. The trust only officially exists since November 2014 after University Hospital of North Staffordshire NHS Trust and Stafford Hospital from the Mid Staffordshire NHS Foundation Trust were integrated.
Richards said: “We recognise that the leadership of the new trust has had the significant task of bringing together two organisations at a challenging time. We have seen that progress has been made and we found several areas of outstanding practice but there is still more to be achieved to improve services so that they meet the standards people have a right to expect.
“The trust had a challenging winter managing its delivery of acute services, specifically in meeting A&E targets at this very busy time. During the April inspection, we found that the emergency department at Royal Stoke University Hospital was consistently failing the four-hour waiting time target.
“In addition, the trust lacked an end of life care strategy and discharge was slow for patients choosing to go home to die. The trust needs to ensure these issues are addressed.”
He added that since the inspection they have been monitoring the trust and working closely with the Trust Development Authority and other stakeholders such as local CCGs and NHS England.
Under its new inspection model CQC has given individual ratings to each core service, including A&E, medical care, surgery, critical care, maternity and family planning, children and young people’s services, end of life care and outpatients.
Despite largely negative ratings, the trust’s core service of children and young people’s services at Royal Stoke University Hospital was found to be ‘outstanding’ in terms of being ‘caring’.
Other examples of specialist ‘outstanding’ work included innovative practice carried out in the Specialist Neurological Unit at the County Hospital and improvements in the Alcohol Liaison team at Royal Stoke. A specialist one-stop clinic had also been developed for pregnant women with substance misuse issues.
Mark Hackett, the trust’s chief executive, welcomed the report and said they are “addressing the various areas for improvement the CQC has identified”.