Statement in response to CQC inspection report

Deborah Needham, Chief Operating Officer/Deputy CEO, said:

“The report highlights the improvements noted by inspectors; we had already recognised the need for improvements in many of these areas and had put actions in place to address them. 

"Internal structures were revised to support the organisation to be assured that these actions were monitored and progressed in a timely manner and we are delighted the CQC recognised and formally acknowledged the improvements in their follow up visit of September 2014,  including lifting the formal warning notice.

"We continue to work on outstanding areas requiring improvement, some of which are in keeping with challenges that many other NHS Trusts currently face.

“Some of the recommendations from the original inspection in January 2014, which were part of the warning notice, were quickly resolved at the time. For instance, within hours of the CQC inspection and initial feedback we immediately stopped the practice of sending out medicines by taxi, revised our ‘do not resuscitate’ forms and training, and ensured that all medical equipment was tested and properly labelled.

“It’s worth noting that the inspection took place in September 2014 and in the intervening nine months, we’ve pressed ahead with our improvement programme.  Major developments include:

• the opening of a new resuscitation unit which doubles our capacity to care for critically ill patients and we now provide dedicated paediatric care facilities in the A&E department with 24 hour access to a Registered Sick Children’s Nurse
• The introduction of daily clinical safety ‘huddles’ to identify potential delays and safety issues earlier and taking immediate action. 
• Improved our governance arrangements to ensure we identify and mitigate risks to patients and learn from experiences such as complaints, ‘near-misses’ and serious incidents
• Increased the level of mandatory staff training by improving the range of options for staff to access training (for example by e-learning)
• Improved our end of life care by introducing new personalised care plans and having a designated consultant to be our lead for end of life care
• Carried out a further assessment of the Intensive Care Society core standards for intensive care, and approved a business case to recruit further ITU consultants and medical trainees, as well as increasing capacity and nursing establishment

“We have seen improvement in our performance against the four-hour standard during May and June. We are working hard both within the hospital and with our partners to minimise the length of time patients stay in hospital. With sustained and increased pressure on the whole urgent care system, we ensure that during periods of intense pressure, we continue at all times to prioritise the safe care of our patients.

"Going forward, we are committed to building on the improvements and sustaining the required performance by prioritising a multi-agency response to addressing the county’s urgent care problem.”

Ends

Notes to editors

The inspection report can be read on the CQC website 

The original warning notice was issued for failing to comply with Regulation 10(1)(a), 10(1)(b) and 10(2) (c)(i) and related to: 

• Sending prescriptions to patients’ home in a taxi 
• Issues re mandatory training attendance in Medicine
• Internal out of hours transfers between wards
• Stroke imaging pathway failure 
• Actions described against ITU care standards compliance were not met
• Actions against ECIST review not progressed for A&E improvements
• Failure to follow up actions on an action plan noted in Trust Board minutes 
• Low appraisal rates 

The percent of assessments carried out in A&E within four hours:

• May 2015: 93.61 %
• June 2015 to date: 94.5 %
• Year to date (April-June 23): 93.36 %