The University Hospitals of North Midlands NHS Trust has been rated as Requires Improvement following a Care Quality Commission inspection.
Between 5 June and 1 August 2019, CQC inspected the trust’s core services at Royal Stoke University Hospital and County Hospital in Stafford. These services included; urgent and emergency care, medical care, surgery, maternity and gynaecology, children and young people’s services and end of life care; and they carried out an inspection under CQC’s question of whether the service is well-led.
Inspectors found that several improvements are needed at the trust since their last visit in October 2017. As a result, the trust’s rating remains as Requires Improvement overall.
The University Hospitals of North Midlands NHS Trust is rated Requires Improvement overall as well as for whether its services are safe, effective, responsive and well-led. It is rated Good for whether services are caring.
Professor Ted Baker, CQC’s Chief Inspector of Hospitals, said:
“On our return to The University Hospitals of North Midlands NHS Trust we found a number of improvements were needed.
“The trust must ensure it continues make changes that will lead to sustainable improvements, so that people receive the care they should be able to expect.
“We found significant concerns regarding the care and treatment of patients in the emergency department at Royal Stoke Hospital. During busy periods, we were not assured that there were enough staff available to manage patients safely in the corridor. Staff did not follow a consistent approach to monitoring and recording observations.
“Governance systems, although embedded, were over-complicated and unreliable. However, we found that the newly appointed chief executive was undertaking extensive work to improve these systems.
“Despite improvements being needed across some services, we also found examples of outstanding practice, most notably in children and young people’s services.
“We have given our feedback to the trust and we will return to carry out further inspections to check on its progress with improvement.”
The trust has been told it must make several improvements including:
- All staff must be up to date with mandatory training across services.
- Patient privacy must be maintained within urgent and emergency care. All reasonable efforts should be made to make sure that discussions about care, treatment and support only take place where they cannot be overheard.
- Patient observations must be completed in medical care within required timeframes to monitor potential deterioration of health.
- Sufficient numbers of suitably qualified, competent, skilled and experienced staff must be deployed in urgent and emergency services.
- Systems for monitoring patient outcomes and key performance indicators in outpatients must be comprehensive and reliable.
- Deliveries of chemotherapy in outpatients must be done in a timely manner.
Inspectors found examples of outstanding practice at Royal Stoke University Hospital, including:
- Distraction bags were given to children and young people with mental health needs. These bags contained items to help children and young people manage their mental health during their assessment or admission. Items contained within the bags included; fidget toys, stress toys, puzzles, therapeutic colouring and a notepad and pen.
- The children’s service worked with the local authority and National Literacy Trust to provide each neonate with a story pack. These packs contained a book for parents to read to their neonate helping parents to bond with their child when they were unable to hold them for lengthy periods.
- The whole staff team, from consultants to health care support workers prioritised their time to celebrate the end of treatment with children, young people and their families. Inspectors attended a bell ringing celebration and saw the staff had decorated and personalised the wall around the bell for the child and staff who had been involved in the child’s care.
- The outpatients service ran a #keepstokesmiling campaign about oral hygiene. The campaign aimed to help educate young people in Stoke on Trent about the damaging effects of too much sugar on teeth.
Full details of CQC’s inspection, its ratings for the trust, including a ratings grid, are given in the report published online at: www.cqc.org.uk/provider/RJE
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