Central Manchester University Hospitals NHS Foundation Trust rated Good by Chief Inspector of Hospitals

England's Chief Inspector of Hospitals has rated the services provided by Central Manchester University Hospitals NHS Foundation Trust as Good following an inspection by the Care Quality Commission

The trust serves a population of over 500,000 people across Manchester, providing a wide range of services to people in hospital and in the community. Inspectors found that services were safe, effective, caring and well led but that the trust required improvement to be responsive.

The Manchester Royal Infirmary, Trafford Hospital and Altrincham Hospital were all rated as Good and Child and Adolescent Mental Health Services provided at the Manchester Royal Infirmary and in the community and were both rated as Outstanding.

The full reports on all core services are available.

Professor Sir Mike Richards, CQC’s Chief Inspector of Hospitals, said:

“When we inspected Central Manchester University Hospitals NHS Foundation Trust, we found a good standard of care throughout the trust. We found the care provided for children and young people receiving mental health services to be exemplary.

“Staff engagement is very good. There is a supportive leadership team with a clear vision and values that staff understand and work towards. There is a positive culture throughout the trust and all the staff we met on the inspection spoke positively about ensuring that patients received a consistently high service and experience.

“Clearly this trust serves its local community very well. We have identified some areas which require improvement, but I am confident that the trust will build on this particular inspection to ensure that this high standard continues.”

Inspectors found that across the trust staff displayed a clear commitment to providing patients with high quality care and treatment. The trust had a strong safety culture with robust systems in place to protect patients from avoidable harm. Hospital acquired harms such as pressure ulcers and falls were below the national averages.

There was a good standard of cleanliness throughout the trust. Staff were aware of current infection prevention and control guidelines and were supported by relevant training

The trust had the lowest mortality rate in the North West of England and was active in reviewing and assessing mortality. There was good medical and board oversight. It was evident deaths were reviewed and learning opportunities shared and applied to improve patient outcomes and reduce incidents of avoidable death.

Although there was a strong and clear focus on discharge planning there were a number of patients who were experiencing delayed discharge and remained in hospital longer than they needed to be. This was sometimes due to the delayed provision of care packages in the community.

There were nursing vacancies across a number of services. The trust was actively recruiting nursing staff to address the shortfalls, however staffing remained a challenge.

Inspectors identified some areas where the trust must improve including ensuring that sufficient numbers of suitably qualified, competent, skilled and experienced staff are deployed in all services, particularly urgent and emergency services, medical care, surgery services and end of life care. This also includes midwives in all areas of the maternity services and sufficient doctors to provide timely review of patients when requested.

The trust also needs to put a greater focus on patient flow through the Manchester Royal Infirmary, St Mary’s Hospital and Royal Manchester Children’s Hospital, particularly in maternity services, medical care, surgery services and A&E.

There were a number of areas where inspectors identified outstanding practice including:

• Staff at St Mary’s hospital participated in an extensive programme of local, national and internationally recognised research. In areas such as female genital mutilation (FGM), senior staff within the hospital were participating in the development and implementation of national guidelines.
• The neonatal unit used video technology to support women who were not well enough to visit their baby, and a bleep system for parents so that they were involved when decisions were being made by medical teams.
• The gynaecology emergency unit was locally unique in that it allowed patients to refer themselves to a specific unit for assessment and treatment of gynaecological emergencies and problems in early pregnancy.
• The diagnostic imaging department used innovative new technology for assessing coronary artery disease which was available in only two centres in the UK. This meant that patients only required a single one hour visit rather than two visits and three hour appointments.

The reports which CQC publishes today are based on a combination of its inspection findings, information from CQC’s intelligent monitoring system, and information provided by patients, the public and other organisations.

CQC carried out the inspection in November 2015.The team included CQC inspectors and a variety of specialists including: medical, surgical and midwives, nurses, allied health professionals, community nursing staff, a dentist, junior doctors and a paediatric doctor.

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