England's Chief Inspector of Hospitals has told University Hospitals Plymouth NHS Trust that it must continue to make improvements in its diagnostic and pharmacy services following its latest inspection by the Care Quality Commission.
A team of inspectors visited Derriford Hospital in December 2018 to check the trust’s progress in making improvements required by an inspection in August 2018.
CQC had issued two Warnings Notices requiring Derriford Hospital to take urgent action to improve the management of medicines across the trust and to ensure there were significant improvements in the diagnostic services.
Initially inspectors found the diagnostic imaging service was not meeting the seven-day internal target for the imaging of patients suspected of having cancer.
There were also no safeguards to ensure medicines had been delivered to patients using the trust transport service and patients were adequately advised on their medicines.
During the follow up inspection CQC found there had been progress in addressing the concerns within the pharmacy areas, where staff had been overstretched, leading to severe restrictions in the service at times across the Trust. At the time of this inspection the issues had and were continuing to be addressed.
But inspectors found that further improvements were needed in diagnostic services. The warning notice had required a better understanding of the issues at board level. Although there had been some progress, the changes that were needed in staff culture would take time to be implemented.
Dr Nigel Acheson, Deputy Chief Inspector of Hospitals in the South, said:
“It is disappointing to report that since our original inspection, University Hospitals Plymouth NHS Trust has not made enough progress to satisfy our Warning Notices. Although we have seen real improvements in pharmacy, we have made it clear that we require further work to address the issues we had found in diagnostic services.
“On the whole we found the trust has a strong and engaged workforce but I am concerned that some staff in the diagnostic and imaging teams described a culture of poor behaviour from managers which belittled and humiliated junior staff. Radiographers felt unable to raise this with their managers or with their freedom to speak up guardians.
“The trust needs to sustain the improvement we have found and address the issues which we have again identified. We will return in due course to ensure that the necessary improvements have been made.”
During the inspection, trust’s chief operating officer acknowledged that the trust had not allocated enough resources to meet in full the requirements of the Warning Notice within the pharmacy services. Plans were being made to deliver sustainable solutions, and the trust was working to improve resilience of clinical support in the department.
Inspectors found there was improving performance for patients waiting longer than six weeks for a routine scan and an improved management of processes within the imaging department. But some consultants said the workload had not reduced and most reported working harder than at the time of the last inspection
On the whole we found the trust has a strong and engaged workforce but I am concerned that some staff in the diagnostic and imaging teams described a culture of poor behaviour from managers which belittled and humiliated junior staff.
Dr Nigel Acheson, Deputy Chief Inspector of Hospitals in the South