Chief Inspector of Hospitals finds The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust requires improvement and should remain in special measures

England's Chief Inspector of Hospitals, Professor Sir Mike Richards, has published his first report on the quality of care provided by The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, and recommends the trust should remain in special measures for a further six months.

The trust was placed into special measures, following an inspection last year after concerns were raised about mortality rates and standards of care.

Under its new inspection model, CQC has given individual ratings to each of the core services at the trust’s hospitals, accident and emergency (A&E), medical care (including older people’s care), surgery, critical care, maternity and family planning, services for children and young people, end of life care, and outpatients.

The Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust was rated as Requires Improvement overall, following CQC’s inspection which took place from 1 July to 3 July 2014.

A&E, medical care, surgery, maternity and family planning end of life care and outpatients were rated as Requires Improvement while critical care and children and young people’s services were both rated as Good.

The trust was rated as Good with regard to whether services were caring and effective, Requires Improvement on whether the trust was safe and responsive and Inadequate on whether the trust as a whole was well-led.

Full reports for the trust can be found on CQC’s website here.

The trust has been told that it must make improvements to ensure that:

• Concerns around the management of medical outliers are addressed. The trust was not effectively tracking outliers, and therefore appropriate monitoring and follow-up care was not always being provided.
• Improvements are made within the trust’s surgery service. Several elective surgeries were cancelled due to capacity and low availability of beds.
• Urgent efforts are made to comply with the warning notice issued last year in regard to safeguarding people who use services from abuse, restraint of patients, staffing levels and staff training.
• Progress is made towards embedding a robust governance structure. The trust’s governance system must work more effectively to provide assurance to the board that the services being provided are safe and effective. This included ensuring that the trusts policies are up to date as during the inspection CQC inspectors found almost 200 polices were out of date.

Inspectors saw some areas of good practice at the trust and this included:

• Good progress had been made in strengthening the executive capacity of the board and establishing a pace of change towards improving quality.
• The use of ‘Project Search’, which supports people in the community with a learning disability to gain work experience and employment in the community and within the hospital.
• The endoscopy service operating a single sex patient list for elective cases.
• The use and implementation of guideline-specific care plans through the Acute Medical Unit (AMU) into the hospital which has improved patient care and outcomes.
• Staff across all grades and disciplines were seen to be caring, supportive and friendly towards patients. Patients told inspectors that staff were excellent, efficient and went the extra mile.
• The neonatal service supports mothers with premature babies at home with feeding and breathing to ensure families begin to bond and return to normality.

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

“We saw that staff at The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust had been working over the last year to make improvements but clearly the trust still has some way to go before it reaches the required standard.

“That is why I have recommended to Monitor that the trust remains in special measures for a further six months. I hope that, in six-month’s time, the trust will be able to demonstrate enough improvement to review this again.

“People deserve to be treated in services which are safe, caring, effective, well-led, and responsive to their needs and this is what we look at when we carry out our inspections. We will continue to monitor this trust closely and this will include further inspections.”

The report which CQC publishes today is based on a combination of their findings, information from CQC’s Intelligent Monitoring system, and information provided by patients, the public and other organisations.

CQC inspectors will return to the hospital in due course to check that the required improvements have been made.

Ends

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