England's Chief Inspector of Hospitals has found improvement in Worcestershire Acute Hospitals NHS Trust’s urgent and emergency and medical care services but says more work is needed.
The trust was placed into special measures in December 2015 and has been subject to frequent inspection and rigorous action by CQC during this time. It is currently rated as Inadequate overall.
Between 1 and 3 November 2017, a team of CQC inspectors visited urgent and emergency care and medical care at the trust’s Worcestershire Royal Hospital and Alexandra Hospital. The inspection was carried out to check on progress with improvements regarding a warning notice CQC issued the trust with in July 2017.
The inspection identified improvements but more work is needed to ensure services met the standards people should be able to expect.
Although the overall rating for the trust has not changed as a result of this inspection, urgent and emergency care services at both hospitals are now rated as Requires Improvement for whether services are safe. Both were previously rated as Inadequate for whether services were safe.
In addition, the rating for whether medical care at the Alexandra Hospital is safe has improved from Inadequate to Requires Improvement. The rating for whether urgent and emergency services are effective at Worcestershire Royal Hospital is now Good, it having previously been rated as Requires Improvement in this area.
Chief Inspector of Hospitals, Professor Ted Baker, said:
“We found a number of improvements had been made in the urgent and emergency care and medical services at both the Alexandra Hospital and Worcestershire Royal Hospital. However, urgent and emergency care at Worcestershire Royal Hospital still requires further improvement in order to move its rating from Inadequate.
“While the improvements haven’t resulted in a change to the trust’s overall rating of Inadequate, and the trust remains in special measures, it demonstrates that the trust is working to improve services for its patients.
“Further improvements are still needed and we will continue to monitor the trust closely. This will include further inspections.
“The trust board knows what it must do to bring about sustainable change to its services and ensure people receive the care they should be able to expect.”
Inspectors found increased stability in the executive team on their return. Staff spoke positively about this and the focus on achieving and sustaining good patient care. They also said they felt respected, supported and valued and said the new executive team had made a difference to the trust.
However, inspectors highlighted areas where the trust it must take action to bring urgent and emergency and medical care services up to the required standards.
Not all staff in senior roles had the experience, knowledge, capacity or capability to lead effectively and shortly before the inspection clinical divisions had been reconfigured. There was a risk of instability across management divisions with some posts being filled by interim staff or acting up posts.
The trust had a vision for what it wanted to achieve and objectives to support this, but CQC found that a robust strategy had not yet been developed. A framework for mitigating risks was also in place but this was yet to be embedded enough to be fully effective or to provide assurance regarding improvements to the safety and quality of patient care.
Full details of the ratings, including a ratings grid, are given in the report.
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While the improvements haven’t resulted in a change to the trust’s overall rating of Inadequate, and the trust remains in special measures, it demonstrates that the trust is working to improve services for its patients.
Professor Ted Baker, Chief Inspector of Hospitals