Chief Inspector of Hospitals finds that Tameside Hospital is inadequate and recommends that the trust remains in special measures

England's Chief Inspector of Hospitals has recommended that Tameside Hospital NHS Foundation Trust at Tameside Hospital, Ashton-under-Lyne, Greater Manchester, should remain in special measures, following his first inspection of the quality of its services.

The trust had been  placed into special measures by Sir Bruce Keogh in July last year after concerns were raised about mortality rates, emergency care, staffing levels, patient experience and leadership.

While CQC found that some improvements had been made at the trust since then, there has not yet been enough progress to recommend that the trust leave special measures at this time.

Under the new inspection model, CQC has given individual ratings to each of the core services at the hospitals, including accident and emergency, 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.

Overall Tameside Hospital NHS Foundation Trust has been rated as Inadequate.  Accident and emergency (A&E), maternity & family planning and children’s care were all rated Good, while critical care at the hospital was rated Inadequate.   Medical care, surgery, end of life care and outpatients were rated Requires Improvement.  The full reports on the hospital and the wider trust are available below.

While inspectors found that the leadership of the trust was now stronger and beginning to support change and despite improvements in many areas since the Keogh inspection, the trust had not made enough progress in the last 12 months.

Inspectors found that, in the medical wards, risks to patients were not properly assessed, monitored or managed effectively, and care and treatment didn’t always follow best practice guidance. Patients were experiencing unnecessary delays while they were in hospital, and were not always admitted to wards which met their care and treatment needs.

Inspectors found that critical care services were not being planned and delivered in a way which met the needs of local people.

Safety issues like cleanliness, staffing levels and stock levels of medication were not being monitored in real time, which created a risk to patients. Senior managers were not aware of the issues relating to capacity and staffing that CQC identified.

Despite the issues identified across the trust, most patients spoke positively about their recent experiences at the hospital. They gave examples of how staff treated patients with compassion. Inspectors saw across the trust that staff were caring and worked well within their teams and were well motivated.

The trust has been told that it must make improvements in a number of areas, including taking action to ensure that:

• Adequate supplies of medication are available, safely administered and safely disposed of.
• There are, at all times, enough appropriately skilled staff on the wards or on call to meet people's needs.
• Staff promptly assess all patients, and promptly respond where their condition changes.
• Patient records are fit for purpose, and that patient information is protected.
• Staff carry out regular equipment checks and repairs as required.
• Staff are adequately trained and regularly appraised, and that they report and learn from incidents, complaints and concerns.
• Suitable infection prevention and control measures are in place.

Inspectors also identified a number of areas of good practice, including:

• Facilities for bereaved parents, which included a private room, access to a named midwife (usually bereavement trained), and a home visit after leaving the hospital.
• An outside dementia friendly garden area for patients.
• A teenage pregnancy reduction initiative in response to local need, developed by the maternity service, which had achieved a positive impact in reducing the number of teenagers who were expecting their second child.
• The consultant-led physiotherapy team, which was available seven days a week.

CQC’s Chief Inspector of Hospitals, Professor Sir Mike Richards, said: “Despite some areas of development, notably maternity and children’s care, overall Tameside Hospital NHS Foundation Trust has made inadequate progress for me to recommend that it can leave special measures at this time. Despite hard work by the staff – evidenced by the feedback patients gave us - there are still significant issues in a number of areas which are preventing local people receiving the care they deserve.

“I have recommended to Monitor that the trust remains in special measures for now. I am cautiously optimistic that, in the next few months, the trust will be able to demonstrate enough improvement for me to review this again.

“People deserve to be treated in services which are safe, compassionate, effective, and responsive to their needs. We will continue to monitor the trust closely and will inspect again in due course.”

An inspection team which included doctors, nurses, hospital managers, trained members of the public, CQC inspectors and analysts made announced visits to sites run by the trust in April.

Inspectors also visited the sites unannounced as part of the inspection, held focus groups with staff, and held a public listening event. 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.

Under the new inspection model, CQC has given individual ratings to each of the core services at the hospitals, including  Accident and emergency, 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.

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

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