Chief Inspector of Hospitals publishes report on the quality of care provided at Colchester General Hospital

England's Chief Inspector of Hospitals, Professor Sir Mike Richards, has published a report on the quality of care provided at Colchester General Hospital.

CQC carried out an inspection at the hospital in April to look specifically at areas of concern from the previous inspection and to review any improvements. It focussed on a selection of inpatient wards and the emergency department and the inspection team also interviewed the senior management team.

The areas looked at were highlighted as being of concern during CQC’s inspection in September 2015. An extension of special measures status was issued as a result of that inspection and this gave the trust a deadline of March 2016, by which it was expected to demonstrate sustainable improvements.

Inspectors carried out this inspection to check on whether significant improvements had been made.

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

“Our findings at Colchester General Hospital did not represent the degree of improvement we would have wanted to see or the level of care we feel people should be able to expect.

“It was a real concern to us that significant improvements had not been made. Based on the findings of this inspection I authorised urgent enforcement action be taken against the trust in respect of the emergency department streaming process and patients being cared for in the corridor area. I also authorised enforcement action to be taken on the surgery service in respect of ensuring that safer surgery checklists are completed so that patients are protected from the immediate risk of harm.

“The trust has been in special measures for more than two years and, based on the lack of improvement, I have been unable to recommend a further extension to special measures. However, a partnership agreement with Ipswich Hospital NHS Trust has now been established. The chairman and chief executive of Ipswich are now overseeing Colchester Hospital University NHS Foundation Trust.

“We are optimistic about what will be achieved at the trust through this partnership, based on the strength of leadership that we have previously assessed at Ipswich.

“Our inspectors are in regular contact with both the leadership at Ipswich and Colchester and we continue to monitor this situation very closely.”

During the inspection we found:

• Significant concerns regarding the nursing leadership on Peldon Ward - concerns surrounding a bullying culture on the ward were raised with inspectors.
• Concerns surrounding the care of patients on Peldon Ward. The inspection team requested that the trust take immediate action to ensure patients were protected from the risk of harm or abuse.
• There was a lack of clinical leadership in the Emergency Department and, although nursing leadership was good, doctors were disengaged in the delivery of a safe, effective and responsive service.
• The streaming process (which should support the flow of patients through the Emergency Department) did not function effectively due to staff shortages. There was there was no contingency plan in place for if there was a shortage of staff.
• There were many patients in the corridor area near the ambulance bay in the Emergency Department, and still in ambulances, due to the department being full.
• Despite some improvements, the management and trust board still lacked a robust grip and proactive identification of risk, there was insufficient pace to address the significant improvements needed and there was a lack of action and response by the board on key issues such as accident and emergency performance and safer surgery checks; despite an awareness of the risk these posed.
• There was a lack of recording of discussions with family and patients in end of life care and a lack of evidence that information was provided about what they might expect.
• The completion of Do Not Attempt Cardio Pulmonary Resuscitation (DNACPR) forms had not improved, with many reviewed being completed poorly or incorrectly. Several were seen with reasons for DNACPR given as ‘Dementia’.
• Inspectors found improvements in the Emergency Assessment Unit, on Birch Ward and in the culture and levels of staff support in endoscopy.

Professor Sir Mike added: “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.

“The trust knows what it needs to do to make sustainable improvements and our inspectors will continue to monitor the trust closely; including further inspections.

“Our new strategy sets out how we’ll be making increasing use of these shorter, more focussed inspections where we have concerns – so we can go in quickly to make sure that improvements are being made and people are protected. We’ll still conduct full comprehensive inspections where necessary, but new technology and better use of information will help us target our inspections more tightly than ever to where people may be at risk of poor care.”

A full report of our inspectors’ findings at Colchester General Hospital is published.

Ends

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