England’s Chief Inspector of Hospitals has found improvements are needed at East Suffolk and North Essex NHS Foundation Trust following an inspection by the Care Quality Commission.
Between 11 June and 18 July 2019, a team of CQC inspectors visited services across Colchester Hospital and Ipswich Hospital. As a result, inspectors rated the care provided by staff to be Requires Improvement overall.
The trust is also rated as Requires Improvement for whether its services were safe and responsive. The trust is rated as Good for whether its services are effective, well-led and caring.
East Suffolk and North Essex NHS Foundation Trust provides both acute hospital and community health care across Colchester, Ipswich and surrounding areas. It was formed on 1 July 2018 following the acquisition of The Ipswich Hospital NHS Trust by Colchester Hospital University NHS Foundation Trust.
Both hospitals had been inspected in 2017 under their previous registration. This was the first time CQC has inspected the new trust.
Chief Inspector of Hospitals, Professor Ted Baker, said: “Our visit to East Suffolk and North Essex NHS Foundation Trust found a number of improvements were needed.
“Whilst it’s encouraging that the trust has areas of outstanding practice and is rated good for being effective, caring and well-led, more progress needs to be made to change the overall rating.
“Some of the issues we found were understandably caused by complications following the formation of a new trust and one which is the biggest in the locality.
“For example, the trust was in the process of recording the provision of mandatory training in key skills to all staff. This had been challenging due to the different recording systems and mandatory training programmes from each former hospital.
“At the time of our inspection, the trust was still aligning systems and programmes. This meant that some of the information submitted prior to inspection and within this report did not reflect an accurate picture of training performance.
“Risks to patients were not always assessed, monitored and managed effectively. In the emergency departments staff did not always complete risk assessments for patients in a timely manner, particularly for patients with mental health needs.
“Despite these concerns, inspectors observed that the leadership across services was mostly effective despite the challenges of managing a newly merged trust.
“Leaders had the skills and abilities to run the trust effectively and they understood the priorities and issues they were faced with. They were visible and approachable in the service for patients and staff alike and supported colleagues to develop their skills and take on more senior roles.
“All staff were committed to continually learning and improving services. They had a good understanding of quality improvement methods and the skills to use them.
“The trust has told us they have listened to our inspectors’ findings and its board knows what it must do to ensure it makes the necessary improvements. We will return in due course to check on the progress that they have made.”
The trust has been told it must make several improvements, including:
- Staff did not always support patients who lacked capacity to make their own decisions. In critical care and the emergency department at Ipswich Hospital staff were not consistently applying the Mental Capacity Act in relation to assessment and care of patients.
- Systems and processes to maintain cleanliness and control infection were not being implemented effectively.
- In critical care at Ipswich Hospital and urgent and emergency care at Colchester hospital, outcomes and recommendations from audits were not always used to improve services.
- In medical care, staff were not always completing nutrition and hydration risk assessments to ensure that patients had enough food and drink to meet their needs.
Inspectors witnessed areas of outstanding practice, including:
- Staff in urology were using new technology to carry out prostate urethral lifts. The procedure relieves urinary symptoms caused by an enlarged prostate. The new technology allows staff to perform minimally invasive surgery, resulting in fewer complications.
- The service had recently introduced a virtual fracture clinic. Patients were no longer required to attend the hospital for a fracture assessment. Instead, the patient’s x-ray and initial assessment documentation were reviewed virtually by an orthopaedic consultant and plaster technician.
- Consultants within urgent and emergency services dedicated their own time to provide training opportunities to medical and nursing staff on a regular basis. Staff described how valuable this training was.
Full details of the ratings, including a ratings grid, are given in the report published online at: www.cqc.org.uk/provider/RDE
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