England’s Chief Inspector of Hospitals has rated the services provided by Southend University Hospital NHS Foundation Trust as Requires Improvement following an inspection by the Care Quality Commission.
Between 21 November and 14 December 2017, a team of CQC inspectors visited core services at the trust including urgent and emergency care, medical care, surgery, children and young people’s services, end of life care and outpatient services.
Inspectors rated the care provided to be Good regarding whether services were caring, effective and well-led. It is rated as Requires Improvement regarding whether services are safe and responsive.
The trust was rated as Requires Improvement following a comprehensive inspection in January 2016. Inspectors carried out a further responsive inspection in February 2017.
The trust provides acute services from its main Southend Hospital site and outlying clinics across Southend-on-Sea, Castle Point and Rochford.
Chief Inspector of Hospitals, Professor Ted Baker, said:
“On our return to Southend University Hospital NHS Foundation Trust we found a number of improvements had been made. However, some of these changes were yet to be embedded and there remain areas where further work is needed.
“At this inspection we did not inspect critical care or maternity services but we found further work was needed with regard to medical services. The means the overall rating for whether the trust’s services are safe remains Requires Improvement.
“And, due to a declining performance in referral to treatment times in surgery, the rating for whether the trust’s services are Responsive remains the same.
“However, we found a number of improvements in urgent and emergency care, services for children and young people and end of life care, across which a number of ratings have changed for the better.
“Across the trust we found caring staff who worked together to meet patients’ needs, deliver treatment competently and who treated patients with dignity and respect.
“While we found improvements had been made at the trust, and saw a number of areas of outstanding practice, the trust needs to ensure improvements are embedded and sustained. That is why the trust’s overall rating remains as Requires Improvement overall.
“We have reported our findings to the trust leadership, which knows what it must do to bring about further improvements and ensure it maintains any already made. We will return to check on the trust’s progress.”
CQC’s inspection highlighted a number of areas of outstanding practice, including the emergency department’s (ED) mobile rapid assessment and treatment team that moved around the department, rather than being in a fixed area, which helped to improve the flow of patients through the department.
In medical care services, the stroke unit had developed a seven day trans-ischaemic attack (TIA) clinic which could be accessed within 24 hours. The clinic supported GPs to make urgent referrals and provided an online triage tool for GPs to help prioritise more urgent cases.
Staff in the surgery team were part of a national network developed to promote best practice in management of sepsis. And, in end of life care services, inspectors found staff went ‘the extra mile’ for patients and their loved ones. Several wedding ceremonies were coordinated by staff to bring comfort and love to a patient’s last days, birthday cards were given to patients while in hospital and concessionary car parking and accommodation were made available for families.
Meanwhile, the trust must make a number of improvements including that mandatory training rates and attendance improve to ensure all staff are aware of current practice and legislation.
The trust must ensure complaints are handled in line with trust policy and in a timely manner to identify areas for improvement and provide feedback to patients and the public.
Plans for improvements to the mortuary must continue to progress and the trust must ensure processes and systems to improve performance in referral to treatment (RTT) times continue to develop to improve access for patients, specifically in relation to surgery, and outpatients.
Full details of the ratings, including a ratings grid, are given in the report.
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While we found improvements had been made at the trust, and saw a number of areas of outstanding practice, the trust needs to ensure improvements are embedded and sustained.
Chief Inspector of Hospitals, Professor Ted Baker