Chief Inspector of Hospitals recommends Cambridge University Hospitals NHS Foundation Trust comes out of special measures following improvements in care

England's Chief Inspector of Hospitals has recommended that Cambridge University Hospitals NHS Foundation Trust exits special measures following a Care Quality Commission inspection.

The trust was rated Inadequate overall and placed into special measures following an inspection in April 2015. A focused inspection in February 2016, to check on progress at the trust, found a number of improvements had been made and when inspectors returned again in September 2016, they found the trust had made further and significant improvements. As a result the trust is now rated as Good overall.

During the most recent inspection CQC found considerable progress had been made across the trust; which includes Addenbrooke’s and The Rosie hospitals. There were a number of areas of outstanding practice and it was clear that staff and the trust leadership had worked hard to ensure improvement took place.

While the majority of CQC’s findings reflected the positive change that had taken place at the trust, there were some areas where further work was needed.

However, the work the board and senior management had done was seen to be making a very significant difference and, as a result, Professor Sir Mike Richards is recommending the trust now exits special measures.

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

“Our return to Cambridge University Hospitals NHS Foundation Trust showed very significant improvement had taken place. This is reflected in the trust’s new rating - which has improved from ‘Inadequate’ to ‘Good’ - and our recommendation to NHS Improvement that the trust now comes out of special measures.

“Senior staff at the trust described being placed in special measures as “a wake up call” which prompted an increased focus on relationships and communication between hospital staff and the senior team; the resulting improvements were evident in our inspection and in conversations we had with staff, who reported a more positive culture within the trust.

“The inspection found improvement in the quality and safety of services. There had been an increase in permanent staffing levels, resulting in low levels of agency nurses being used across the trust, and a system of monitoring allowed senior managers and clinical staff to adjust staffing levels to meet patients’ needs. Governance systems had been revised which ensured robust information was available for the senior team. Many of the concerns our inspectors identified at previous inspections had been addressed.

“Staff were very caring, there was an open culture at the trust, staff reported incidents and there was increased evidence of learning from incidents. Staff spoke positively about local management and patients spoke highly of the care they received.

“Significant improvements had been made in reducing the number of patients waiting for outpatient appointments, but more work was needed to further reduce appointment waiting lists.

“The trust’s staff and leadership should be proud of their achievement so far and they know what they must do to ensure those remaining improvements are made. We will continue to monitor the trust and this will include further inspections.”

Inspectors found examples of outstanding practice at the trust, including:

• A ward which ran weekly ‘music and movement’ classes to help meet the holistic needs of patients during their recovery. Staff encouraged patients and their relatives to attend and this received excellent feedback.
• The teenage cancer unit provided outstanding facilities for young people receiving cancer treatment.
• The emergency department team had developed a mobile phone app called ‘Choose Well’ which offered guidance on waiting times and hospital services across Cambridge, to improve patients’ experience.
• The emergency department secured £100,000 funding from the Small Business Research Initiative (SBRI) to support the development of a crowd prediction modelling tool, so the trust could understand and map patient flow through the department.
• An initiative for ‘Family Facetime’ proposed the purchase of two tablets to enable mums, who are too unwell to visit their baby on the neonatal intensive care unit, to see their child on video through Facetime.

However, there were areas where the trust must make improvements, including:

• Medicines, including controlled medicines, must be securely stored at all times.
• End of life care must be properly audited (such as preferred place of death and DNACPR) and action must be taken in response to those audits.
• Complaints must be responded to in a timely way.
• Resuscitation decisions must be documented legibly and completed fully in accordance with the trust’s policy and the Mental Capacity Act 2005.

Cambridge University Hospitals NHS Foundation Trust is rated Good overall, Good for being safe, effective and well-led, Requires Improvement for being responsive and Outstanding for being caring.

Ends

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