Chief Inspector of Hospitals recommends Northern Lincolnshire and Goole NHS Foundation Trust is taken out of special measures with continuing support

England’s Chief Inspector of Hospitals has recommended that Northern Lincolnshire and Goole NHS Foundation Trust should be taken out of special measures following a full inspection by the Care Quality Commission.

Professor Sir Mike Richards and his inspectors found that sufficient progress had been made to justify the recommendation to NHS Regulator Monitor - although the trust will receive ongoing support to ensure that its performance continues to improve.

Northern Lincolnshire and Goole NHS Foundation Trust had been put into special measures in July 2013 following the Keogh Review into hospitals with higher than average mortality rates.

Reports which are published today show the trust has made significant improvements in a number of areas, although inspectors conclude that of the trust’s three main hospitals, Diana Princess of Wales, Scunthorpe General Hospital are rated “requires improvement” and Goole and District Hospital is rated “good.”

The hospitals were inspected by CQC in April and May under its new inspection regime. The inspection team which included doctors, nurses, midwives, hospital managers, trained members of the public, a variety of specialists, CQC inspectors and analysts spent three days at the trust in April and May.

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.

The Chief Inspector, Professor Sir Mike Richards, said: “It is clear that Northern Lincolnshire and Goole NHS Foundation Trust has worked hard to improve since being placed in special measures last year.

"The trust has made real progress to meet the requirements of the Keogh Review, with the way that it is led changing significantly. Staff told us the culture of the trust was changing and this was backed up by what we saw, an engaged workforce who were increasingly proud of where they worked.

“While there are signs that this trust is improving, a number of these improvements are new and need time to become fully ingrained in the service. The trust still needs to take action to make sure that people using its services receive good quality treatment and care all the time.

“Special measures are designed to provide intensive support to struggling trusts and Northern Lincolnshire and Goole NHS Foundation Trust has clearly gained from this support. There is no doubt that the trust is heading in the right direction and will continue to benefit from the ongoing support from Monitor as they come out of special measures. We will return in time to check that the improvements we have identified on this inspection have been made.”

Overall, inspectors found that in parts of the trust safety needed to improve particularly in critical care at Diana, Princess of Wales Hospital which was rated as inadequate. Patients were generally positive about their experience, and the inspection team found staff to be kind and caring.

The trust has been told that it must make improvements in 21 areas, including:

• Ensure that there are sufficient qualified, skilled and experienced staff, particularly in A&E, medical and surgical wards. This is to include provision of staff out of hours, bank holidays and weekends.
• Review the skills and experience of staff working with children in the A&E to meet national recommendations.
• Review the consistency of care and level of consultant input, particularly out of hours and at weekends in the High Dependency Unit at Diana Princess of Wales Hospital.
• Ensure that the Intensive Therapy Unit uses nationally-recognised best-practice guidance in terms of consultant wards rounds and reviewing admissions to the unit and review delayed discharges from Intensive Therapy Unit in terms of the negative impact this can have on patients.
• Review the environment and lay out of the accident and emergency department at Scunthorpe General Hospital so that it can meet the needs of children and patients with mental health needs.
• Ensure that all staff attend and complete mandatory training, particularly for safeguarding children and resuscitation.
• Review the effectiveness of handovers, particularly in the medical services.

The inspection team identified two particular areas of good practice:

• The maternity service at Scunthorpe General Hospital had won a national award for promoting a natural birth experience. A midwifery-led vaginal birth after caesarean section clinic had been introduced which worked with women who had a previous caesarean section. This meant that women were given increased opportunities to have a natural birth.
• The facilities team received the National Annual Hospital Estates and Facilities Management Association Team of the Year Award, with the Hotel Services Manager being awarded Project Manager of the Year for improving patient and staff experience. This included the creation of a multi-skilled role – ward caterer, ward domestic and nursing support.

The Care Quality Commission has already presented its findings to a local Quality Summit, including NHS commissioners, providers, regulators and other public bodies. The purpose of the Quality Summit is to develop a plan of action and recommendations based on the inspection team’s findings.

Ends

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