England's Chief Inspector of Hospitals has recommended that The Princess Alexandra Hospital NHS 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 June 2016.
Between 5 and 7 December 2017 CQC returned and inspected six of the trusts core services. These services included urgent and emergency care, medicine, surgery, critical care, children and young people’s services and end of life care.
Inspectors found that, while further work was needed, a number of improvements had been made at the trust. As a result, it is now rated as Requires Improvement overall and Professor Ted Baker is recommending the trust now exits special measures.
Professor Ted Baker, CQC’s Chief Inspector of Hospitals, said:
“Our return to The Princess Alexandra Hospital NHS Trust showed significant improvement had taken place. This is reflected in the trust’s new rating - which has improved from Inadequate to Requires Improvement overall - and our recommendation to NHS Improvement that the trust now comes out of special measures."
“Our inspectors found a dedicated staff at the trust who had worked hard to ensure improvements were made. They also witnessed a number of areas of outstanding care, particularly in the children and young people’s service, all of which was fantastic to see."
“As a result a number of ratings for the trust’s services and in the key questions CQC asks when it carries out its inspections have changed. While the trust’s overall rating has improved, how effective and well-led the trust’s services also improved to be rated as Good overall. Previously we rated whether the trust was well-led as Inadequate overall, while the rating for whether services were effective was Requires Improvement."
“We also saw improvements in the ratings for end of life care, critical care and urgent and emergency services."
“However, this trust has to ensure it continues and consolidates this work and makes further changes so that people receive the care they should be able to expect. We have given feedback to the trust on where it needs to make improvements and we will return to check on its progress. The trust’s staff and leadership should be proud of their achievement so far and they know what they must do to ensure any remaining improvements are made.”
Inspectors found examples of outstanding practice at the trust, notably in children and young people’s service. This included the neonatal unit (NNU) which had recently implemented a project to improve nurse-led discharges in straightforward and low risk cases, which meant nursing staff didn’t have to wait for a doctor to approve patient discharge.
The critical care unit had implemented a secure medication return bin, which meant staff could return any unused medicines to the pharmacy for recycling or disposal. In the first month of use the bin saved the hospital £1,200 by recycling unused medicines.
However, the trust has been told it must make a number of improvements. This includes that the trust must ensure mandatory training improves to meet the trust’s target of 95% and that staff annual appraisal completion rates improve.
Fridge temperatures in urgent and emergency services must be consistently monitored, and any concerns surrounding this are acted upon. Medical records must contain a complete contemporaneous record for each patient and appropriate risk assessments must be completed and documented.
Patients arriving by ambulance to the emergency department must be appropriately assessed and triaged in a timely manner and the trust must take action to address mixed gender accommodation breaches in the critical care unit.
In the children and young people’s service, the trust needed to ensure it met the Royal College of Nursing (RCN) requirements to ensure enough staff, with the correct competencies, were available to provide care on Dolphin ward.
Paediatric life support training needed to improve to ensure staff had the required knowledge and competencies to recognise and respond to patients at risk.
In end of life care the trust needed to review ‘do not attempt cardio-pulmonary resuscitation’ (DNACPR) forms to ensure they were completed fully and in line with trust policy and national guidance.
The Princess Alexandra Hospital NHS Trust is rated Requires Improvement overall as well as for whether its services are safe and responsive. It is rated as Good for whether services are caring, effective and well-led overall.
Full details of CQC’s inspection, its ratings for the trust, including a ratings grid, are given in the report published on our website.
Ends
For further information, please contact Louise Grifferty on 07717 422917.
Journalists wishing to speak to the press office outside of office hours can find out how to contact the team here.
Please note: the press office is unable to advise members of the public on health or social care matters. For general enquiries, please call 03000 61 61 61.
The trust’s staff and leadership should be proud of their achievement
The Chief Inspector of Hospitals, Professor Ted Baker