Chief Inspector of Hospitals recommends University Hospitals of Morecambe Bay NHS Foundation Trust should be placed into special measures

26 June 2014

England's Chief Inspector of Hospitals, Professor Sir Mike Richards, has recommended that University Hospitals of Morecambe Bay NHS Foundation Trust should be placed into special measures.

The trust has been rated as inadequate following an inspection in February under the new inspection regime introduced by the Care Quality Commission to provide a much more detailed picture of care in hospitals than ever before.

Inspectors acknowledged that care in some services, such as maternity and A&E, had improved since previous inspections, but in other areas despite previous concerns being raised by CQC, care had still not been addressed effectively.

Overall, the inspectors conclude that the quality of care provided by Furness General Hospital at Barrow in Furness and the Royal Lancaster Infirmary both required improvement, while the Westmorland General Hospital overall was providing a good service. Full reports of the inspection have been published on the CQC website and you can read them here: University Hospitals of Morecambe Bay NHS Foundation Trust.

The ratings reflect the fact that many services at the Royal Lancaster Infirmary and Furness General require improvement, with medical care in one part of the Royal Lancaster being of particular concern. At the Royal Lancaster Infirmary, inspectors found that despite recruiting additional staff there were still concerns about standards of care particularly on the medical wards.

Inspectors found that the trust lacked a clear vision for its staff. There were three distinct cultures across the hospital sites. The lack of clarity about the trust’s future left staff feeling disengaged and remote from the executive team and the board.

The Care Quality Commission has identified seven areas where the trust must improve:

• Staffing levels and skill mix in all clinical areas must be appropriate for the level of care provided.
• The trust must continue to actively recruit medical and specialist staff in areas where there are identified shortfalls.
• Nurses’ records on the medical wards must improve.
• All staff must be aware of their responsibilities to both report incidents and implement remedial action and learning as a result.
• The trust must ensure that appropriate action is taken in response to local  audits where poor practice is identified.
• Accurate and timely performance information must be used to monitor and improve performance in all clinical areas.
• Performance information must be consistently and systematically collected and collated in order to support service improvement.

The Chief Inspector of Hospitals, Professor Sir Mike Richards, said:

“There is a long history of concern with the quality of service provided by University Hospitals of Morecambe bay NHS Foundation Trust – so it is disappointing to report that a number of  the issues that have been identified in the past remain unresolved.

“I do not believe that the trust is likely to resolve its challenges  without external support. This is why I am recommending that the trust is placed in to special measures. I am looking to Monitor and the other organisations responsible for healthcare in the area to work together to support improvement.

“Despite the reorganisation of the trust's clinical services - we have found a lack of clarity about the trust's plans for the future that has left the staff feeling disengaged and remote from the executive team.

“I note that last year the trust made some progress in recruiting more staff - but the overall recruitment of nurses and doctors remains a fundamental concern, with too much reliance on temporary staff in a number of wards and departments.

“While many patients we met told us of good and compassionate care from committed and professional staff, it was clear that in medicine staff shortages meant care was not always provided at a good standard

Our review of patient safety incidents has shown how similar themes are repeated, and we found the trust’s own local audits identifying issues that were not then used to secure improvement or manage risks. The trust and partner agencies will be developing an action plan to address the identified shortfalls and my inspectors will return to the trust to follow up on improvements in due course."

An inspection team which included doctors, nurses, and hospital managers, trained members of the public, CQC inspectors and analysts spent three days at Furness General Hospital, Royal Lancaster Hospital and Westmorland General Hospital in February. They examined the care provided in accident and emergency, medical care (including older people’s care), surgery, intensive/critical care, maternity and family planning, children’s care, end of life care and outpatients. Inspectors also visited Royal Lancaster Infirmary and Furness General Hospital out of hours unannounced.

Ends

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