City Hospitals Sunderland NHS Foundation Trust rated as Good overall by Chief Inspector of Hospitals

England’s Chief Inspector of Hospitals has rated the services provided by City Hospitals Sunderland NHS Foundation Trust as Good overall following a Care Quality Commission inspection in September.

Trust services were rated as Good for being effective, caring, and well led, and as Requires Improvement for being safe and responsive.

CQC found that the trust had an established and stable senior leadership team, which staff said was visible and approachable. The majority of staff felt engaged and involved in the development of their services, and expressed pride in the person-centred care delivered. The trust had a clear vision and strategy for the future delivery of services.

All areas of the trust visited were clean, and there were good infection control procedures in place. Patients told inspectors that they were happy with the quality and quantity of food, and were able to access special diets if these were needed. Patients were provided with care in a compassionate way and were treated with dignity and respect.

Inspectors noted that there was effective communication and collaboration between multidisciplinary teams. The children and young people’s service had an outstanding leadership team, and regularly implemented innovative improvements. Critical care was compassionate and provided psychological and emotional support services for people after they had left the unit. The importance of patient and public feedback being heard and acted on was recognised across the trust.

Inspectors found, however, that there were staff shortages at Sunderland Royal Hospital. This was a particular problem on the medical wards, although the trust was actively recruiting to fill vacancies. There were no concerns about staffing levels or skill mix at Sunderland Eye Infirmary. Improvements were also needed at Sunderland Royal Hospital in medicines management and to the incident reporting and investigation process.

The full reports on the trust and on each hospital are available here.

Inspectors identified a number of areas of outstanding practice across the trust:

• Close collaborative working between paediatrics and emergency medicine, including shared medical consultants qualified in paediatric emergency medicine.
• An inspection of the paediatric service by a team of young service users which had taken place and had been facilitated by the paediatric team.
• The use of telehealth in maternity services to allow women to check their blood pressure and blood glucose levels at home in order to avoid unnecessary hospital visits.
• The compassion expressed to families by staff if their relative had died on the critical care unit.
• The enhanced recovery pathway for cataract surgery and role of the primary nurse at Sunderland Eye Infirmary, which were achieving good outcomes for patients

CQC also identified a number of areas where the trust had to make improvements, including ensuring that:

• There are sufficient qualified, skilled and experienced nursing staff on duty at all times at Sunderland Royal Hospital, especially on medical wards and in children’s services.
• Staff are suitably skilled and supported through completion of mandatory training and appraisals, especially in A&E at Sunderland Royal Hospital.
• Medicines are managed appropriately at all times at Sunderland Royal Hospital, with appropriate pharmacist support to wards and units.
• Patients at Sunderland Royal Hospital are placed on the most appropriate wards to meet their clinical needs.
• A&E at Sunderland Royal Hospital fully complies with the four hour wait target and the 15 minute handover time for patients arriving by ambulance.
• Incidents are investigated, graded and reported appropriately to ensure that lessons can be learnt to improve the safety and quality of services.

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

“When we inspected the hospitals run by City Hospitals Sunderland NHS Foundation Trust, much of what we saw was good.

“We saw that staff took great pride in their work, and that they felt the leadership team were approachable. Teams communicated well with each other, and we saw some good examples of collaborative working to improve the treatment and care people received.

“We did, however, also see a number of areas where the trust needed to make improvements. If the trust listens to what we have said – which they have told us they will – I can see no reason why they should not be able to receive a Good rating (or better) across the board when we next return.

“People are entitled to receive treatment and care in services which are consistently safe, effective, caring and responsive to their needs. The trust has told us they have listened to our inspectors’ findings and begun to take action where it is required. We will return in due course to check that the improvements needed have been made.”

The inspection team, which included doctors, nurses, hospital managers, trained members of the public, CQC inspectors and analysts, visited the hospitals over a period of four days. They also made unannounced visits as part of the inspection.

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