CQC find significant improvement at Tameside Hospital

England's Chief Inspector of Hospitals has recommended that Tameside Hospital NHS Foundation Trust at Ashton-under-Lyne, Greater Manchester, should come out of special measures following its latest inspection by the Care Quality Commission.

Inspectors found that Tameside General Hospital had made significant progress to improve, particularly in critical care services which had previously been rated Inadequate, and also in dealing with governance and patient complaints.

The trust had been placed into special measures two years ago after concerns were raised about mortality rates, care of emergency and deteriorating patients, staffing levels, patient experience and leadership.

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

"I am satisfied that Tameside Hospital NHS Foundation Trust has made considerable progress in those areas where we had concerns last year, which is why I am pleased to recommend to Monitor that the trust should come out of special measures.

"The trust has been going through a period of significant change. On our most recent inspection we have seen for ourselves that there is now a stronger culture which is committed to putting patients and safety first.

“The senior management team has led this programme of change, taking care to involve staff to ensure that this improvement is sustained. This is a credit to all the staff; we found them to be a highly dedicated workforce, committed to caring for their patients.

"There is still much to be done. I am particularly concerned that patient flow through the hospital appears to be putting continual pressure on beds, and overall the trust is not yet as safe, effective or responsive as it should be. But we can see that the trust has the systems in place to support this improvement and it is our view this is entirely within the trust’s grasp.

“We will continue to monitor Tameside Hospital. Our inspectors will return in due course to check that it has continued to make progress."

The trust was placed into special measures by Monitor following a recommendation by Sir Bruce Keogh in July 2013. After a further inspection last year rated the trust as Inadequate, Sir Mike recommended that it should remain in special measures.

Following the latest inspection, in April, the trust has now been rated as Requires Improvement overall. The trust has been rated Good for being well led, and Good for caring. The full reports and ratings are available at www.cqc.org.uk/provider/RMP.

In 2014, CQC had been specifically concerned about the critical care services, medical care, surgical and outpatient services. This year inspectors found there had been significant improvements in each of these areas.

In critical care, staffing levels now met patients’ needs, patient safety was monitored and incidents were investigated and shared with staff to assist learning and improve care. Patients received care and treatment by staff working well together in multidisciplinary teams with a visible leadership. Inspectors found staff were enthusiastic about changes taking place.

In medical care, inspectors found that all staff contributed to systems to manage and monitor safety, with an improved culture encouraging them to report mistakes and incidents openly. Staffing levels had been reviewed and improved. While patient flow through the hospital was better, too many patients were still transferred during the night and some could not be accommodated on appropriate wards.

In surgery, patient safety was being monitored and incidents were investigated to assist learning and improve care. While outcomes were positive for most patients, too many operations had been cancelled, although there were plans to improve theatre capacity to reduce waiting times and meet standards.

In the outpatients department, there had been an increased in nursing staff, resulting in more clinics being available. There was now better management of the waiting lists and improved communication with patients.

The emergency department was failing to meet many of the national access targets, although the trust was working closely with commissioners and other agencies to improve flow through the department. In some areas, inspectors noted a number of omissions in records of controlled medicines.

CQC has told the trust it must make improvements in a number of areas:

The trust must ensure that it has enough doctors to meet the needs of patients at all times including out of hours.

Patient flow must improve throughout the hospital to reduce the number of patients transferred at night and ensure timely access to the service best suited to meet the patient’s needs, particularly in A&E and medical care services.

There must be improvements in completion levels of mandatory training and appraisals for nursing and medical staff.

Medicines, particularly controlled drugs must be stored, checked and disposed of in line with best practice, particularly in A&E and outpatients.

Ends

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