The Chief Inspector of Hospitals has found that surgery provided by North Cumbria University Hospitals NHS Trust is safe and well led, following an inspection by the Care Quality Commission.
A team of inspectors visited the trust’s two main hospitals, the Cumberland Infirmary, Carlisle and the West Cumberland Hospital, Whitehaven during September to review measures taken by the trust after a series of ‘never events&rsquo between June 2015 and February 2016. These had raised concerns about the lack of compliance in surgery with the completion of safety checks and procedures within theatres.
At the same time inspectors also reviewed services for children and young people, where a shortage of doctors, particularly at consultant level, was highlighted at the trust’s previous inspection in 2015.
Full reports of the inspection are published today.
The Chief Inspector of Hospitals, Professor Sir Mike Richards said
“Since our last inspection, there were six never events – patient safety incidents that are wholly avoidable. The trust responded by introducing a quality improvement plan covering procedures before, during and after operations.
“Although this new system is still in its early days, I am glad to report that there have been no further never events. In general the surgery division appears to have good systems and processes in place to protect patients and maintain safety. At both hospitals we found that staff understood the process for reporting and investigating incidents.
“The difficulties in the recruitment and retention of appropriate staff has clearly been recognised by the trust. This remains a real concern at both the Cumberland Infirmary where nursing staff told us they were often exhausted from working extra hours, and at West Cumberland Hospital where there is a shortage of senior doctors.
“We have again identified some areas of poor practice where the trust must continue to make improvements. Our inspectors will visit the trust again on the 6 December to conduct a further inspection covering all services, and we will report back on the trust’s progress.”
Inspectors found surgical services at both hospital were safe, although patients who should have been on the medical wards were being cared for on the surgical wards.
At the Cumberland Infirmary inspectors found large numbers of shifts understaffed. Staff morale had been affected, with some staff reporting they felt exhausted and burnt out. Although staff were worried that this may affect patient care, the inspectors did not find evidence to support this.
At the West Cumberland Hospital. some individuals had been working under extreme pressures for some time to cover shifts. The role of nurse practitioners had been developed to make up for the shortfall in junior doctors
In Children’s and Young People’s Services there was a full complement of consultants in post at the Cumberland Infirmary, although the unit did not meet standards set by the Royal College of Paediatric and Child Health which covers areas such as consultant presence, time to consultant review and consultant led handovers.
Unit managers were considering a variety of options to bolster nurse staffing numbers and train staff. This included further recruitment adverts, internal promotion with backfill of more junior posts, training staff up to become advanced nurse practitioners.
At the West Cumberland Hospital, some senior consultants’ posts were filled by locums. Although staff were passionate about their work, some were concerned about proposals being considered to remodel the service.
The report includes a number of areas where the trust must make improvements:
- At the Cumberland Infirmary. the trust must ensure ward rotas within surgery services are staffed to establishment in line with the needs of patients.
- At the Cumberland Infirmary nurse staffing levels within services for children and young people must adhere to establishment and meet recognised national standards.
- At both hospitals, the trust must ensure children and young people services meet standards for acute services set by the Royal College of Paediatrics and Child Health.
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