CQC requires improvement at Bradford Teaching Hospitals NHS Foundation Trust

8 January 2014

The Care Quality Commission has told Bradford Teaching Hospitals NHS Foundation Trust that it must make improvements to comply with national standards of quality and safety.

This follows an unannounced one day inspection at Bradford Royal Infirmary in September 2013, and an unannounced four day inspection which took place in October 2013.

The CQC’s inspection report, which is published today, identifies that the Trust was failing to meet four of the six national standards reviewed. 

Most significantly CQC found staff shortages across a number of wards and departments particularly in the Accident and Emergency Department (AED). There were also concerns in relation to staffing skill mix in some areas. The inspectors  raised concerns that this was impacting directly on the Trust’s ability to provide safe and effective care that fully met patient’s needs. 

Areas of concern included:

• Delays in triage (the process of assessing and prioritising people's injuries/illness) for patients attending  the  AED due to insufficient staff numbers, and delays in moving people out of the department 
• A shortage of senior level medical staff cover in the AED, particularly during the early hours of the morning. There was also a shortfall of medical consultant doctors on the Medical Admissions Unit (MAU).
• The AED was overcrowded during busy periods and this meant that patients being attended to were afforded limited privacy.
• Care records on one elderly care ward in particular were basic and did not demonstrate clearly that patients’ individual needs were adequately assessed and supported.
• Inspectors identified concerns regarding the Trust’s governance and noted delays by the Executive Team in addressing problems such as staffing and patient flow in a responsive manner.
• On the MAU, an eight bedded trolley bay area designed to manage patients with moderate to low risk, was at times being used to place acutely unwell patients due to limited available bed space.
• Inspectors also observed occasions where nursing staff did not communicate with patients in an appropriate or respectful way.

As a result of the inspection, CQC has issued a formal warning to the Trust, requiring improvements in relation to staffing. We have also told the Trust that action is  required to address shortfalls against national standards relating to respect and involvement of people who use services; care and welfare and assessing and monitoring the quality of service provision.

Inspectors will return, unannounced, to check that the necessary improvements have been made.

Malcolm Bower-Brown, CQC’s Regional Director for the North said:   

“The issues we identified at the Bradford Royal Infirmary are unacceptable and the Trust must take further action to ensure national standards are met. 

“We have warned the Trust that improvements must be made and we continue to monitor the situation closely, to ensure that patients receive the service they are entitled to expect".

Any regulatory decision that CQC takes is open to challenge by a registered person through a variety of internal and external appeal processes.

Ends

For further information please contact the CQC Regional Communications Team, David Fryer 07901 514 220 or Kirstin Hannaford 0191 233 3629.

For further information please contact the CQC press office on 0207 448 9401 or out of hours on 07917 232 143.

Notes to editors

We have published a full report at Bradford Royal Infirmary.

Inspectors found that the Bradford Teaching Hospital NHS Foundation Trust was failing to meet four standards:

• Care and welfare of service users
• Respecting and involving people who use services
• Staffing
• Assessing and monitoring the quality of service provision