The Care Quality Commission (CQC) has rated the services provided by Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust to be Good following its latest inspection.
A team of inspectors visited the trust from 3 September to 10 October 2019 to assess four core services across Doncaster Royal Infirmary, Bassetlaw District General Hospital, Montagu Hospital and Retford Hospital. These were: urgent and emergency, maternity, outpatients and diagnostics. Inspectors also looked specifically at management and leadership to answer the key question: is the trust well-led?
When the trust was inspected in December 2017 and January 2018 it was rated as Requires Improvement overall. During CQC’s latest inspection, a number of improvements were found. The rating for whether the trust’s services are effective has improved to Good, while the trust maintained its ratings of Good for whether its services were caring, responsive and well-led. The trust is rated as Requires Improvement for whether its services are safe.
Ann Ford, Deputy Chief Inspector of Hospitals, said:
“At our latest inspection we found improvements in urgent and emergency services at Doncaster Royal Infirmary and Bassetlaw District General Hospital, however whilst some improvements had been made in maternity services, staffing remained a concern. We also found some outstanding practices. Due to the improvements, the trust and all its hospital sites are now rated Good overall.
“We found the trust’s leadership team to be knowledgeable and experienced, and understood the priorities and challenges it faced. There was a clear vision for the future coupled with a strategy focusing on patient safety and the sustainability of services. Whilst there was some confusion amongst staff regarding their roles and accountabilities, work was underway to address this. Work was also underway to strengthen the governance processes and leaders were openly engaging with staff and patients to improve care.
“Some further improvements are required, particularly in relation to staffing shortages in some core services and in the uptake of mandatory training. However, the trust should be proud of the improvements it has made to achieve a Good overall rating.”
Inspectors found the trust had acted positively to many of the concerns identified at the previous inspection. In urgent and emergency care services, paediatric staffing had improved and patients inspectors spoke with said they had a positive experience. There was strong collaborative team working between healthcare professionals across the trust, to benefit patient care. People were treated with compassion and kindness, and staff took into account peoples’ individual needs and supported them to make their own decisions about their care.
Outpatient services were inspected for the first time and found there were enough skilled and qualified staff to support people. Staff were supported by effective leadership to deliver high-quality care, and were able to quickly respond to patients that risked deterioration. Leadership of the trust had a vision and strategy focused on patient safety, it was aligned to the priorities of the local healthcare economy. Leaders and staff knew how to monitor the application of the strategy in order to assess the effectiveness of its progress.
However, compliance for mandatory and safeguarding training was low across staff groups, particularly medical staff, and was a continued concern from the previous inspection. There were staff shortages in maternity and diagnostic services and inspectors were concerned about the out of hours cover at Doncaster Royal Infirmary’s and Bassetlaw District General Hospital’s urgent and emergency service. Montagu Hospital’s minor injuries unit did not operate a triage system and patients were required to wait for treatment in chronological order, in contradiction of national guidance.
CQC has also published the trust’s Use of Resources (UoR) report, which is based on an assessment undertaken by NHS Improvement. The trust has been rated as Good for using its resources productively. The combined rating for the trust, taking into account CQC’s inspection for the quality of services and NHSI’s assessment of Use of Resources, is Good.
A full report of the inspection will be published on the CQC website: www.cqc.org.uk/provider/RP5
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For further information please contact CQC Regional Engagement Officer Mark Humphreys mark.humphreys@cqc.org.uk 01912011675 / 07384 902 623 or Louise Grifferty Louise.Grifferty@cqc.org.uk, Regional Engagement Manager, on 07717 422917.
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