Hull and East Yorkshire Hospitals NHS Trust has been rated Requires Improvement following an inspection by the Care Quality Commission (CQC) in June and July 2016.
The trust was rated Good for whether its services were caring and Requires Improvement for whether its services were safe effective, responsive and well-led.
The trust’s two hospitals, Hull Royal Infirmary and Castle Hill Hospital, were both rated as Requires Improvement.
The inspection looked at all eight core services at Hull Royal Infirmary and the five that were provided at Castle Hill Hospital. Inspectors also visited the minor injuries service operated by the trust at the East Riding Community Hospital and outpatient services at the Westbourne NHS Centre.
CQC’s Chief Inspector of Hospitals, Professor Sir Mike Richards, said:
“The trust had made a number of improvements since our last inspection but these were not significant enough to change its rating. Considerable improvements had been made in some areas. We especially found this to be the case in the emergency department (A&E) which was now rated as Good. Medical care, surgery and children’s services had also improved."
“The care of patients within the emergency department had significantly improved since the last inspection. At the time of the inspection the trust was meeting locally agreed targets for the number of patients seen within four hours but it was still breaching the national standard."
“Before we inspected in June and July 2016 the trust had identified a backlog of 30,000 patient appointments. This sometimes led to delays in diagnosis and some incidents of harm to patients. However, we saw the trust had implemented a process to reduce the likelihood of this happening again."
“At our inspection in May 2015 we saw there was no overall long term vision and strategy for the trust. On our return it was evident leadership had improved, there was a clear vision and strategy for the trust, with a plan for its delivery, we found staff were engaged and there was evidence of good teamwork.
“We have highlighted the areas where the trust needs to make further change. The trust leadership knows what it needs to do to bring about improvement and our inspectors will return to check on its progress.”
Inspectors found several areas where the trust must make improvements including:
- Care planning and delivery must meet national accident and emergency department standards so that referral to treatment times are met and any backlogs in patients waiting follow up appointments are eliminated.
- Staff must be knowledgeable about when to escalate care for deteriorating patients to ensure people receive timely and appropriate treatment. Escalation procedures must also be audited to ensure they are effective.
- Staff must be suitably skilled, competent and experienced to provide safe care and treatment for children with mental health needs and patients requiring critical care services.
- Staff must complete risk assessments and take action to mitigate any risks to patients, in particular with regard to risk assessments for falls and children with mental health concerns.
Inspectors also witnessed several areas of outstanding practice across the trust, including:
- The urology service had introduced robotic surgery for prostate cancer and colorectal surgery.
- The perinatal mental health team and midwifery team had been shortlisted for the Royal College of Midwives Annual Midwifery Awards 2016, for effective partnership working in supporting women with perinatal mental health.
- The International Glaucoma Association had awarded the ophthalmology department an innovation award for its glaucoma monitoring work.
- The breast care unit used digital tomosynthesis, a three-dimensional imaging system, which is considered more accurate than other methods of scanning and significantly improves the detection of breast cancer. The unit also carried out vacuum assisted biopsies, a single procedure, which avoids the need for patients to have multiple biopsies and significantly reduces stress and anxiety for patients
Full reports, including the latest ratings of all core services, have been published on our website.
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