Inspectors from the Care Quality Commission have found improvements for patients at Newham University Hospital in East London. But they have called for further improvements to protect the security of new-born babies.
The hospital in Plaistow, part of Barts Health NHS Trust, had previously been rated Inadequate by CQC. The trust was placed into special measures in 2015.
Following its latest inspection in November 2016, Newham University Hospital (NUH) has now been rated Requires Improvement overall.
In the latest inspection CQC carried out a focused unannounced inspection of five core services: Medicine (including older people’s care) and Surgery were both rated as Good, while Maternity & Gynaecology, End of Life Care and Services for Children were rated as Requires Improvement. A full report has will published at http://www.cqc.org.uk/location/R1HNH on Friday 28 April 2017.
At the previous inspection in May 2015, the security of babies in maternity services had been identified as a risk because of insufficient staff to monitor access to the unit. At the time of the most recent inspection, planned security measures had not been implemented and this remained a concern.
The trust must now take steps to ensure that plans to improve the security of babies in maternity services are implemented. It must also ensure further recruitment to providing sufficient number of appropriately skilled midwives to meet the needs of the service.
Insufficient consultant cover in maternity resulted in less than 50% of women in labour with a consultant present on the labour ward. Staff told inspectors this meant patients were waiting longer for pain relief and treatment.
Elsewhere, the trust must ensure that children and young people have adequate pain management when required.
The trust must also ensure that standards of cleanliness and hygiene are maintained in the mortuary and that it is managed properly. The trust must ensure there are systems in place to determine appropriate transfer of deceased patients in the event of a fridge breakdown.
However, inspectors did find a number of improvements, including:
- There was good compliance with infection control training on surgical wards.
- There were improvements in the number of maternity patients with management plans in their notes. Use of the modified early obstetric warning score (MEOWS) chart was at 97%.
- The hospital and community midwifery team worked proactively to support women to breastfeed and provided continuing support to women at home. The percentage of women breastfeeding remained high.
- On medical wards staff demonstrated consistent infection control practices in relation to hand washing, decontamination of the use of personal protective equipment and adherence to the bare below the elbow policy.
- There were business continuity and major incident plans in place. Senior staff were aware of the plans and were able to explain their roles in the event of an interruption to normal service.
- Risks to children and young people were assessed, monitored and managed on a day-to-day basis; and risk assessments were child-centred, proportionate and reviewed regularly.
The Chief Inspector of Hospitals, Professor Sir Mike Richards, said:
“I’m pleased that this inspection showed improvements in several areas. It’s disappointing, however, that our inspectors found the security risks surrounding maternity services at Newham University Hospital hadn’t yet been addressed."
“But there were some areas of very good practice. Staff took innovative steps to improve engagement with patients living with diabetes. For example, to improve the care of young people with diabetes, staff introduced remote video chat appointments. This reduced the number of wasted appointments and patients gave very positive feedback about the flexibility this affords them."
“Staff also introduced innovative measures to improve access and flow, particularly at a weekend. This included the implementation of consultant-led discharge ward rounds and a new patient flow coordinator post. In addition staff had negotiated 24-hour, seven-day-a-week access to a social worker that meant complex discharges could be planned outside of the previous Monday to Friday model.
“An overseas team provided dedicated support to patients cared for on an inpatient basis who had complex needs relating to immigration, asylum or refugee status."
“There was a clear, sustained focus on offering opportunities to student nurses and medical trainees. Feedback from site visits by sponsoring universities were consistently good.”
You can read the report in full on our website.
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