England’s Chief Inspector of Hospitals has rated the services provided by North Tees and Hartlepool NHS Foundation Trust as Good overall following an inspection by the Care Quality Commission. The trust rating has improved from Requires Improvement.
A team of inspectors inspected urgent and emergency care, medical care (including older people’s care), and maternity care at the University Hospital of North Tees and University Hospital of Hartlepool between during November 2017. These services were inspected because they were considered to be risk areas based on our ongoing monitoring of services.
The rating for safety stayed the same. It was rated it as Good because incidents were investigated and managed appropriately and inspectors saw evidence of learning following incidents. There were robust systems in place to manage staffing shortfalls which helped maintain safe patient care. Additionally, nurse documentation had been radically changed since the last inspection, to better assess and plan care.
The rating for effectiveness improved from Requires Improvement to Good. There was evidence of good multidisciplinary working, seven day services and some health promotion - such as access to drug and alcohol dependency support services. Pain was reviewed effectively - mechanisms were in place to ensure that patients did not remain in pain.
Caring stayed the same at Good. Staff were kind, caring and compassionate and had a good understanding of the needs of patients. Inspectors observed staff go the extra mile in urgent and emergency services several times and their care and support exceeded good care standards. The caring relationships were highly valued by staff and promoted by the matron. Patients and their relatives said that they were involved in planning their care and that communication with staff was good and inspectors saw that staff recognised the importance of the emotional needs of patients.
Responsiveness stayed the same at Good. Since the last inspection access and flow across the trust had improved. The accident and emergency department had consistently performed better than the England average and there were good discharge planning processes in place across the trust. Inspectors saw a proactive approach to understanding the needs and preferences of different groups of people including those with protected characteristics under the Equality Act and vulnerable people with complex needs.
In respect of well-led, the overall rating improved to Good. Inspectors could see that leaders at every level were visible and approachable. Morale across services was generally good and staff described good teamwork across the wards. There were processes to support staff and promote their positive wellbeing.
At trust level, inspectors did find that there was low compliance in some mandatory training modules in some of the services inspected. Additionally, they also noted there were risks in the emergency department to patients with mental health needs.
At both hospital sites, the trust’s overall rating improved from Requires Improvement to Good.
At the University Hospital of North Tees maternity services improved. Inspectors found the proactive work of the maternity training team to be an outstanding feature. The training lead undertook emergency obstetric scenarios in different directorates, as part of their training programme.
At the University Hospital of Hartlepool, the rating of services improved overall because maternity services had improved. However there are challenges at Hartlepool with a need for better access times to antenatal services.
Ellen Armistead, Deputy Chief Inspector, Hospitals for the North, said:
“Since our last inspection at North Tees and Hartlepool NHS Foundation Trust, in July 2015, the rating for the trust has improved from Requires Improvement to Good. This represents very good progress, the trust are to be congratulated for their dedication and hard work."
“Inspectors observed outstanding examples of care. Staff showed determination and creativity to overcome obstacles to delivering care for vulnerable people and those with additional needs. We witnessed medical professionals going above and beyond the call of duty."
“At trust board level the executive team had the experience, capability and integrity to ensure that strategy could be delivered and risks to performance addressed. They were knowledgeable about issues and priorities for the quality and sustainability of services, understood the challenges and were taking action to address them."
“The trust has demonstrated that it can address areas that need improvement. It is clear the trust has the vision and leadership to sustain its improvement and I look forward to seeing further progress at the next inspection.”
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This represents very good progress, the trust are to be congratulated for their dedication and hard work
Ellen Armistead, Deputy Chief Inspector of Hospitals