Portsmouth Hospital NHS Trust rated Requires Improvement by CQC

Published: 9 August 2018 Page last updated: 9 August 2018
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England’s Chief Inspector of Hospitals has told Portsmouth Hospital NHS Trust that further improvements are required following an inspection by the Care Quality Commission.

In April and May 2018 inspectors carried out a comprehensive inspection of all nine core services at the Queen Alexandra Hospital. These were: medicine, outpatients, diagnostics, maternity, children and young people, critical care and end of life care, surgery and urgent and emergency care. CQC also looked specifically at management and leadership to answer the key question: Is the trust well led?

At the trust’s last comprehensive inspection in February 2015 it was rated as Requires Improvement. At this inspection it was rated as Requires Improvement for being safe, effective, responsive and well led and the overall rating is unchanged at Requires Improvement. CQC found that some areas had improved, some had stayed the same and others had deteriorated. But inspectors found that the new leadership team was tackling the challenges with compassion and energy.

Professor Ted Baker, CQC’s Chief Inspector of Hospitals, said:

“Although the overall rating for Portsmouth Hospital NHS Trust remains Requires Improvement, I am pleased to report that there were signs of change across the organisation. Staff also reported this new approach and ‘hope’ for the future and that there was momentum for change.

“The board understood the importance of this new positive culture that supported and valued staff, and some work had begun to address the immediate cultural issues. However, further work is required to implement and sustain cultural change across the organisation.

“The critical care team remain consistent in their approach and reflected the new culture providing an outstanding service and were rated accordingly.

“However, it is concerning to note that within both medical and urgent and emergency care staff were not always involving patients and those close to them in decisions about their care and treatment or treating them with compassion.

“With regard to the caring rating, we found wide variation across the trust, with outstanding for caring in services for children and young people and critical care, and five services rated Good in this area. But in medical care and urgent and emergency services work is needed to ensure that care is provided in a consistently compassionate and respectful way.

“As a priority the trust must focus its efforts on those areas where we have identified the need for further improvement.

“We will continue to monitor the service closely and return in the future to check on the trust’s progress.”

In urgent and emergency care, inspectors found that some patients were waiting too long for treatment. There were instances of poor patient flow throughout the department meant which patients were still waiting in corridors or ambulances outside the emergency department because of the congestion. We were aware that the leadership team were making improvements to address this. However, plans were at an early stage and changes were not fully embedded.

Within the emergency department, staff were not always providing patients with compassionate or respectful care or behaving in a way which was consistent with the trust’s values or desired practice. Staff did not always provide emotional support to patients and relatives to minimise their distress.

In both medical and urgent and emergency care, staff did not always involve patients in decisions about their care and treatment. Some patients and relatives told inspectors there was little communication from staff and they were not kept well informed about what was happening.

In contrast, there was strong leadership of the critical care unit, with senior staff looking for ways to drive the unit forward in delivering excellent patient care, while promoting a happy, passionate, inclusive, and open culture among the staff. There was a strong culture of safety with an effective and sophisticated patient computer information system that was used to manage and monitor patient care.

Read the latest reports, including ratings for all nine core services.

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In medical care and urgent and emergency services, work is needed to ensure that care is provided in a consistently compassionate and respectful way.

Professor Ted Baker, CQC’s Chief Inspector of Hospitals

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.