The Care Quality Commission (CQC) has published a report following an inspection at Northern Lincolnshire and Goole NHS Foundation Trust (NLAG) in June and July.
This unannounced inspection was carried out as part of our continual checks on the safety and quality of healthcare services. Additionally, at the last inspection in September 2019, the trust was in special measures and receiving support from NHS England to help it improve.
The support programme which was in place in 2019 has been replaced by the NHS System Oversight Framework, which is for NHS trusts facing the toughest challenges.
NLAG provides acute hospital services and community services across North and North East Lincolnshire and East Riding of Yorkshire. The trust has around 750 beds across three hospitals: Diana Princess of Wales Hospital, Goole and District Hospital and Scunthorpe General Hospital.
This inspection included all three hospitals, which were given the following ratings:
- Diana Princess of Wales Hospital – remains rated requires improvement overall, and for being effective, responsive and well-led. Safe has improved from inadequate to requires improvement, caring remains rated as good
- Goole and District Hospital – overall the hospital has improved from requires improvement to good. How safe and responsive the hospital is has improved from inadequate to good. Effective and caring have remained rated as good, and well-led has remained rated as requires improvement
- Scunthorpe General Hospital – the overall rating remains rated as requires improvement, as well as effective, responsive and well-led. Safe has improved from inadequate to requires improvement, and caring remains rated as good.
The overall trust rating remains rated as requires improvement, as well as effective, responsive and well-led. Safe has improved from inadequate to requires improvement. Caring remains rated as good.
Sarah Dronsfield, CQC head of hospital inspection, said:
“When we inspected Northern Lincolnshire and Goole NHS Foundation Trust, we found the leadership had improved since our last visit, and we were pleased to see they had started to make some improvements, however more work was required to make sure these were sustained and embedded across the whole organisation.
“The board had identified where they needed to make changes to improve both people’s experience of services and the culture within the organisation, and for the changes to be reflected in positive outcomes for people.
“Although, we found across most services there still wasn’t enough staff with the right qualifications, skills, training and experience to meet people’s needs. The trust must continue to address this as a priority.
“Additionally, in the trust’s urgent and emergency care services. People couldn’t access services when they needed it and continued to experience long delays waiting for treatment. There were also long ambulance handover times as a result of access and flow issues.
“However, most people were happy with the care provided and it was evident that staff worked hard to achieve the best possible outcomes for people throughout the services we inspected.
“We will continue to monitor the trust to make sure changes are made and embedded, and we will return to check on progress.”
Inspectors found:
- Inspectors found delays in every part of the patient journey. Waiting times for treatment referrals, and arrangements to admit, treat and discharge across several core services continued to be a challenge. People were also staying too long in hospital due to these discharge issues, which negatively on access and flow throughout the whole hospitals
- The trust was continuing to develop a more open culture and improve communication with people, their families and staff but there was more work required to progress this and have an impact
- Visibility of senior leadership team was variable across the services inspected
- Information and data overall were well managed across the trust. New systems had been developed to strengthen data collection, analysis and there was evidence of information being used to drive improvements and demonstrate sustained successes. However, there were instances on wards and departments where people’s information was not stored securely.
However:
- There were examples of people receiving compassionate care, with staff ensuring people’s privacy and dignity was maintained
- The trust had worked hard to improve performance in terms of elective pathways and complaints management
- Since the last inspection there had been a marked improvement in actions to address the backlogs for waiting times and reporting times within diagnostic services
- At the time of our inspection, the trust was preparing to commence a wider culture transformation programme. This links into the wider trust priorities and people strategy, as continuing to improve culture and staff engagement for 2022/23 is an area of particular focus within the trust’s priorities
- Since our previous inspection the trust had appointed a permanent full-time freedom to speak up guardian (FTSUG).