The Care Quality Commission (CQC) has rated Bedfordshire Hospitals NHS Foundation Trust good, following an inspection undertaken in August and September.
Inspectors visited the trust’s urgent and emergency care, medical care and maternity services at Bedford Hospital and Luton and Dunstable Hospital to assess concerns about the quality of the services.
CQC also carried out an inspection of the trust’s leadership arrangements, due to the link between leadership and the quality of care people receive.
In addition to rating the trust good overall, CQC rated it good for being effective, caring, responsive and well-led. It rated it requires improvement for being safe.
The trust was created by the merger of Luton and Dunstable Hospital NHS Foundation Trust and Bedford Hospitals NHS Trust in April 2020.
Zoe Robinson, CQC head of hospital inspection, said:
“Overall, the trust was providing good standards of care to people. This included working to ensure its services are resilient to challenges.
“Behind this was the trust’s work with other local healthcare partners, its effective use of information and the culture its leaders had built to support its staff to meet patient need. This is commendable bearing in mind the challenges of bringing two trusts together to form a new trust.
“The benefits of this approach could be particularly seen in medical care at Luton and Dunstable Hospital, where staff consistently achieved good outcomes for patients. However, the trust must improve its management of facilities and equipment in this service so it is doing all it can to prevent the spread of infection.
“It had also helped drive some improvement in maternity at Bedford Hospital, which has improved its rating from inadequate to requires improvement.
“However, the trust must give attention to its urgent and emergency care, where gaps in staff training undermined patient care, and people waited too long for assessment and treatment.
“Following the inspection, we reported our findings to the trust’s leaders – so they know where they have work to do. We continue to monitor the trust to ensure people receive safe and effective care and treatment.”
The inspection found:
- The trust was meeting standards enabling it to be rated good overall. Considering the ratings of the trusts from which it was formed, this does not represent a change – however, ratings for whether it is responsive to people’s needs and well-led deteriorated from outstanding to good
- Luton and Dunstable Hospital was meeting standards enabling it to be rated good, although ratings for whether it is responsive to people’s needs and well-led also deteriorated from outstanding to good
- Bedford Hospital was not rated following the inspection. This is because the inspection at the hospital only assessed specific concerns.
- Six of the trust’s 16 services were inspected:
- Two were rated good: medical care and urgent and emergency services at Luton and Dunstable Hospital
- Three were rated requires improvement: maternity at Luton and Dunstable Hospital, and maternity and medical care at Bedford Hospital
- One was unrated: urgent and emergency services at Bedford Hospital.
- Across the trust, staff treated patients with compassion and kindness. They respected patients’ privacy and dignity, and they provided emotional support to patients, families and carers
- Leaders were visible and approachable, and they provided staff with development opportunities
- Leaders planned services to meet the community’s needs
- Staff understood the trust’s values and were generally focused on the needs of patients receiving care. They were also clear about their roles and accountabilities.
However:
- Staff did not always complete mandatory training and there were not always enough staff to meet patient needs
- People could not always access the care and treatment they needed in a timely manner. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients did not meet national standards.
Following the inspection, CQC told the trust that it must take some actions to meet legal requirements. These include:
- Ensuring all staff mandatory training, including for safeguarding, is completed in line with trust targets where this is not happening already
- Ensuring people can access urgent and emergency care when they need it, in line with national standards
- Ensuring fire doors are kept closed, where this is not happening already
- In medical care at Bedford Hospital, the trust must ensure that all ward areas and equipment are clean and well-maintained, and that medical gas cylinders are stored appropriately. The trust must also undertake audits to monitor performance in medical care at Bedford Hospital to identify where improvements are required, and it must ensure actions arising from audits are implemented
- In maternity at Bedford Hospital and medical care at Luton and Dunstable Hospital, the trust must ensure it has infection control and prevention guidance that is followed
- In urgent and emergency care at Luton and Dunstable Hospital, equipment checks must be completed in line with trust policy. The trust must also ensure people can access this service when they need it and improve waiting times for patients.