The Care Quality Commission (CQC) has told University Hospitals Plymouth NHS Trust that further improvements are needed at Derriford Hospital, following an inspection in September.
Inspectors carried a focused inspection of the trust’s urgent and emergency care and medical wards. They also assessed the trust’s progress in meeting the conditions previously imposed, following an inspection last year.
Catherine Campbell, CQC’s head of hospital inspection, said:
“Our inspection at Derriford Hospital took place during a period of significant and sustained pressure on urgent and emergency care and medical services across the country.
“The pressures at Derriford Hospital were mainly due to limited availability of social care beds and community care, which has impacted on the number of medically fit people able to be discharged. This has hindered flow throughout the hospital, causing people to experience long delays.
“In October 2021, we did highlight the same problems to the trust’s leadership and local stakeholders. The conditions we imposed at this previous inspection are still applicable as people continue to experience long delays and the trust is struggling to meet the fundamental standards of care due to the significant and sustained pressures.
“We are aware a lot of work has been completed to improve care for people, but system wide pressures have impacted on the effectiveness of these changes. We will return to assess whether there has been further progress we have told the trust it must make.”
“The trust’s senior leaders know what must be done to manage the issues. This includes closer working with local healthcare partners.
“In the meantime, the conditions will remain in place and we will continue to monitor the service closely. We will return to assess whether there has been progress with improvements we have told the trust it must make.”
In the medical wards, inspectors found:
- There were not always enough nursing and support staff to keep people safe. Ongoing recruitment and staff development ware high priorities, but the trust continued to experience staff shortages due to sickness absence
- The trust faced challenges with access and flow which meant it could not always ensure people could access the service when they needed it
- People could not always access and receive treatment in the right speciality ward or area. However, this was improving as the hospital monitored demand
- In a number of areas inspectors visited, staff morale was low. This was due to staff shortages and the significant pressures on the service. The leadership team was aware of this, and it was working to resolve the problem.
In the urgent and emergency services, inspectors found:
- The trust faced challenges with access and flow, which meant it could not always ensure people could access the emergency department when they needed it to receive timely treatment. Performance data showed delays in patients both accessing the emergency department and waiting to be seen
- The service did not always have enough staff to care for people and keep them safe due to gaps in nurse and medical staffing. However, managers proactively used temporary staff, and they were working to recruit into vacant positions
- Due to overcrowding of the department, people were not always treated within an environment that supported their privacy and dignity
- Measures to divert people whose needs could be sufficiently met elsewhere, to reduce pressure on the emergency department, were not always successful
- Staff did not always feel valued or respected by the wider organisation