The Care Quality Commission has told University Hospitals Plymouth NHS Trust that it must continue to make improvements following its latest inspection by the Care Quality Commission.
A team of inspectors visited Derriford Hospital in August and September 2019. This was to check the trust’s progress after an inspection in December 2018 and also to check the quality of four core services: maternity, medical care, diagnostic imaging and surgery. CQC also looked specifically at management and leadership to answer the key question: Is the trust well led?
Overall the trust remains rated as Requires Improvement for the quality of its services. The trust’s rating for caring remains as Outstanding. The trust is also rated as Requires Improvement for whether its services were safe, effective, responsive and well-led.
CQC has also published the trust’s Use of Resources report, which is based on an assessment undertaken by NHS Improvement. The trust has been rated as Requires Improvement for using its resources productively.
You can read the reports in full when they are published on CQC’s website.
Dr Nigel Acheson, Deputy Chief Inspector of Hospitals in the South, said:
“Although we have seen real improvements in maternity which is now rated Good overall. It is disappointing to report that since our previous inspections University Hospitals Plymouth NHS Trust has still not made enough progress. We have made it clear that we require further work to address the issues we had found in surgical services where we have seen a decline in ratings.
“The trust has a strong and engaged workforce but I am concerned that the leadership team despite having the integrity to lead the trust were not always visible for patients and staff.
“The trust needs to sustain the improvement we have found and address the issues which we have again identified. We will return in due course to ensure that the necessary improvements have been made.”
Medical care remained as Requires Improvement. Inspectors found care was planned and provided in a way that met the needs of local people and the communities served. The team worked with others in the wider system and local organisations to plan care. However, the demand for beds was overtaking capacity and the management of medical patients in non-medical beds needed to improve to support this.
Although surgery was now rated as Requires Improvement, staff were providing compassionate care to patients. Staff were supporting patients to make informed decisions about their care and treatment. But patients could not always access the service when they needed it. Waiting times were mostly worse than national levels. The percentage of operations cancelled and not rebooked within 28 days was consistently worse than the England average.
Maternity services improved to Good overall with an Outstanding rating for being caring. The service had a vision for what it wanted to achieve and a strategy to turn it into action. This had been developed with all relevant stakeholders. The vision and strategy were matched to local plans within the wider health economy. Staff felt respected, supported and valued and were focused on the needs of women receiving care. There was an open culture where people, their families and staff could raise concerns without fear. There was an evident collaborative culture throughout the service.
Diagnostic services improved from Inadequate to Requires Improvement. Some patients had to wait longer than intended to receive diagnostic imaging procedures. Despite being short staffed, managers and staff actively responded to work out why targets were not always being met and acted to improve services. Staff at all levels told inspectors there was a slowly improving culture within the service and all staff felt able to speak up about concerns they may have.