Chief Inspector of Hospitals publishes his findings on Royal Liverpool and Broadgreen University Hospitals NHS Trust

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England’s Chief Inspector of Hospitals has published his first report on the quality of care provided by the Royal Liverpool and Broadgreen University Hospitals NHS Trust.

Overall, the report concludes that Royal Liverpool and Broadgreen University Hospitals NHS Trust is providing patients with safe, effective and compassionate care. Services were of a good standard at all times of day and night. Patients said that they were satisfied with how staff had treated them, and that staff were caring and professional.

The inspectors also identified a number of areas where the trust needed to improve. Staffing levels in some areas were a concern. The trust has been told it must also take action to minimise risk of infection, improve arrangements to ensure the dignity and privacy of patients, and to manage medicines more effectively.

An inspection team which included doctors, nurses, and hospital managers, trained members of the public, CQC inspectors and analysts spent four days at the Royal Liverpool University Hospital and Broadgreen Hospital during November, December and January. They examined the care provided in accident and emergency, medical care (including older people’s care), surgery, intensive/critical care, end of life care and outpatient services.

The trust was one of the first to be inspected under radical changes which have been introduced by the Care Quality Commission to provide a much more detailed picture of care in hospitals than ever before.

The reports which CQC has published are based on a combination of the inspection findings, information from CQC’s Intelligent Monitoring system, and information given by people who have received care provided by the Trust and information from other organisations.

Read the full report on the Royal Liverpool and Broadgreen University Hospitals NHS Trust profile page.

The inspection team found areas of good practice which included:

End of life care service and dedicated bereavement team.

Effective Critical Care Outreach Team (CCOT).

Cohesive A&E and Acute medical unit.

Initiatives to improve the knowledge of all staff in the hospitals regarding supporting a person with a long standing tracheostomy.

The stroke service, which was ranked third in the country by the Sentinel Stroke National Audit Programme (SSNAP).

Purpose-built urology department at Broadgreen Hospital and improvements made in response to patient feedback.

Nurse-led discharge on the surgical wards.

Multidisciplinary meetings on the surgical wards every day.

Evening educational meetings for patients due to be admitted for surgery to remove their prostate gland at Broadgreen Hospital.

Inspectors said that the trust must improve in a number of areas, including:

Resolving recruitment issues so that staff can take up posts in a timely manner.

Addressing the use of theatre recovery and the A&E observation room as overnight facilities. Improving the responsiveness of pharmacy on admission and discharge and ensuring that the emergency department has access to medication at all times.

Addressing the excessive workloads of junior doctors.

Supporting the training of ward staff in how to respond to the needs of deteriorating patients and those with a tracheostomy.

Improving the process for learning from complaints. Improving the care received by patients not cared for on wards of the relevant speciality.

Ensuring that staff on the Post-Operative Critical Care Unit are appropriately skilled. Improving the infection control procedures within the emergency department. Ensuring that there is regular auditing of the World Health Organisation surgical checklist at both sites.

CQC’s Chief Inspector of Hospitals, Professor Sir Mike Richards, said: “Patients told us that they appreciated the care they received from a hardworking, caring and compassionate team of staff, working at times under difficult circumstances. We saw examples of excellent work which demonstrated patients were, overall, receiving effective care and treatment.

“But there is no doubt that the trust is under pressure and that this is affecting patient care. Staffing levels are only maintained by the use of temporary nursing staff, and there weren’t enough junior doctors in some surgical areas.

“We found patients were regularly cared for on wards of a different speciality to the one they required. Due to emergency pressures, patients were staying in unsuitable physical environments for longer than expected, both in theatre recovery areas and an A&E observation room.

“We have told the trust that they must take action to address these issues. We will return in future to check that the improvements have been made.”

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