Chief Inspector of Hospitals recommends East Lancashire Hospitals NHS Trust is taken out of special measures, but with continuing support
England’s Chief Inspector of Hospitals has recommended that East Lancashire Hospitals NHS Trust should be taken out of special measures following a full inspection by the Care Quality Commission.
Professor Sir Mike Richards and his inspectors found that sufficient progress had been made to justify the recommendation to the NHS Trust Development Authority – although the trust will receive ongoing support to ensure that its performance continues to improve.
East Lancashire Hospitals had been put into special measures in July 2013 following the Keogh Review into hospitals with higher than average mortality rates.
Reports which are published today show the trust has made significant improvements in a number of areas, although inspectors conclude that the trust’s two main hospitals, Royal Blackburn Hospital and Burnley General Hospital, both require improvement.
The hospitals were inspected by CQC in April under its new inspection regime. The inspection team which included doctors, nurses, midwives, hospital managers, trained members of the public, a variety of specialists, CQC inspectors and analysts spent three days at the trust in April and May.
Under the new inspection model, CQC has given individual ratings to each of the core services at the hospitals, including Accident and emergency, Medical care (including older people’s care), Surgery, Critical care, Maternity and family planning, Services for children and young people, End of life care, and Outpatients.
The Chief Inspector, Professor Sir Mike Richards, said: “It is clear that East Lancashire Hospitals NHS Trust has worked hard to improve since being placed in special measures last year.
“The trust has made real progress to meet the requirements of the Keogh Review, with the way that it is led changing significantly Staff told us the culture of the trust was changing and this was backed up by what we saw, an engaged workforce who were increasingly proud of where they worked.
“While there are signs that this trust is improving, a number of these improvements are new and need time to become fully ingrained in the service. The trust still needs to take action to make sure that people using its services receive good quality treatment and care all the time.
“Special measures are designed to provide intensive support to struggling trusts and East Lancashire Hospitals NHS Trust has clearly gained from this support. There is no doubt that the trust is heading in the right direction and will continue to benefit from the ongoing support from the Trust Development Authority as they come out of special measures. We will return in time to check that the improvements we have identified on this inspection have been made.”
Overall, inspectors found that in parts of the trust safety needed to improve. Patients were generally positive about their experience, and the inspection team found staff to be kind and caring. The trust had taken steps to address capacity and patient flow issues in Accident and Emergency.
The trust has been told that it must make improvements in 13 areas, including:
- The flow of patients must be improved – from attendance in A&E to admission to wards and discharge.
- Interim posts should be filled with permanent staff to ensure stable leadership at the trust.
- Risk registers should be used consistently, with risks escalated as appropriate.
- The management of complaints must improve.
- There must be enough suitably skilled staff employed in A&E at all times to care for very unwell children.
- People attending A&E and the urgent cares centres with mental health needs must receive prompt, effective, personalised support from appropriately trained staff.
- Equipment checks are done and documented in theatre.
- Ensure that all staff work in line with the medicines management policy.
The inspection team identified two particular areas of good practice:
- The vast majority of staff spoke of the improvement they had experienced in the culture in the organisation. Staff felt proud to work in the trust and said that they would now recommend it as a place to work.
- The trust’s maternity services had received a national award for their innovative work to improve maternity services, promote normal births and facilitate staff activities. This work had improved normal birth rates, reduced caesarean section rates and increased birth choice for women.
The Care Quality Commission has already presented its findings to a local Quality Summit, including NHS commissioners, providers, regulators and other public bodies. The purpose of the Quality Summit is to develop a plan of action and recommendations based on the inspection team’s findings.
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