CQC lifts registration conditions on Northern Lincolnshire and Goole Hospitals Foundation Trust

14 July 2010

The Care Quality Commission (CQC) today (Wednesday) said Northern Lincolnshire and Goole Hospitals NHS Foundation Trust has made necessary improvements to its accident and emergency department at the Diana Princess of Wales Hospital, Grimsby.

The regulator will now lift the conditions it had imposed on the trust’s licence on 1 April, when it introduced a tough new registration system for NHS trusts. Northern Lincolnshire and Goole was one of 22 trusts registered with conditions to improve aspects of quality and safety.

CQC had previously identified concerns during an inspection of A&E at the Diana Princess of Wales Hospital on 14 and 15 January. Inspectors found that some patients admitted by ambulance were being made to wait in a corridor area prior to triage and their medical problems weren’t always properly investigated.

CQC imposed conditions, requiring the trust to take action by 1 April to ensure:

  • all ambulance patients are seen by a senior clinician as soon as possible after arrival at A&E  
  • there are systems to regularly assess and monitor the quality of services provided by the A&E department. This includes taking action to identify and minimise risks.

To check whether the necessary improvements had been made, CQC made an unannounced site visit on 26 and 27 May. Inspectors interviewed patients and staff and reviewed relevant documentation.

CQC found that the arrangements for receiving, monitoring and treating patients arriving by ambulance had improved. It reported that:

  • a nurse is responsible for “triaging” patients upon arrival
  • protocols are in place to ensure faster handover of patients from ambulance to A&E staff
  • about 68% of people arriving in an ambulance were triaged within 15 minutes
  • the hospital has secured funding for a new triage area
  • the trust board will scrutinise the top 10 risks for each department
  • nurses interviewed said more incidents were being reported
  • A&E staff have more input into clinical governance arrangements.

Jo Dent, CQC’s regional director for Yorkshire and Humberside, said: “We arrived unannounced so we could see the A&E department as patients experience it. It

was clear to our inspection team that a considerable amount of work had gone into  improving the department. There are now better systems in place to ensure patients arriving by ambulance are seen quickly and by a clinician, such as a nurse.

“We’re also very pleased to see the trust working closely with its Local   Involvement Network (LINk) to secure funding for a new triage unit. This collaborative approach is to be commended.

“Finally, I would like to thank the patients, visitors and staff who provided us with vital evidence during our visit.”

The Care Quality Commission will continue to monitor improvement through the new registration process, returning to the trust, if necessary, at regular intervals.

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For further information please contact or David Fryer, Regional Communications Manager, on 07901 514220.

Alternatively, contact the national press office on 0207 448 9401 or on 07917 232 143 out of hours.

Notes to editors:

About the Care Quality Commission

  • The Care Quality Commission (CQC) is the independent regulator of all health and adult social care in England. We inspect all health and adult social care services in England, whether they are provided by the NHS, local authorities, private companies or voluntary organisations. We also seek to protect the interests of people whose rights are restricted under the Mental Health Act. We make sure that essential common standards of quality are met everywhere care is provided, from hospitals to private care homes, and we work towards their improvement. We promote the rights and interests of people who use services and we have a wide range of enforcement powers to take action on their behalf if services are unacceptably poor.
  • Our work brings together (for the first time) independent regulation of health, mental health and adult social care. Before 1 April 2009, this work was carried out by the Healthcare Commission, the Mental Health Act Commission and the Commission for Social Care Inspection.
  • Our aim is to make sure that better care is provided for everyone, whether it is in hospital, in care homes, in people’s own homes, or anywhere else that care is provided.
  • Registration: The Health and Social Care Act 2008 introduced a new, single registration system that applies to both health and adult social care.  The new system will make sure that people can expect services to meet new essential standards of quality and safety that respect their dignity and protect their rights.  The new system is focused on outcomes, rather than systems and processes, and places the views and experiences of people who use services at its centre.
  • Since 1 April 2010, all NHS care providers are required by law to be registered with CQC and must show that they are meeting the essential standards. All adult social care and independent healthcare providers must be registered under the 2008 Act (which replaces the Care Standards Act 2000) from 1 October this year. Registration isn’t just about initial application for registration.  We will continuously monitor compliance with the essential standards as part of a new, more dynamic, responsive and robust system of regulation.