England’s Chief Inspector of Hospitals rates University Hospitals Bristol NHS Foundation Trust as Outstanding

Published: 2 March 2017 Page last updated: 3 November 2022
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The Chief Inspector of Hospitals has praised NHS staff in Bristol for their work in driving improvement for patients – and making University Hospitals Bristol one of the highest-rated NHS trusts in England.

In two years the trust, which includes the Bristol Royal Infirmary and seven other hospitals, has moved from a rating of Requires Improvement to Outstanding, following its latest inspection by the Care Quality Commission. It is the first hospital trust in England to have improved from Requires Improvement to Outstanding between two inspections. 

The Chief Inspector of Hospitals, Professor Sir Mike Richards, said:

“In September 2014, my inspectors found the trust was providing effective and caring services – but with a number of keys areas for improvement. The high demand was affecting urgent and emergency services, surgery, medical care, critical care and outpatient services."

“I am delighted that University Hospitals Bristol has taken to heart our original inspection report and built on it – not just in those areas where improvements were required, but in their stronger areas too."

“This determination to develop a culture of continuous improvement has improved services for patients – and ensured that the trust has move upwards from a rating of Requires Improvement to Outstanding. It is a tremendous achievement."

“Throughout the inspection we found a strong culture of safety across the trust in which all staff were engaged. Staff spoke positively about the patient journey and the striving for continual improvement. This was especially clear in surgery which we rated as Outstanding for both caring and well led, with staff working effectively as a team in a coordinated way for the patients best interests."

“The hard work has paid off in making a real difference to the lives of people using the services, in the immediate Bristol area and in the wider South West in general. Everyone who has played a part in this should be very proud of this outcome.”

CQC carried out this announced inspection between 22 and 24 November 2016. A further unannounced inspection was conducted on 1 December 2016.

The focus of this inspection was on services previously rated as requires improvement: surgery; medical care; and outpatients and diagnostics. Inspectors also looked at urgent and emergency care.

Full reports are available on our website.

Inspectors found quality and safety was the driving force behind a clear statement of vision and values within the trust. Staff understood the vision and strategy and their role in in delivering it. Many said they were proud to work for the hospital and demonstrated a kind and caring culture, both to patients and relatives and to colleagues. There was a strong sense of mutual respect for each other. 

Staff went "above and beyond" to meet the emotional and physical needs of patients. They took the time to get to know and understand patients and ensure they were comfortable, responding compassionately to those in pain or distress and giving reassurance and support. 

Leadership in the trusts surgical services was found to be enthusiastic and staff were motivated to succeed. Patients gave very positive feedback about the service they received and of the compassion, kindness and caring of all surgical staff, who ensured patients experienced dignified and respectful care. 

Overall, inspectors identified a number of areas of outstanding practice, including:

  • In times of crowding the emergency department was able to call upon pre-identified nursing staff from the wards to work in the department. This enabled nurses to be released to safely manage patients queueing in the corridor.
  • New starters in the emergency department received a comprehensive, structured induction and orientation programme, overseen by a clinical nurse educator and practice development nurse. This provided new staff with an exceptionally good understanding of their role in the department and ensured they were able to perform their role safely and effectively.
  • Staff in the teenagers and young adult cancer service continually developed the service, and sought funding and support from charities and organisations, in order to make demonstrable improvements to the quality of the service and to the lives of patients diagnosed with cancer. 
  • There was a focus on leadership development at all levels in order to support the culture and development of the trust.
  • There was a use of innovation and research to improve patient outcomes and reduce length of stay and the use of a discrete flagging system to highlight those patients who had additional needs.
  • The trust introduced a drop in chest pain clinic to improve patient attendance.

Ends

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Throughout the inspection we found a strong culture of safety across the trust in which all staff were engaged. Staff spoke positively about the patient journey and the striving for continual improvement.

CQC's Chief Inspector of Hospitals, Professor Sir Mike Richards

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.