CQC recommends Colchester Hospital University NHS Foundation Trust exits special measures

England's Chief Inspector of Hospitals has recommended that Colchester Hospital University NHS Foundation Trust should be taken out of special measures after a Care Quality Commission (CQC) inspection.

During the inspection, which took place between 25 and 27 July and on 2 August 2017, CQC inspectors found significant improvements had been made at the trust.

The trust is now rated as Requires Improvement overall, as well as for whether services are safe and responsive. It is rated as Good for whether services are effective, caring and well-led.

Colchester Hospital University NHS Foundation Trust was originally placed into special measures in November 2013 following concerns about patient care in cancer services.

Subsequent inspections highlighted further concerns and the trust did not demonstrate the required level of progress with improvements for CQC to be satisfied that people were receiving the level of care they should be able to expect.

Ongoing concerns resulted in CQC undertaking urgent action to restrict services at the trust’s emergency department, emergency assessment unit and operating theatres in April 2016. Shortly afterwards, a long-term partnership between Colchester General Hospital and Ipswich Hospital NHS Trust was recommended to secure services for patients.

But on CQC’s return inspectors found improvements across all of the trust’s services.

Professor Ted Baker, the Chief Inspector of Hospitals, said:

“I am very pleased to be able to recommend that Colchester Hospital University NHS Foundation trust exits special measures."

“When we returned to conduct our inspection we found considerable improvements had taken place. We found a strong leadership team, which engaged positively with a staff that was committed to ensuring change took place and we witnessed significant improvements across all of the trust’s services."

“The chief executive and managing director had created stability in the senior executive team that we had not previously seen. We also saw many examples of managers and senior staff who were motivated and engaged in seeking solutions to drive through further improvement."

“While there is still work to be done at the trust, reflected in its overall rating of Requires Improvement, there is no doubt that much positive change has taken place. This is testament to the hard work and commitment of staff and the trust’s leadership, and they are to be congratulated for what they have achieved."

“The trust knows what it must now do to ensure this work is maintained and to make sure the remaining improvements take place. We will return to check on its progress.”

Inspectors found a number of areas of outstanding practice at the trust, including:

• The trust has the only dedicated children’s transition team in the region, which other trusts sought advice from. The transition team worked with other teams to meet the more complex individual needs of patients at the age of transitioning to other services.
• The neonatal unit (NNU) was piloting a ‘discharge passport’ to empower parent involvement in ensuring a timely discharge for babies.

CQC has told the trust it must make improvements in a number of areas, including:

• Nursing and medical staff must complete all safeguarding and mandatory training including basic life support.

• All equipment must be maintained and fit for purpose.
• Initial assessments within the emergency department must be undertaken and documented to maintain an accurate clinical record, and initial assessments in the emergency department must be documented.
• The trust must ensure access to a designated mental health assessment room.
• The trust must take action to ensure that patients are clinically risk assessed as safe to wait for outpatient appointments.
• Medical records must contain completed risk assessments relevant to patient care.
• Do not attempt cardiopulmonary resuscitation (DNACPR) decisions must be undertaken in line with national guidance and best practice.
• The design and layout of the paediatric emergency department must enable effective oversight of paediatric waiting areas to ensure patient safety.
• The trust must ensure that there is an effective governance and risk management framework in place to identify and assess all risks relevant to the emergency department.
• Patient’s dignity must be protected in changing cubicles in In Beta X-ray.
• Doors for Beta X-ray must be fully fitted and a risk assessment must be in place to ensure patients are not a risk of unnecessary exposure of ionising radiation.

Full reports, including ratings of all core services, have been published on our website.

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