Updated 16 December 2022
Bedfordshire Hospitals NHS Foundation Trust (BHFT) formed as a new entity in April 2020 as a result of a merger and acquisition arrangement of Luton and Dunstable Hospital NHS Foundation Trust and Bedford Hospitals NHS Trust. BHFT provides a comprehensive range of acute and specialist service from the two acute locations. The trust also manages some activity at its five other satellite sites:
Luton and Dunstable University Hospital Orthopaedic Centre, Arndale House, Archer Unit, Chaul End Community Centre Health Suite, Kingsway medical centre.
The trust has 1,024 acute inpatient beds, 36 critical care beds and 106 maternity beds and employs around 8,022 full time equivalent staff across the sites. Of these staff, 2,058 are nursing and midwifery staff, 1,082 are medical staff and 4,007 are classified as other staff (Data taken from Insight 22 June 2022).
The main hospitals are located in Bedford and Luton and serve a population of around 700,000 people within the local catchment areas covering South Bedfordshire, Luton and parts of Hertfordshire and Buckinghamshire. Services are mainly commissioned by NHS Bedfordshire, Luton and Milton Keynes Integrated Care Board.
At the time of our inspection, the new entity of BHFT had not yet been fully inspected. This means that some core services at Bedford Hospital location do not yet have ratings. All core services at Luton Hospital location retain their previous ratings.
We carried out unannounced focused and comprehensive inspections of 6 of the acute services provided by this trust:
- Urgent and emergency care at both acute sites because we had concerns about the quality of services.
- Medical Care (including older people’s care) at both acute sites because we had concerns about the quality of services
- Maternity at both acute sites to look at those parts of the service that did not meet legal requirements and because we had concerns about the quality of services.
- We also inspected the well-led key question for the trust overall.
When a trust acquires another trust in order to improve the quality and safety of care, we do not aggregate ratings from the previously separate trust at trust level for up to two years. Our normal practice following an acquisition would be to inspect all services run by the enlarged trust. However, our usual inspection work has been curtailed since the COVID-19 pandemic.
The ratings for the trust in this report are therefore based only on the ratings for Luton and Dunstable Hospital and our rating of leadership at the trust level.
At Bedford Hospital we inspected only those services where we were aware of current risks. We did not rate the hospital overall.
This is the first time we are rating this trust. We rated them as good because:
- We rated safe as requires improvement and effective, caring, responsive and well-led as good.
- We rated 3 of the trust’s 16 services we inspected as good and 3 as requires improvement. In rating the trust, we took into account the current ratings of the 10 services not inspected this time. As some of the inspections we undertook were focused and we have not undertaken an inspection of all core services that have not been previously rated post-merger, not all ratings have been aggregated to trust level.
- Staff treated patients with compassion and kindness, respected their privacy and dignity and provided emotional support to patients, families and carers.
- Leaders were visible and approachable and provided staff with development opportunities.
- Leaders planned services to meet the needs of the community.
- Staff understood the service’s values and were generally focused on the needs of patients receiving care.
- Staff were clear about their roles and accountabilities.
However:
- Staff did not always complete mandatory training and there were not always enough staff to meet the needs of patients.
- People could not always access the care and treatment they needed in a timely manner. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients were not in line with national standards.
How we carried out the inspection
We carried out the core service inspections from 2 to 3 August 2022 and the well-led inspection on 20 and 21 September. We visited areas relevant to each of the core services inspected and spoke with a number of patients, staff and patient representatives.
We spoke with 144 members of staff at all levels of the organisation across various specialities and including healthcare assistants, nurses, midwives, junior doctors, pharmacy staff, consultants and administrative staff.
We also spoke with 27 patients and 5 relatives. We observed care and reviewed 91 sets of care records. We also looked at a wide range of documents including policies, standard operating procedures, meeting minutes, action plans, risk assessments, training records and audit results.
You can find further information about how we carry out our inspections on our website: www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection.