You are here

Inspection Summary


Overall summary & rating

Good

Updated 23 July 2019

In rating the location, we took into account the previous ratings of services which were not inspected on this occasion.

Our rating of services stayed the same. We rated it them as good because:

  • The hospital always had enough staff with the right qualifications, skills, experience and training to keep patients safe from avoidable harm and abuse, and to provide them with the care and treatment they needed. Staffing levels were matched to patient need and clinic activities. All staff understood their responsibilities to safeguard patients from abuse and neglect and had appropriate training and support.
  • There was a well-embedded incident process and learning from the investigative process was valued by staff.
  • Departmental leaders had the knowledge and experience to lead and support staff. They promoted a positive culture, which valued and respected staff. There was a commitment to the improvement of waiting times, patient access and the whole patient experience.
  • Staff engaged well with patients, staff, the public and local organisations to plan and manage appropriate services and collaborate with partner organisations effectively. Feedback from patients was used to develop services.

However:

  • Some of the expected service delivery targets were not being met. This included the referral to treatment (RTT) targets for all the specialities and in cancer services patients receiving their first treatment within 62 days of an urgent GP referral.
  • A significant number of patients had overdue follow up appointments, which posed a risk to some. Patients had long waits in some clinics and were not always offered a choice of appointments times.
  • Medicine administration was not always in line with trust policy.
  • Mandatory training in key skills was available to all staff but expected completion rates for this was not being met.
  • The premises were not always suitable for the intended use and patients’ privacy and dignity could not always be maintained. Equipment was not always safely managed.
  • Staff did not always complete patient records to professional standards.
Inspection areas

Safe

Requires improvement

Updated 23 July 2019

Effective

Good

Updated 23 July 2019

Caring

Good

Updated 23 July 2019

Responsive

Good

Updated 23 July 2019

Well-led

Good

Updated 23 July 2019

Checks on specific services

Outpatients

Requires improvement

Updated 23 July 2019

We previously inspected outpatients jointly with diagnostic imaging so we cannot compare our new ratings directly with previous ratings. We rated outpatients as requires improvement because:

  • Medicine administration was not always in line with trust policy.

  • The service was not meeting the referral to treatment (RTT) targets for all the specialities. For cancer services, the trust is performing worse than the operational standard for patients receiving their first treatment within 62 days of an urgent GP referral.

  • The service provided mandatory training in key skills to all staff and but did not ensure everyone completed it to meet the trust targets.

  • The service did not always have suitable premises or equipment and did not always look after them well.

  • Documentation in paper records and medicine administration was not always in line with trust and professional standards.

  • The trust had many patients with overdue follow up appointments and it was unclear how the trust was managing the risks to these patients.

  • Patients’ privacy and dignity was not always maintained due to the layout of some the clinical areas.

  • Patients told us they regularly experienced long waits in clinic and they were not always offered a choice of appointments times.

However:

  • The service had enough staff, with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.

  • There were effective systems to protect people from avoidable harm. Learning from incidents were discussed in departmental and governance meetings and action was taken to follow up on the results of investigations.

  • Leaders were very knowledgeable about their services and were committed to develop the service to improve waiting times, patient access and patient experience.

  • The services engaged well with patients, staff, the public and local organisations to plan and manage appropriate services and collaborate with partner organisations effectively. The views of patients were sought in several different ways and senior leaders engaged with staff to keep them informed of important changes.

  • Managers promoted a positive culture that supported and valued staff.