The Robert Jones & Agnes Hunt Hospital

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

During the assessment we found that policies and documents were in date. Staff were able to show us how they accessed documents and policies on the intranet.

Staff were aware of the Freedom to Speak Up (FTSU) service through posters and training.

Leaders completed various leadership courses. Staff we spoke with told us they were able to raise concerns to their managers, who they felt were visible and approachable.

Various critical care team meetings took place. Meetings reported on quality issues such as medicine management and standard operating procedures.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a shared vision, strategy and culture.

The trust had a clear set of values, with quality and sustainability as the top priorities. Staff knew and understood the provider’s vision and values and how they were applied in the work of their team.

Staff demonstrated the trust values during our inspection, as all were friendly and caring to patients, relatives/carers and each other. Staff were observed to be carrying out their role to the best of their abilities; demonstrated professionalism and respect to others.

The clinical lead maintained an honorary contract to stay current in intensive care practice and was exploring a shared contract model to attract additional intensivists, ideally with ortho-geriatrics expertise. The unit addressed the rising complexity of patients by commissioning an external review and aligning with broader NHS changes, ensuring contractual requirements for complex orthopedic hip revisions, spinal services, and enhanced care were met.

The last staff survey dated 2024 identified that 74% recommended the trust as a place to work; 92% of staff said they were happy with the standard of care provided by the trust if a friend or relative needed treatment and 75% of staff said they felt valued by their team. However, only 68.4% of staff said they felt secure about raising concern about unsafe clinical practice, and 59.6% felt confident the trust would address concerns. Almost 30% of non-white staff responded to the survey they had experience harassment, bullying or abuse from patients, relatives or the public compared to 18% of white staff that responded. however, this was not critical care specific. Working groups and action plans had been implemented and improvements was a working progress.

The service focused on continuous learning, innovation and improvement across the organisation and local system. Staff encouraged creative ways of delivering equality of experience, outcome and quality of life for people. Staff actively contribute to safe and effective practice.

There was evidence of improved culture across the service and there was strong leadership.The divisional leaders and ward managers acted to make improvements in the running of the critical care services. They had regular meetings where learning was discussed in a variety of forums.

All staff we spoke with were passionate about the care and treatment delivered. Steps had been taken since last inspection, although at early stages the trust were now benchmarking themselves against other similar units.Staff participated in national audits and learned from them. Staff used quality improvement methods and knew how to apply them.

Senior staff had an interest in expanding the unit to become a national spine unit, which would require additional staffing and resources. The need for more intensivists was noted, given the increased complexity and frailty of patients. The unit leaders stated they may need to become more advanced to meet these challenges, also mentioned by clinical leads. Justification for further specialisation and resources allocation was necessary, especially in comparison to larger specialised units.

The unit aspired to expand its capability for longer-term ventilation and more advanced care as part of its development goals.During 2023/24 the trust went live with ‘enhanced recovery’. This had seen significant improvements in length of stay (LOS). Trust overall elective LOS was 3.24 days (February 2024.) Improvements sustainability was a significant part of focus for 2024/25 plans and HDU was a big part of this initiative to drive patient outcomes.