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Norfolk and Norwich University Hospital Requires improvement

We are carrying out a review of quality at Norfolk and Norwich University Hospital. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 15 May 2019

  • Records were not always stored securely and medicines were not always stored appropriately in outpatient areas, which were both raised at our previous inspection.
  • Data on waiting times was not formally recorded and therefore efficiency and areas for improvement could not be monitored and identified. This was raised at our previous inspection.
  • People could not always access the service when they needed it. Waiting times from referral to treatment were not in line with national guidance.
  • Clinics continued to run behind time. We observed, and patients told us, that clinics frequently ran late, however the trust did not monitor clinic waiting times formally to enable oversight and improvement.
  • An average of 18.8% of clinics were cancelled at short notice (under six weeks).
  • The service was not always managing information effectively. Staffing related information held by the trust, such as training, appraisals and vacancy numbers, did not always clearly identify compliance for outpatient medical staff. Therefore, we were not assured there was sufficient oversight of medical staffing of the service.

However:

  • The service controlled infection risk well. Staff kept themselves, equipment and the premises clean.
  • There was an appropriate process for responding to risk for patients that were waiting for appointments.
  • Staff of different kinds worked together as a team to benefit patients. Doctors, nurses and other healthcare professionals supported each other to provide good care.
  • Staff understood their roles and responsibilities under the Mental Capacity Act 2005. They knew how to support patients who lacked the capacity to make decisions about their care.
  • Staff cared for patients with compassion, involved them in decisions about their care and treatment and provided them with emotional support to minimise their distress.
  • Outpatient specialties offered some out-of-hours appointments, one-stop clinics, community based appointments, and telephone appointments, which provided patients with flexibility and choice.
  • The service treated concerns and complaints seriously, investigated them and learned lessons from the results, which were shared with all staff.
  • Managers promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values.
  • The service engaged well with patients and staff to plan and manage appropriate services.

Inspection areas

Safe

Requires improvement

Updated 15 May 2019

Effective

Requires improvement

Updated 15 May 2019

Caring

Good

Updated 15 May 2019

Responsive

Requires improvement

Updated 15 May 2019

Well-led

Requires improvement

Updated 15 May 2019

Checks on specific services

Medical care (including older people’s care)

Requires improvement

Updated 15 May 2019

A summary of our findings about this service appears in the Overall summary.

Services for children & young people

Requires improvement

Updated 15 May 2019

A summary of our findings about this service appears in the Overall summary.

Critical care

Requires improvement

Updated 15 May 2019

A summary of our findings about this service appears in the Overall summary.

End of life care

Requires improvement

Updated 19 June 2018

A summary of our findings about this service appears in the Overall summary.

Surgery

Requires improvement

Updated 15 May 2019

A summary of our findings about this service appears in the Overall summary.

Urgent and emergency services

Requires improvement

Updated 15 May 2019

A summary of our findings about this service appears in the Overall summary.

Maternity

Requires improvement

Updated 15 May 2019

A summary of our findings about this service appears in the Overall summary.

Outpatients

Requires improvement

Updated 15 May 2019

A summary of our findings about this service appears in the Overall summary.

Diagnostic imaging

Requires improvement

Updated 19 June 2018