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The Princess Alexandra Hospital Requires improvement

This service was previously managed by a different provider - see old profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 21 March 2018

Inspection areas

Safe

Requires improvement

Updated 21 March 2018

Effective

Good

Updated 21 March 2018

Caring

Good

Updated 21 March 2018

Responsive

Requires improvement

Updated 21 March 2018

Well-led

Requires improvement

Updated 21 March 2018

Checks on specific services

Critical care

Good

Updated 21 March 2018

Our rating of this service improved. We rated it as good.

Outpatients and diagnostic imaging

Good

Updated 19 October 2016

Outpatient and diagnostic imaging services at The Princess Alexandra Hospital have been rated as good overall. Safe, caring and well-led have been rated as good with responsiveness requiring improvement. We do not rate effective in outpatient and diagnostic services due to there being an inconsistent data set for services of these types.

During this inspection we followed up on a number of areas which we found to be inadequate or requiring improvement during our last inspection in July 2015. The previous issues related mainly to patients having to wait unsafe amounts of time before being offered an appointment. We found that the service had taken action and improvements were seen.

We rated this service as good because:

Staff were aware of how to report incidents and when this should be done. There was a clear escalation pathway for safeguarding concerns and medication was stored appropriately, in line with manufacturer’s guidance. Mandatory training compliance was good and staff were competent in their roles. However, the main outpatient department was dated and in need of repair and refurbishment, and 10 out of the 11 patient records we reviewed did not contain up to date patient information.

Policies and procedures were developed using relevant national best practice guidance and patient outcomes were monitored via national audit arrangements. However, the local audit plan was limited in content meaning that there was limited opportunity to improve patient outcomes locally.

Staff provided compassionate and respectful care to patients. We observed that staff were understanding and maintained patient dignity. The majority of patient feedback that we received during our inspection was positive, and the latest Friends and Family Test (FFT) results demonstrated 96% of patients would recommend the service.

Outpatient and diagnostic imaging services were well-led. There was a cohesive leadership team and staff felt managers were approachable and that there was a strong open culture. Patients and staff were engaged in the running of the service and staff were enabled to be innovative. Since our previous inspection, governance systems had been reviewed and a clear structure had been put in place.

Urgent and emergency services

Requires improvement

Updated 21 March 2018

Our rating of this service improved. We rated it as requires improvement.

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

Maternity and gynaecology

Outstanding

Updated 19 October 2016

Overall we rated maternity services as outstanding. With caring and well-led outstanding and safety, effective and responsiveness being rated as good.

Incident reporting and learning from incidents was embedded within the service. The environment within the unit was secure. The service was consistently providing 60 hours, or more, of consultant time to the labour ward per week. Staffing levels were monitored and managed effectively.

Outcomes for women who used services were generally better than expected when compared with other similar sized services. However caesarean section rates were higher than the national average. Breastfeeding rates were better than the England average and natural vaginal delivery rates were the best in the East of England and comparable with the national average for England. The service had an outstanding process for auditing, learning from national reports and recommendations as well keeping up to date with current guidelines. The termination of pregnancy service was outstanding and followed all elements of national guidelines and legislation.

The maternity service was rated as outstanding for being caring because staff providing both maternity and gynaecology care were dedicated, compassionate, caring and they consistently went beyond the call of duty to deliver the best experience possible for the women.

The services were delivered working in partnership with commission teams and community services within Essex and across the borders. However, we also found that the lack of a gynaecology in-patient ward meant that women did not always receive timely care whilst accommodated in various wards across the trust.

The governance and risk management systems within maternity and gynaecology services were robust and well established. The medical, midwifery and operational leadership team were respected and staff spoke highly of the clinical leads for the service and how involved and approachable they were, which created an open culture.

Medical care (including older people’s care)

Requires improvement

Updated 21 March 2018

Our rating of this service stayed the same. We rated it as requires improvement.

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

Surgery

Requires improvement

Updated 21 March 2018

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

Services for children & young people

Requires improvement

Updated 21 March 2018

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

End of life care

Good

Updated 21 March 2018

Our rating of this service improved. We rated it as good.

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