Chief Inspector of Hospitals finds improvements at the Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust

England’s Chief Inspector of Hospitals has rated The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust as Requires Improvement following a third inspection by the Care Quality Commission.

A team of inspectors has found that the trust is rated as Requires Improvement for safe, effective, responsive and well-led services. The trust was rated Good for providing caring services.

The inspection team visited both the Royal Bournemouth Hospital, rated Requires Improvement, and Christchurch Hospital, rated Good. The full reports will be available from Thursday 25 February on the CQC website at: www.cqc.org.uk/provider/RDZ.

The Chief Inspector of Hospitals, Professor Sir Mike Richards, said:

"I am pleased to report that our latest inspection has found that the trust is still making headway in many areas.

“On this inspection we have found improvements, particularly in the leadership of the trust. However, there is still progress to be made. Christchurch Hospital was rated as Good, Royal Bournemouth still requires improvement.

"Change has been clinically led and is now moving at pace. However, we still have concerns and would like to see a more consistent level of service across the trust. Particular attention should be paid to patient care and flow in the emergency department at Royal Bournemouth Hospital

“While I am satisfied that the trust is heading in the right direction, I look forward to further improvements being implemented and fully embedded by the time of our next inspection.“

The team of inspectors and specialists, including doctors, nurses, managers and experts by experience, inspected the hospitals over three days during October 2015 and conducted unannounced inspections on two days in November 2015.

Inspectors found staff were caring and worked hard to ensure patients were treated with dignity and respect. The trust had invested in staff to ensure safer staffing levels. Staff were positive about working for the trust and the quality of care they provided. They were also positive about the trust focus on improving its culture to one that was more open and transparent and focused on patients.

The trust had involved staff in developing improvement plans that were expected to deliver savings and reduce the trust’s financial deficit. Staff were also being supported and encouraged to innovate and improve services.

There were comments from staff about the lack of visibility of senior managers. Inspectors found the leadership team was showing a renewed commitment to develop and continuously improve services and a new leadership style was helping to change the culture of working in the trust. This was in its early stages and was still being developed with staff.

The trust had improved the effectiveness of its governance arrangements, which now include a better focus on safety at ward level. There was still room for development so the trust could demonstrate progress against the targets it had set itself.

Inspectors found in the emergency department at the Royal Bournemouth Hospital, there were delays in admitting patients to hospital beds. This meant that the emergency department was often full and could not immediately treat new patients. The number of ambulances waiting more than an hour to hand over patients had reduced significantly since the introduction of a rapid assessment and treatment area. An ambulatory emergency centre had been developed by the hospital but inspectors saw little evidence that it had improved treatment for emergency department patients.

The inspection identified a number of areas for improvement, including:

• Ensuring emergency department patients are assessed and treated according to nationally agreed standards, particularly those for sepsis and fractured neck of femur Ensuring emergency department transfer equipment is checked regularly to ensure that it is always ready for use.
• Ensuring the privacy and dignity of patents is protected during care and treatment.
• Improving hospital escalation procedures so that delays to ambulance patients are minimised Reviewing delays in discharge to prevent patients needing to stay in an inappropriate location and mixed sex breaches, particularly in critical care services.
• Ensuring there are effective systems to identify, assess, monitor and improve the quality and safety and mitigate risks across departments, in particular maternity and gynaecology services and the emergency department.

The reports highlight several areas of outstanding practice including:

The interventional radiology department had been awarded exemplar status by the British Society of Interventional Radiology for continuous audit, review and research in the unit, and improving patient experience. This award had been retained twice. The staff team were particularly proud of this achievement, particularly as they were not linked to a teaching hospital.

The Maternity and Gynaecology team offered support to women that were assessed as being vulnerable. They could be vulnerable due to mental illness or learning disability, but also from alcohol and substance misuse. The team worked with the local centre that cared for women who had been trafficked to Britain. The Sunshine team worked across health and social care and had excellent relationships with the police, education and the mental health. The service had been recognised by an all-party parliamentary group for its work with vulnerable women.

The Care Quality Commission will present its findings to a local Quality Summit, including NHS commissioners, providers, regulators and other public bodies. The purpose of the Quality Summit is to develop a plan of action and recommendations based on the inspection team’s findings.

The reports which CQC publish today are based on a combination of its inspection findings, information from CQC’s Intelligent Monitoring system, and information provided by patients, the public and other organisations including Healthwatch.

Ends

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