Chief Inspector of Hospitals publishes his findings on the Northampton General Hospital NHS Trust

27 March 2014

England's Chief Inspector of Hospitals has published his first report on the quality of care provided by the Northampton General Hospital NHS Trust.

• Northampton General Hospital, Cliftonville - Overall rating: Requires improvement
• Isebrook Hospital, Wellingborough - Overall rating: Requires improvement
• Danetre Hospital, Daventry - Overall rating: Requires improvement
• Corby Community Hospital, Corby - Overall rating: Requires improvement

The trust was inspected under radical changes introduced by the Care Quality Commission, which provides a much more detailed picture of care in hospitals than ever before.

As well as good care, during its inspection CQC uncovered several concerns and areas for improvement at the trust’s Northampton General Hospital in relation to how its services are assessed and monitored. These have prompted the regulator to issue a warning notice to the trust. 

What inspectors found

Overall, the report concludes that despite Northampton General Hospital NHS Trust having some areas of good practice, improvements are needed across several departments.

The inspection team found areas of good practice, which included:

• Staff were caring and compassionate in each of the service areas visited. Patients and their relatives spoke very highly of the caring nature of staff.
• The trust was very clean throughout and performed well in relation to infection prevention and control.
• The critical care unit was effective, caring and well led.
• The maternity unit offered the choice of home births and had an adequate numbers of midwives on hand at all times.

However, there were also a number of areas that require improvements. For example, Northampton General Hospital had no effective system to identify, assess and manage the risks to the health and welfare of patients who were moved wards at night. The inspection team noted that some patients were transferred as late as 3am. Ward transfer records did not note the times or number of patients who were transferred at night.

Also, there were concerns regarding staff development. Information provided by the hospital showed that less than a third of staff had an up to date performance development plan (PDR) in place in January 2014. There was no evidence that actions were in place to ensure that these omissions were being addressed. 

CQC has told the Northampton General Hospitals NHS Trust that it must take action to improve in the following areas:

• Review and act on how children are treated in the A&E department, as dedicated staff and facilities were limited.
• Ensure medical equipment is adequately tested and maintained.
• Strengthen governance to ensure it functions consistently at all levels.
• Improve the service provided to patients who access the hospital as an emergency.
• Address the significant issue with bed availability at the trust due to delays in appropriate discharge.
• Improve compliance with both mandatory training and staff appraisals.
• Review how medication is dispensed to patients after they have been discharged from hospital.

The report, based on a combination of findings, information from CQC’s Intelligent Monitoring system, and information provided by patients, the public and other organisations, will be available on CQC’s website today.

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

“Whenever we inspect we will always ask the following five questions of every service: Is it safe? Is it effective? Is it caring? Is it responsive to people’s needs? Is it well-led?

“While some services were delivered effectively at the trust, the issues at the A&E department, poor management, staff training, and equipment maintenance must be improved.

“The trust appeared to have hard working staff but there were concerns surrounding the lack of mandatory training being completed which could affect the way care is delivered. It is essential that staff are being adequately supported and developed in their roles.

“Despite this shortfall, we observed caring and compassionate staff in each of the service areas. Patients and their relatives spoke very highly of the caring nature of the staff.”

Siobhan Jordan, head of hospital inspection, said:  “The concerns CQC found were unacceptable and we have warned the trust it must improve. CQC will continue to monitor the service closely and our inspectors will be returning unannounced to check on whether improvements have been made and standards are being met.

“I am pleased the trust was open and honest throughout the inspection and I am also grateful to the public who took the time to express their views at the listening event. We believe the report will provide the trust with the opportunity to work with partners to improve services.”

CQC spent three days at the Northampton General Hospital NHS Trust, including Northampton General Hospital, Danetre Hospital, Corby Community Hospital and Isebrook Hospital in January. The inspection team included doctors, nurses, hospital managers, trained members of the public, CQC inspectors and analysts. They examined the care provided in accident and emergency, medical care (including older people’s care), surgery, intensive/critical care, maternity, children’s care, end of life care and outpatients.

The reports, which CQC has published today (Thursday, 27 March), are based on a combination of their findings, information from CQC’s Intelligent Monitoring system, and information provided by patients, the public and other organisations.

CQC will return to the trust at a later date to follow up the findings of this inspection and to report on the trust’s progress in making the required improvements.

Ends

For media enquiries, call regional communications officer, Helen Gildersleeve, on 0191 233 3379 or email Helen.gildersleeve@cqc.org.uk.

The CQC press office is also available on 020 7448 9401 during office hours or out of hours on 07917 232 143. For general enquiries, call 03000 61 61 61.

Notes to editors

The Care Quality Commission has already presented 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.

CQC inspectors will continue to monitor the Northampton General Hospital NHS Trust and will return in due course to carry out further inspections as part of its regulatory programme.

The Chief Inspector of Hospitals for CQC, Professor Sir Mike Richards, announced in July that he will lead significantly larger inspection teams than before, headed up by clinical and other experts including trained members of the public.