Chief Inspector of Hospitals rates Bedford Hospital NHS Trust as Requires Improvement

England’s Chief Inspector of Hospitals has rated the services provided by Bedford Hospital NHS Trust as Requires Improvement following an inspection by the Care Quality Commission.

The CQC inspected Bedford Hospital which is provided by Bedford Hospital NHS Trust between 15 and 17 December 2015. Two unannounced inspections were also undertaken on 6 and 7 January 2016. The trust provides a full range of district general hospital services to its local population, with some links to hospitals in Luton and Dunstable, Milton Keynes and Cambridge.

A team of inspectors, which included a variety of specialists and experts by experience visited hospitals and services provided by the trust and full reports of their findings, including ratings for all of the provider’s core services are available at: www.cqc.org.uk/provider/RC1

The CQC has rated the trust as Requires Improvement overall. It was rated as Good for being caring and Requires Improvement for being safe, effective, responsive, and well led.

CQC’s Chief Inspector of Hospitals, Professor Sir Mike Richards, said:

“Our inspectors found that some improvements were needed at Bedford Hospital NHS Trust.

“We were not assured that serious incidents were effectively managed in the maternity unit. The root cause analysis in relation to serious incidents did not always demonstrate analysis or learning. Following our inspection, we were reassured to see that the trust had commissioned an external review of maternity services which would be run by a programme board using project management methodology.

“There was recognition that the trust needed to make changes in response to our concerns that some service models required reviewing. For example, the trust must ensure there are appropriate numbers of qualified paediatric staff in the emergency department and paediatric unit to meet national standards.

“It must also be noted that we have also seen many areas of good practice that staff should be proud of.

“We were particularly impressed by the excellent facilities to meet the needs of patients living with dementia. The trust had implemented processes to meet patient needs and a range of facilities were available to support them.

“We saw some good examples of multi-disciplinary working across the trust. Staff appeared to know each other well and worked together as a team in most services.

“The executive team were passionate about wanting to see improvements within the organisation. In most areas staff morale was good all of the staff we spoke to were proud to work for the trust and felt they did the very best they could for patients.

“Since our inspection we have been monitoring the trust and working closely with NHS Improvement and other stakeholders, such as the local Clinical Commissioning Group and NHS England.

“The trust leadership knows what it needs to do to bring about improvement and our inspectors will return at a later date to check on what progress has been made.”

The CQC has told the trust to take action in several areas, including:

• The trust must ensure lessons learnt and actions taken from never events, incidents and complaints are shared across all staff.
• There must be sufficient numbers of staff trained to the expected standard to give life support to paediatric patients.
• The trust must improve the incident reporting process to ensure all incidents are reported, including those associated with staffing levels.
• The trust must ensure patients’ privacy and dignity is always maintained at all times.
• The trust must ensure patient records are accurate, complete and fit for purpose, including ‘do not attempt cardio-pulmonary resuscitation’ forms.
• Risk registers must reflect the risks within the trust.

The CQC inspection team also found a number of areas of outstanding practice, including:

• The hospital offered endovascular stent-grafts for popliteal aneurysms, which is an alternative method to open surgery. Early indication suggests it is safer and more effective for patients.
• The critical care complex had designed and built an attachable portable unit for the end of a patient’s bed, to prevent disruption to the patient’s care and welfare. The unit was used when patients needed to go for a computerised tomography (CT) scan or a magnetic resonance imaging (MRI).
• A high risk birthing pool pathway was developed and implemented at the beginning of 2015. This meant that women with high risk pregnancies had the opportunity to experience the benefits of water whilst in labour. Midwives who were involved with the development of this project were selected as finalists in the Royal College of Midwives Innovation Awards 2015.
• Dementia facilities met the needs of patients living with dementia. Facilities included a cinema area, activity tables, coloured and picture coded bays. Under bed lighting assisted patients to differentiate between beds and flooring at night, and reported falls had decreased since the lighting was implemented.

Full reports for the trust will be published on CQC’s website today at the following link: www.cqc.org.uk/provider/RC1

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