England’s Chief Inspector of Hospitals has rated the services provided by Southend University Hospital NHS Foundation Trust as Requires Improvement following an inspection by the Care Quality Commission.
The CQC inspected the core services provided by Southend University Hospital NHS Foundation Trust for three days in January 2016.
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.
The CQC has rated the trust as Requires Improvement overall. It was rated as Good for being effective and caring and Requires Improvement for being safe, responsive and well-led. Urgent and Emergency Services were rating Outstanding for being well-led.
CQC’s Chief Inspector of Hospitals, Professor Sir Mike Richards, said:
“Following our visit, our inspectors found that despite some areas of good practice, several improvements were needed at Southend University Hospital NHS Foundation Trust.
“During our inspection the trust was on a high state of escalation due to the increased number of patients coming in to the hospital. This caused high numbers of elective surgery and outpatient clinic cancellations due to congestion within the hospital.
“Staffing numbers were not adequate to meet patients’ needs. The identified shortfalls compromised patient safety. However the trust responded promptly when we identified the concern.
“The strategy to open escalation beds which increased the hospital bed base numbers had put increased pressure on the whole of the hospital, such as staffing, outliers, and cancelled elective procedures.
“Cancelled outpatients clinics were an issue due to the capacity and congestion within the hospital; outpatients staff were required to work on the wards which negatively impacted on those waiting for appointments.
“Patient discharges were not taking place in a timely fashion which was having a knock on effect across other departments. We saw this in critical care where patients ready for discharge were delayed as they waited for beds on the wards.
“It must be noted, however, that the trust had several areas of good practice and we were particularly impressed by the urgent and emergency service which we rated Outstanding for being well-led.
“The local leadership and team in the urgent and emergency department worked well to deliver the service and effective governance practices ensured risks were identified and managed.
“Across the trust, staff went the extra mile for patients and demonstrated caring and compassionate attitudes. Patients were aware of their treatment plans and had sufficient information. National guidelines were well embedded, used and demonstrated.
“In addition, stroke services demonstrated good outcomes 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.
“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 make improvements in several areas, including:
- The trust must take action to ensure that learning from serious incidents in ophthalmology is shared with all outpatient departments.
- The trust must ensure that there is clinical input into decisions to cancel operations within surgery.
- There must be sufficient and appropriate staff available in medical services to provide care and treatment for patients.
- A daily record must be made of the temperature of medicine storage rooms and for medicine refrigerators to ensure that medicines were stored within safe temperature ranges so that they remain effective.
- The trust must ensure that all staff complete the required level of both adult and children’s safeguarding training.
- The trust must take action to ensure sufficient numbers of suitably qualified, competent, skilled and experienced nurses are available at all times on wards caring for palliative and end of life patients. In addition, there must be sufficient end of life care consultants available to the trust.
- The trust must take action to ensure that the back log patients waiting for follow up appointments in ophthalmology and respiratory services are managed in a timely manner.
The CQC inspection team also found a number of areas of outstanding practice, including:
- The emergency department was rated as Outstanding. The local leadership and team worked well to deliver the service and the governance practices ensured risks were identified and managed. Staff were engaged and motivated.
- Stroke service patient outcomes received the highest rating by Sentinel Stroke National Audit Programme. CT head scanning was delivering a 20 minute door to treatment time which was a significant achievement.
- The trust had implemented an Early Rehabilitation and Nursing team (ERAN). The ERAN Team supported the early discharge of primary hip surgery and knee surgery patients.
- Safe @ Southend was a new daily initiative to allow staff to share day to day clinical and operational issues with executive directors for rapid action. An open invitation to all staff to share concerns and challenges in an open environment which often resulted in prompt action.
- In the outpatients department, a patient ambassador group was set up to look at issues raised by patients. Solutions to issues raised had been implemented.
Ends
For media enquiries contact Helen Gildersleeve, regional engagement officer on 0191 2333379 or CQC’s press office on 0207 4489401. For general enquiries, call 03000 61 61 61.
The trust had several areas of good practice and we were particularly impressed by the urgent and emergency service.
Professor Sir Mike Richards, Chief Inspector of Hospitals