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Chief Inspector of Hospitals recommends George Eliot Hospital NHS Trust is brought out of special measures
England’s Chief Inspector of Hospitals has recommended that George Eliot Hospital NHS Trust is brought out of special measures following a Care Quality Commission inspection.
The recommendation follows the publication of his first report on the quality of care provided by the trust, which was found to be good. NHS regulator Monitor put the trust into special measures in July last year following Sir Bruce Keogh’s report into concerns around mortality rates and standards of care.
At the CQC inspection in April 2014, inspectors rated medical care, critical care, maternity and family planning services, children’s care, end of life care and outpatients’ services as Good. Accident and Emergency (A&E) and surgery at the hospital were rated Requires Improvement.
Overall, CQC rated the hospital as Good, as it did the wider trust after it was rated Good for caring, effectiveness, responsiveness and leadership. Inspectors rated the trust Requires Improvement for safety because improvements were needed in some services in this area. The full reports on the hospital and the wider trust are available at George Eliot Hospital NHS Trust.
Inspectors found that staff were caring and compassionate, and were positive about working for the trust and the changes made. Patients were experiencing good care, and the hospital had scored higher than the national average on the NHS Friends and Family Test across most inpatient wards and A&E.
The trust had opened a new acute medical admissions unit which, along with the ambulatory care unit, was intended to improve the flow of emergency patients through the hospital by speeding up assessment, treatment and discharge. Emergency care had been improved. Seven-day services were developing well, and new ways of working had been developed to standardise care for people who were acutely ill.
Staffing levels had been increased, but while safe levels were being maintained, there was a heavy reliance on bank and agency staff while recruitment continued. Medicines were not always safely stored and managed in A&E and the surgical department. Concerns were identified relating to storage and stock control, including that of controlled drugs. The trust was taking action on this. Some poor infection control practice was seen in A&E.
CQC identified a number of areas of outstanding practice, including:
- The ambulatory care unit, opened in December last year, which was having a positive impact on preventing admissions by meeting people’s needs in the community.
- Initiatives to help people with dementia to eat, including warmed plates and adapted cutlery.
- The use of individual booklets in all medical wards by members of the multidisciplinary team (including social services) to try and ensure safe discharge.
- Multidisciplinary networks in children’s and young people’s services, developed to deliver care closer to their homes.
- A special service developed to offer information and positive parenting support to teenage mothers and those identified as vulnerable.
- A team of volunteer therapists, who had a professional qualification in relaxation, would identify and support patients who may be anxious about surgery at their pre-operative assessment.
Inspectors also found two areas where the trust must improve, alongside a number of other areas where it should make improvements, to ensure that:
- Medicines are managed in accordance with the law at all times.
- Leadership and governance arrangements are effective in A&E, surgery, maternity and radiology.
CQC’s Chief Inspector of Hospitals, Professor Sir Mike Richards, said:
“Our inspection in April found significant improvements in a number of areas, and I am very pleased to be able to recommend that George Eliot Hospital NHS Trust should exit special measures.
“I have formally made my recommendation to the Trust Development Authority, which supports trusts seeking foundation status, and welcome their announcement today regarding this.
“Some improvements are still needed, so the trust cannot be complacent. But, as the trust has moved forward and made improvements across its services, CQC has developed confidence in the trust’s leadership to continue to work to make further changes for the good of its patients.”
An inspection team which included doctors, nurses, hospital managers, trained members of the public, CQC inspectors and analysts made an announced visit in April. Inspectors also returned unannounced in May.
CQC inspectors will return to the hospital in due course to check that the remaining improvements required have been made.
For media enquiries, contact Louise Grifferty, regional communications manager, on 07717 422917 or contact CQC’s press office on 020 7448 9401, during office hours, or, out of hours, on 07917 232 143. For general enquiries, call 03000 61 61 61.
- Last updated:
- 30 May 2017
Notes to editors
Trusts exiting special measures:
George Eliot Hospital NHS Trust was placed in to special measures following a review by Sir Bruce Keogh and his team last year.
The trusts which went to special measures did so because there was one or more serious inadequacy in their performance that would impact on the safety or quality of services patients were receiving and there was a lack of confidence in the organisations’ leadership to be able to respond to the challenge of improvement.
As CQC assesses the organisations that were subject to the Sir Bruce Keogh inspections 12 months on we are looking to confirm what improvement there has been and if the organisation is able to exit special measures. The two key determining factors as to whether an organisation can exit special measures are whether the leadership of the organisation has shown it has tackled the issues facing it, and whether it has been able to show a demonstrable effect on performance and therefore improve patient care?
An organisation can exit with areas still requiring improvement but will not be allowed to do so if CQC does not have confidence that the leadership has satisfactorily demonstrated the ability to make or maintain improvement without the full range of special measures support.
As a trust exits we may recommend it to continue being supervised in particular areas and that the TDA or Monitor will provide specific support such as the continuation of a buddying arrangement or transformation director position.
The Chief Inspector of Hospitals, Professor Sir Mike Richards, is leading significantly larger inspection teams than before, headed up by clinical and other experts including trained members of the public. By the end of 2015, CQC will have inspected all acute NHS Trusts in the country with its new inspection model. Whenever CQC inspects it 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?
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.
This report describes our judgement of the overall quality of care provided by this trust. It is based on a combination of what we found when we inspected, information from our ‘Intelligent Monitoring’ system, and information given to us from patients, the public and other organisations.
The overall trust, individual hospitals and individual services within those hospitals have been given one of the following ratings (on a four point scale): Outstanding, Good, Requiring improvement, Inadequate.