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Chief Inspector of Hospitals recommends Wye Valley NHS Trust comes out of special measures following improvements in care
England's Chief Inspector of Hospitals has recommended that Wye Valley NHS Trust exits special measures following a Care Quality Commission inspection.
The trust was rated Inadequate overall and placed into special measures following an inspection in June 2014. It was re-inspected in September 2015 and remained in special measures. When inspectors returned in July this year, they found the trust had made improvements and it is now rated as Requires Improvement overall.
The inspection found that, while considerable progress had been made since 2014, further work was needed to address areas where the service fell short of the standards people should be able to expect.
However, the work the board and senior management had done to develop a strategic vision, with staff and patients, was seen to be making a difference. As a result, Professor Sir Mike Richards is recommending the trust now exits special measures.
Professor Sir Mike Richards, CQC’s Chief Inspector of Hospitals, said:
“Our return to Wye Valley NHS Trust showed significant improvement had taken place. This is reflected in the trust’s new rating - which has improved from ‘Inadequate’ to ‘Requires Improvement’ - and our recommendation to NHS Improvement that the trust now comes out of special measures.
“Special measures is designed to provide intensive support to struggling trusts and Wye Valley NHS Trust clearly gained from the special measures regime and the support it provided.
“There clearly remain areas where further work is needed, in particular with regard to the trust’s responsiveness in A&E, bed occupancy concerns and referral to treatment times, but we found considerable and positive change had taken place. Morale had significantly improved and there was a sense of pride amongst staff towards working in the hospital who felt respected and valued.
“Following the trust being placed into special measures in October 2014, a comprehensive quality improvement plan was developed, which included a number of projects and actions. We saw that the action plans were reviewed regularly, with monitoring of compliance against targets and details of completed actions.
“We were particularly impressed with the critical care and end of life care departments which we rated as Good overall.
“Throughout and immediately following our inspection we raised concerns with the trust and the senior management team informed us of the immediate action it would to take to address those issues.
“The trust’s staff and leadership should be proud of their achievement so far and they know what to do now to ensure those changes takes place. We will continue to monitor the trust and this will include further inspections.”
Inspectors found examples of outstanding practice at the trust, which included:
- Services for children and young people were supported by two play workers who regularly made arrangements for long term patients to have days out to different places, including soft play areas or bowling. This meant that patients with long term conditions could meet peers who also regularly visited the hospital. Patients found this valuable and liked the opportunity to meet patients who had shared experiences.
- There was a children’s and young people’s ambassador group which was made up of patients who used or had used the service. We spoke with some members of the ambassador group who told us that they were involved in the service redesign when developments took place.
- The respiratory consultant lead for non-invasive ventilation had developed a pathway bundle which was used for all patients requiring ventilator support. The information gathered directed the service to provide an increased level of care within the patient’s own home. Patients were provided with pre-set ventilators and were monitored remotely. This development had achieved first prize in the trust quality improvement project 2016.
- The newly introduced clinic for patients with epilepsy had enlisted the support of a patient with epilepsy; their views had helped the clinic develop so that the needs of patients were met.
However, there were areas where the trust has been told it must make improvements including:
- The trust must ensure that patients are able to access surgery, gynaecology and outpatient services in a timely way for initial assessments, diagnoses and treatment, with the aim of meeting trust and national targets.
- All staff must receive have their required mandatory training to ensure they are competent to fulfil their role.
- The trust must continue to take action to address patient waiting times, and assess and monitor the risk to patients on the waiting list.
- All risks must be identified on the risk register and appropriate mitigating actions taken.
- The trust must ensure effective and timely governance oversight of incident reporting and management, particularly in children and young people’s services.
Wye Valley NHS Trust is rated Requires Improvement overall, Requires Improvement for being safe, effective, responsive and well-led and Good for being caring.
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- Last updated:
- 29 May 2017
Notes to editors
Wye Valley NHS Trust was established in April 2011 and provides hospital care and community services to a population of 186,000 people in Herefordshire and a population of more than 40,000 people in mid-Powys, Wales. The trust also provides a full range of district general hospital services to its local population, with some links to larger hospitals in Gloucestershire, Worcestershire and Birmingham. During this inspection we only inspected the services provided by Hereford Hospital
This report follows a comprehensive inspection on the quality of services provided at Wye Valley NHS Trust. Inspection teams include a range of clinical and other experts including experts by experience.
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?
Registered providers of health and social care services are required to display their ratings on their premises and on their websites so that the public can see their rating quickly and easily. Further information on the requirement for providers to prominently display their CQC ratings.
The 18 trusts that are currently in special measures are:
- The Princess Alexandra Hospital NHS Trust
- Barking, Havering and Redbridge University Hospitals NHS Trust
- Colchester Hospital University NHS Foundation Trust
- Medway NHS Foundation Trust
- East Kent Hospitals University NHS Foundation Trust
- Sherwood Forest Hospitals NHS Foundation Trust
- Wye Valley NHS Trust
- Barts Health NHS Trust
- West Hertfordshire NHS Trust
- East Sussex Healthcare NHS Trust
- Cambridge University NHS Foundation Trust
- Worcester Acute Hospitals NHS Trust
- London Ambulance Service NHS Trust
- North Cumbria University Hospitals NHS Trust
- South East Coast Ambulance Service NHS Foundation Trust
- Brighton and Sussex University Hospitals NHS Trust
- Walsall Healthcare NHS Trust
- St George’s University Hospitals NHS Foundation Trust
The 13 trusts which have been taken out of special measures are:
- Basildon and Thurrock University Hospitals NHS Foundation Trust
- Norfolk and Suffolk NHS Foundation Trust (mental health trust)
- Hinchingbrooke NHS Trust
- Buckinghamshire Healthcare NHS Trust
- East Lancashire NHS Trust
- George Eliot Hospital NHS Trust
- Heatherwood and Wexham Park Hospitals (now dissolved, but part of Frimley Health)
- North Lincolnshire and Goole NHS Foundation Trust
- United Lincolnshire Hospitals NHS Trust
- Queen Elizabeth Hospital King's Lynn NHS Foundation Trust
- Tameside Hospital NHS Foundation Trust
- Burton Hospitals NHS Foundation Trust
- University Hospitals of Morecambe Bay NHS Foundation Trust