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.
Read full reports including ratings of all core services will be published on the CQC website.
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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.
Professor Sir Mike Richards, Chief Inspector of Hospitals