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Chief Inspector of Hospitals recommends Wye Valley NHS Trust is placed in special measures following Care Quality Commission inspection

14 October 2014
  • Media,
  • Hospitals

England's Chief Inspector of Hospitals has recommended Wye Valley NHS Trust is placed in special measures after a Care Quality Commission inspection resulted in it receiving an overall rating of ‘Inadequate’.

Hereford County Hospital was rated as ‘Inadequate’ whereas Wye Valley Community Health Services were rated as ‘Requires Improvement’ under the new inspection regime, introduced by the Care Quality Commission, to provide a much more detailed picture of care in hospitals than ever before.

Inspectors found a number of improvements were needed in the trust’s services.

The trust was judged as ‘Inadequate’ with regard to whether services were safe, well-led and responsive. It was rated as ‘Requires Improvement’ for whether services were effective and ‘Good’ with regard to whether services were caring.

Full copies of the reports relating to the trust can be found on the CQC website here.

An inspection team, including doctors, nurses, midwives, hospital managers, trained members of the public, a variety of specialists, CQC inspectors and analysts spent four days at the hospitals in June.

This included an unannounced inspection on 19 June which followed three consecutive days of inspection from 3 June, which had been announced.

Wye Valley NHS Trust was selected for inspection, under CQC’s new inspection approach, because it was a high priority trust based on CQCs intelligent monitoring and local concerns.

The inspection highlighted a number of concerns and CQC has told the trust it must improve. Areas for improvement include:

  • That the trust continues to improve mortality rates.
  • That action is taken to improve the flow of patients into, through and from the trust and that patient reviews are undertaken in a timely manner.
  • The trust was failing to meet the four-hour target for patients attending A&E. There were instances when patients remained on a trolley for 12 hours.
  • All environments needed to support the privacy and dignity of patients.
  • Patients must have access and support, if required, to appropriate foods and fluids.
  • Staff must be able to report incidents, feel confident to do so and, where appropriate, any lessons learned, needed to be disseminated across the trust. Any risks also needed to be recorded, escalated and acted on.
  • Improvements were needed with regard to discharge planning and arrangements, so that people were able to leave hospital when ready.
  • Medicines must be managed in line with the trust’s medication policy.
  • Forms for recording ‘do not attempt cardiopulmonary resuscitation’ (DNAR) must be completed in line with trust policy.
  • Improvements were needed in end of life care at both the hospital and in the community.
  • Systems for mandatory training and training of staff need to be improved so the trust can assure itself staff have the necessary skills to effectively care for patients.

Inspectors found examples of outstanding practice at the trust, including:

  • Dedicated and committed staff who would go above and beyond the call of duty for patients.
  • Established schemes – such as ‘virtual wards’ and ‘hospital at home’ - which prevent patients having to come into hospital and promote timely and effective discharges.
  • Excellent preoperative assessments, which included public health initiatives.
  • A midwifery academy, which had been developed to aid recruitment and promote retention among new and existing midwifery staff.

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

“Our inspection at Wye Valley NHS Trust highlighted a number of concerns, in particular surrounding the accident and emergency department and medical care. There were a number of other areas where the trust also needed to make improvements and the trust has been given an overall rating of ‘Inadequate’.

“I have made a recommendation to the Trust Development Authority (TDA) that the trust is placed in to special measures and we have informed the TDA of the breaches. The TDA will make sure these are appropriately addressed and that progress is monitored through the special measures action plan.

“Inspectors found some examples of outstanding practice and staff at the trust were seen to be caring, but changes are necessary and the trust faces a number of challenges to ensure it meets the required standards.

“We have told the trust where it needs to be and it is aware of what action it now needs to take.”


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

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?


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 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.






About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.