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Chief Inspector of Hospitals warns Worcestershire Acute Hospitals NHS Trust to make urgent improvements following focused inspection

8 August 2017
Worcestershire Acute Hospitals NHS Trust
  • Media,
  • Hospitals

England's Chief Inspector of Hospitals has told Worcestershire Acute Hospitals NHS Trust that it must make urgent improvements to the quality of healthcare following a focused inspection in April.

The trust has been in special measures since December 2015. That was extended following an inspection in November and December 2016.

An unannounced, focused inspection was carried out on 11 and 12 April 2017. Inspectors visited Worcestershire Royal Hospital, Alexandra Hospital in Redditch and Kidderminster Hospital and Treatment Centre.

They looked at areas of previous concern in the emergency department, medical care, surgery, maternity and gynaecology, children and young people and the minor injuries unit at Kidderminster Hospital and Treatment Centre. Inspectors also visited on 25 April 2017 specifically to interview key members of the trust’s senior management team.

Following this inspection CQC issued a Warning Notice requiring the trust to take action to deal with concerns in relation to governance systems and mitigation of risks.

The trust is currently rated as Inadequate overall. It is rated as Inadequate for being safe, responsive and well-led, Requires Improvement for being effective and Good for being caring.

Professor Ted Baker, the Chief Inspector of Hospitals, said:

“Over the last two years Worcestershire Acute Hospitals NHS Trust has been subject to rigorous and frequent regulatory action."

“I remain concerned that the trust has not taken sufficient action to address the requirements of our previous inspections, and patients using services continue to experience a poor level of care."

“In our recent inspections we have found there was little effective ownership of the need to establish systems to assess quality of services or to recognise, assess and mitigate risks to patient safety."

“The new executive team are recently established and are aware they face significant challenges. It is important that they drive the necessary improvements to the safety and quality of patient care, with continued support from NHS Improvement and others. It is also clear that some of the issues the trust is struggling with can only be addressed in partnership with other agencies who have a responsibility for health services in the area."

“The trust has agreed to provide information demonstrating how specific improvements will be made. We intend to monitor this information closely and will check on these areas when we re-inspect in the near future.”

Inspectors found there had been no tangible improvement in performance since the previous inspection. Staff caring for patients in the corridors in the emergency department had become standard practice. Patient’s privacy, dignity and effective care remained compromised.

The number of patients in the emergency department waiting between four and 12 hours to be admitted or discharged remained consistently higher than the national average.

Some risk assessment records in medical care wards at Worcestershire Royal Hospital were not routinely completed, including elderly patient risk assessments and sepsis bundle assessments.

Inspectors found staff were hard-working, passionate and caring. However, many staff were clearly frustrated that they were not able to effect change due to poor communication between ward, divisional and executive levels.

CQC has told the trust it must make improvements in a number of areas, including:

  • Governance systems must allow full oversight at board level of the potential risk to patients. This must include the recognition, assessment, monitoring and mitigation of risk.
  • Patients in the emergency department must receive medication prescribed for them at the correct time and interval.
  • All patients’ conditions must be monitored effectively to enable any deterioration to be quickly identified and care and treatment is provided in a timely way.
  • The privacy and dignity of all patients in the emergency department must be supported at all times, including when care is provided in corridor areas.
  • Identifiable patient information must be stored securely and not kept on display.
  • All patients in the children and young people’s service with mental health needs must have the appropriate level of staff one to one care in accordance with their risk assessments.
  • Processes must be in place to ensure any medicine omissions are escalated appropriately to the medical team, including when patients refuse to take prescribed medication.

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Last updated:
08 August 2017

Notes to editors

Worcestershire Acute Hospital NHS Trust provides services from four sites: Worcestershire Royal Hospital, Alexandra Hospital in Redditch, Kidderminster Hospital and Treatment Centre and surgical services at Evesham Community Hospital, which is run by Worcestershire Health and Care NHS Trust.

Hospitals are put into special measures when there are problems with the quality of care provided to some or all patients that the leadership of the trust cannot fix in a reasonable time without additional help. Often the decision that a hospital is providing poor care is made following an inspection by the CQC’s Chief Inspector of Hospitals.  Further details can be found here.

Whenever CQC inspects it will always ask the following five questions of every service:
  • Are they safe?
  • Are they effective?
  • Are they caring?
  • Are they responsive to people’s needs?
  • Are they well-led?
Since 1 April, registered providers of health and social care services have been required to display their ratings on their premises and on their websites so that the public can see their rating quickly and easily.

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.