The Care Quality Commission has recommended that London’s Barts Health NHS Trust should be taken out of special measures.
Inspectors found that sufficient progress had been made to justify the recommendation to NHS Improvement. A team of inspectors from CQC visited the trust in September and October 2018 to carry out a comprehensive inspection. CQC also looked specifically at management and leadership to answer the key question: Is the trust well-led?
Overall the trust remains Requires Improvement for the quality of its services. However, it is rated Good for being effective, caring and well-led. It is rated Requires Improvement for being safe and responsive to people’s needs.
CQC has also published the trust’s Use of Resources report, which is based on an assessment undertaken by NHS Improvement. The trust has been rated as Requires Improvement for using its resources productively.
England’s Chief Inspector of Hospitals, Professor Edward Baker, said:
"I am pleased to report that Barts Health NHS Trust has made real, consistent progress.
“In November 2015, CQC rated the trust as Inadequate overall because of concerns relating to patient safety, the organisational culture and governance throughout the organisation. Since that time CQC has been keeping a close watch, with support from local clinical commissioning groups and NHS Improvement. In many areas the quality of service has been transformed.
“Credit must go to the leadership team at the trust and to the commitment and hard work of all the staff. I congratulate them on what they have achieved. While the overall rating remains Requires Improvement there has been substantial improvement in the quality of services at the trust and I am happy to recommend that it is removed from special measures."
“However, there are still areas that require attention, particularly maternity services at Newham. We will return later this year to check that the improvements we have required have taken place. I would be disappointed if we find that the trust has not continued to make further progress. I have asked NHS Improvement to continue providing close support for the trust with this service”
Services at Whipps Cross University Hospital had improved. These included significantly better standards of patient care in medical care, an improved culture around medicines management, and improved record keeping in surgery. There were still several areas of improvement to address such as pockets of bullying in the emergency department, the maintenance of equipment and the environment.
Inspectors were concerned about the persistent issue of poor-quality care and leadership in the maternity wards at Newham University Hospital. Inspectors rated the service Inadequate overall - issuing the trust with a Warning Notice to address concerns surrounding care and leadership.
A follow-up inspection of maternity services at Newham in January 2019 checked against the progress made in response to the Warning Notice CQC issued. Appropriate steps to address concerns had been taken and the requirements of the Warning Notice had been met. There was evidence of improvement to the safety and overall running of the service.
At Whipps Cross Hospital, staff in medical services had significantly improved the accessibility of information available to patients. This included working with a specialist organisation to design a website that enabled patients with physical disabilities to plan their visit in advance, based on step-free access needs and the introduction of a website that could be translated instantly into any of 100 different languages.
At Newham University Hospital, the trust had invested in the Rainbow Centre for children and young people which provided a well organised and child-friendly environment. Staff consistently told inspectors the new environment and facilities made a big difference to their work and they felt reinvigorated and motivated by it. Patients and their parents said the new environment was welcoming and comfortable.
The children and young people service at Newham University Hospital frequently cared for patients with mental health support needs, including some vulnerable and at-risk young people in crisis. The service worked in partnership with the local NHS mental health and community trust to develop a training package called ‘We Can Talk.’ This equipped clinicians with the skills to support patients in mental health crisis when they are receiving urgent medical treatment. Young people with mental health conditions, charity organisations and mental health professionals were involved in developing the training. The trust had developed a training toolkit for hospital staff which was the only programme of its kind in the NHS.
Children’s services had improved at The Royal London Hospital, with outstanding practice recognised in its trauma and specialist burns care, dental hospital and use of robotic surgery.
You can read the report in full when it appears on CQC’s website at www.cqc.org.uk/provider/R1H
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