The Care Quality Commission (CQC) has welcomed improvements in the quality of services for patients during an inspection of North Bristol NHS Trust. As a result of the inspection, the trust is now rated as Good overall. Previously it was Requires Improvement.
A team of inspectors from the Care Quality Commission visited the trust during June and July 2019 to check the quality of five core services: urgent and emergency services, medical care (including older people’s care), surgery, maternity and end of life care. CQC also looked specifically at management and leadership to answer the key question: Is the trust well led?
As a result of this inspection the trust is now rated as Outstanding for being caring and well-led, Good for being safe and effective. The trust remains Requires Improvement for being responsive.
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.
You can read the latest reports in full here: www.cqc.org.uk/provider/RVJ, published on the CQC website.
Dr Nigel Acheson, CQC’s Deputy Chief Inspector of Hospitals for the south, said:
“North Bristol NHS Trust has worked steadily to embed the improvements we requested at our last inspection. I want to congratulate them for this work. It has helped them move from Requires Improvement to Good.
“Our inspectors found a strong patient-centred culture. Staff were doing what was right for their patients, keeping them safe and involving them in decisions about their care. Patients and relatives spoke highly of staff and how they were kept informed of treatment plans, and how these would affect them.
“The trust has worked in a climate of some local scrutiny for the past few years. Despite this, they have managed significant improvements in medical care and surgery which are now rated as Good. End of life care which was rated as Requires Improvement is now rated as Outstanding.
“The credit must go to the hard work and commitment of the staff and leadership team. I congratulate them on their achievements. The overall rating of Good reflects a substantial improvement in the quality of services at the trust. We will continue to monitor the trust’s performance and will return to hopefully report on further improvements in due course.”
Within end of life care, staff had shadowed patients to see the care experience through the eyes of a patient. By doing this the team found ways to make several subtle but important changes to the way in which care was delivered. It involved staff from all areas of the trust, including those who were non-clinical, to deliver person-centred end of life care. Staff described clinical leadership in end of life care as inspirational.
In surgery a hospital at home service had been developed with input from patients and other stakeholders. Provided by specially trained nurses the service provided care and treatment to patients in their own home. While patients received treatment as part of the hospital at home service, they remained under the care of their hospital consultant. The surgery team reported that the hospital at home service had resulted in a reduced length of stay in hospital and was a factor in reducing the number of cancelled operations
The emergency department had developed a vision statement, with input from staff. A series of objectives supported an over-arching statement. Senior staff could clearly describe the streams of work that were ongoing to achieve these objectives while staff were engaged in numerous projects to realise the vision and objectives. There was a sense of shared vision, values and commitment to improve services for patients. Feedback from patients and those close to them was consistently positive. Inspectors saw and heard about numerous examples of care where staff had ‘gone the extra mile’. Staff were highly motivated and inspired to offer the best possible care, that was kind and promoted people’s dignity.
Medical care provided an all-round approach to delivering care and treatment. Therapy approach was embedded within teams within all the clinical pathways. On the stroke unit, therapy presence physiotherapy, occupational therapy and speech and language therapy was available seven days a week. This helped with the ongoing rehabilitation of patients prior to leaving hospital.
In maternity, leaders understood and managed the priorities and issues the service faced. Leaders were visible and approachable in the service and they supported staff to take on more senior roles. Leaders collaborated with partner organisations to help improve services for patients. Staff felt respected, supported and valued and were focused on the needs of patients receiving care.
Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers. Feedback from patients and those close to them was consistently positive. Inspectors found numerous examples of care where staff had ‘gone the extra mile’. This included many examples where staff had undertaken fund-raising events in their own time to provide things that would make a difference to patients’ experiences.
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