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Provider: Liverpool University Hospitals NHS Foundation Trust Good Also known as Aintree University Hospital NHS Foundation Trust - formerly

On 26 September 2019, we published a report on how well Aintree University Hospital NHS Foundation Trust uses its resources. The ratings from this report are:

  • Use of resources: Requires improvement  
  • Combined rating: Good  

Read more about use of resources ratings

We are carrying out checks on locations registered by this provider. We will publish the reports when our checks are complete.

Inspection Summary


Overall summary & rating

Good

Updated 28 January 2021

Liverpool University Hospitals NHS Foundation Trust came into operation on 01 October 2019. The trust has four hospitals – Aintree University Hospital, Royal Liverpool Hospital, Liverpool Dental Hospital and Broadgreen Hospital – which provide a full range of acute services, including acute medicine, accident and emergency, acute frailty units, rehabilitation services, dental services and surgical services, to a population of approximately 630,000 people.

We carried out a short notice announced focused inspection of elements of the safe and well-led domains in urgent and emergency care services, surgical services and medical care services, on both the Royal Liverpool Hospital and Aintree University Hospital sites. We did not rate the core services because this was a focused, short notice inspection in response to specific areas of concern.

We inspected safety and governance processes in urgent and emergency care, surgery and medical care services. We also looked at the wider oversight and management of risk, governance and safety of patients across the trust.

During our inspection, we found significant concerns relating to the management of medicines. We put our concerns formally in writing to the trust and asked for urgent action to mitigate the risks to patients. The trust provided a detailed response including improvement actions already taken or planned, all actions were due for completion by November 2020. This provided assurance that sufficient action had been taken to mitigate any immediate risks to patient safety. We will continue to monitor this information through our routine engagement with the trust.

We found:

  • The leadership, governance and culture did not always support the delivery of high-quality person-centred care.
  • The statement of its vision and guiding values was incomplete and had not been developed into deliverable strategies.
  • The trust’s strategic approach was underdeveloped and did not fully reflect the health economy in which the service operated.
  • The governance arrangements and their purpose were unclear, and there was a lack of clarity and maturity regarding the implementation of the trusts board assurance framework.
  • The arrangements for governance and performance management were not always clear and did not operate effectively.
  • Risks, issues and poor performance were not always known or escalated appropriately, and actions lacked pace and urgency to address the concerns.
  • The trust had inconsistent systems to ensure staff knew about safety alerts and incidents across the locations we inspected. We found an issue where there had been insufficient action to mitigate risks.
  • Following the inspection, the trust acted to make improvements and had implemented a new trust-wide safety bulletin.
  • We found a lack of clarity and proactivity regarding discharge planning, we raised this at the time of inspection and were given assurances from senior leaders that this would be addressed as part of the trust’s winter planning.
  • There was limited evidence of learning and reflective practice among leaders.
  • There were limited processes to review key items such as the strategy, training objectives, implementation plans or the governance framework.
  • Clinical engagement was variable. Medical staff reported that channels of communication were not always effective and appeared to be blocked at middle manager level.
  • The pharmacy department and responsibilities for medicines management and governance sat within the clinical support division. Trust reconfiguration had initially resulted in limited representation from the pharmacy team at trust board level.

However:

  • There was a varied mix of skills and experience across the non-executive directors and a considered approach to the skill set requirements when new non-executive directors were recruited.
  • Staff and leaders recognised the workforce as being loyal to the city, local community, and the trust. Leaders also recognised that staff were hard working and committed to providing high quality patient care.
  • The trust had recently undertaken a series of quality improvement idea sessions with staff from different service areas in the trust.
  • During the first wave of the pandemic, the trust had implemented a number of initiatives to support employee wellbeing, including free accommodation to keep staff and their families safe, provision of free food and car parking, and a ‘Support Our Staff’ appeal that had raised £500,000, which was being used to support improvements for staff break areas.
Inspection areas

Safe

Requires improvement

Updated 28 January 2021

Details appear in the hospital sections of our inspection report.

Effective

Good

Updated 28 January 2021

We did not inspect effective.

Caring

Good

Updated 28 January 2021

We did not inspect caring.

Responsive

Good

Updated 28 January 2021

We did not inspect responsive.

Well-led

Good

Updated 28 January 2021

Assessment of the use of resources

Use of resources summary

Requires improvement

Updated 26 September 2019

Combined rating