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Provider: James Paget University Hospitals NHS Foundation Trust Good

Inspection Summary

Overall summary & rating


Updated 18 December 2019

Our rating of the trust stayed the same. We rated it as good because:

  • We found that there were no regulatory breaches and overall, we have found that the organisation was performing at a level which led to the overall rating as good.
  • Overall, we rated safe as requires improvement, effective, caring and well-led as good, and responsive as outstanding. In rating this trust we took into account the current ratings of the service not inspected on this occasion.
  • We rated the well-led part of the inspection as good.
Inspection areas


Requires improvement

Updated 18 December 2019

Our rating of safe stayed the same. We rated it as requires improvement because:

  • Although the core services we inspected were all rated good for safe. We have to take current ratings not inspected on this occasion into account. Maternity and medicine core services were rated requires improvement for the safe domain at our last inspection which meant that overall safe remained rated as requires improvement.
  • Services generally had sufficient numbers of staff to keep patients safe. In the two core service where there were staff shortages the trust was actively recruiting and mitigated risk by utilising bank staff to fill shifts. Staff completed mandatory training in key skills, and met the trust’s compliance target.
  • Medicines were generally managed and stored correctly, in line with national guidance. In one area we found intravenous fluids incorrectly stored, the service responded quickly and moved them to ensure they were stored correctly.
  • Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse, and they knew how to apply it.
  • Services controlled infection prevention risks well.



Updated 18 December 2019

Our rating of effective stayed the same. We rated it as good because:

  • All core services we inspected were rated as good for effective.
  • Care and treatment was based on national guidance and evidence-based practice. Managers checked to make sure staff followed guidance. Guidelines were in date.
  • Staff gave patients enough food and drink to meet their needs and improve their health. The service made adjustments for patients’ religious, cultural and other needs.
  • Staff assessed and monitored patients regularly to see if they were in pain and gave pain relief in a timely way.
  • Staff monitored the effectiveness of care and treatment and used the findings to make improvements and achieve good outcomes for patients.


  • Critical care, core service were not always able to provide full multidisciplinary team work due to a shortage of physiotherapists.



Updated 18 December 2019

Our rating of caring stayed the same. We rated it as good because:

  • One of the core services we inspected was rated as outstanding all of the others were rated good.
  • 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 for patients and those close to them.
  • Staff within end of life care core service provided some outstanding examples of care given to patients.



Updated 18 December 2019

Our rating of responsive improved. We rated it as outstanding because:

  • Two of the core services we inspected were rated outstanding at this inspection; outpatients and children’s and young people’s services which meant overall the trust was rated outstanding for responsive. At our last inspection maternity was rated outstanding, all of the other core services were rated as good.
  • Services were planned and care was provided in a way that met the needs of local people and the communities served.
  • Services were very inclusive and took account of patients’ individual needs and preferences. Staff made reasonable adjustments to help patients access services. Staff supported people to access health care within the community and liaised with other agencies to work in partnership to improve patient care.


  • Staff from the core services, told us they returned complaint responses in time, however, the trust did not always ensure the complaint process was completed in line with the trust policy.



Updated 18 December 2019

Our rating of well-led stayed the same. We rated it as good because:

  • All of the core services we inspected were rated as good for well-led.
  • Governance processes were fully effective. Staff had regular opportunities to meet, discuss and learn from the performance of the service. Risks and issues were escalated promptly, and mitigating actions were taken quickly to reduce the impact of risks identified.
  • The executive team and managers were visible and approachable throughout all core services.
  • Staff mostly felt respected, supported and valued. They were focused on the needs of patients receiving care. The service provided opportunities for career development.
  • All staff were committed and supported by managers to continually learn and improve their service. They had a good understanding of quality improvement methods and the skills to use them.

Assessment of the use of resources

Use of resources summary


Updated 18 December 2019

The trust has improved its financial position and has also demonstrated achieving further workforce and service productivity improvements, since the last assessment. Please see the separate use of resources report for details of the assessment and the combined rating.

Combined rating