17 April 2019
University Hospital Southampton NHS Foundation Trust has had foundation trust status since 1 October 2011. It is one of the country’s largest university hospitals, and provides local inpatient services to a population of 1.9 million people living in Southampton and south Hampshire. It also provides specialist services to over 3.7 million people living in southern England and the Channel Islands. Services include urgent and emergency care, medicine, surgery, critical care, maternity and gynaecology, services for children and young people, end of life care, and outpatient services including diagnostic imaging. There are approximately 11,500 staff employed to deliver services.
The trust is also a major centre for teaching and research in association with the University of Southampton and partners including the Medical Research Council and Wellcome Trust.
17 April 2019
Our rating of the trust stayed the same. We rated it as good because:
In rating the trust, we considered the current ratings of four other services not inspected this time.
- The staff survey results for 2017/2018 showed trust staff engagement had remained consistently high compared to the NHS average
- The trust was ranked number seven in acute trusts, and the third best university teaching hospital. It was also ranked second in good communication between senior managers and staff.
- Managers involved staff in changes to services.
- Staff understood their responsibilities to raise concerns, to record safety incidents, concerns and near misses and to report them internally and externally.
- The trust had established an integrated medical examiner group (IMEG) to review all deaths twice daily Monday to Fridays.
- Staffing levels, skill mix and caseloads were planned and reviewed so that people received safe care and treatment.
- Staff had access to necessary equipment and medicines; and had a range of policies and procedures based on national standards to support their practice.
- Medicines were appropriately prescribed and administered to people in line with the relevant legislation and current national guidance and had improved since our last inspection.
- People’s physical, mental health and social needs were holistically assessed and their care and treatment delivered in line with legislation, standards and evidence-based guidance.
- Multidisciplinary working was strong across the services. Staff worked well together and with other organisations to deliver effective care and treatment.
- The services had clear arrangements for supporting and managing staff to deliver effective care and treatment.
- Staff had annual appraisals and managers encouraged staff and supported opportunities for development.
- Staff were kind caring and treated patients with dignity and respect. Patients spoke of the positive care they received from staff.
- Staff communicated with people so they understood their care, treatment and condition; and advice was given when required. Staff involved carers and families in the patient’s care, where appropriate.
- Services delivered were accessible and responsive to people with complex needs or in vulnerable circumstances.
- The trust was recognised as one of 16 exemplar Global Digital acute trusts in England. A benefit for staff and patients was through the medical patient records (My medical record) being accessible to patients and promoting supportive management of long term conditions.
- The use of electronic white boards had been introduced for improving patient safety.
- The volunteers for the trust, worked at the hospitals and were involved with a wide range of activities including hospital radio, patient support and chaplaincy and spiritual care.
- In the emergency department services, we found there were delays in triage of patients that could impact on the health and wellbeing of patients.
- In medicine we found that not all paper records were stored securely to protect patients.
- In maternity we found that systems for ensuring secure access to the unit were not well established.
- In maternity and outpatients, we found infection control procedures were not fully applied.
- There were challenges with the aging estates for fire, water, electricity, and ventilation maintenance. The patient environments were showing significant signs of wear and tear.
- In outpatients there was not always the capacity to meet the needs of patients and their relatives attending.
- In outpatients the risks were significant to patients due to delays for waiting for ophthalmology appointments.
- In several services not all staff had recent updated mandatory training.
- Not all staff were satisfied with the promotion of equality and diversity in the trust’s day to day work and for supporting opportunities for career progression. Board members recognised that they had work to do to improve diversity and equality across the trust and at board level.
- The board assurance framework process did not ensure it covered all that the board needed and board meeting minutes did not reflect the degree of challenge and discussion that had been held.
- Complaint response targets had not been met and there were delays responding to patients.