Hospital trust could leave ‘special measures’

England’s Chief Inspector of Hospitals has recommended the move, following a full inspection by the Care Quality Commission.

Professor Sir Mike Richards and his inspectors found sufficient progress had been made to justify the recommendation to NHS Regulator Monitor, although the trust will still receive support to improve.

Scunthorpe Hospital was singled out for good practice in its maternity section, but was told to improve the lay-out of its accident and ememrgency unit to benefit mental health patients.

Northern Lincolnshire and Goole NHS Foundation Trust was placed in special measures in July 2013 following the Keogh Review into hospitals with higher than average mortality rates.

New reports show significant progress, although Scunthorpe General Hospital along with Diana Princess of Wales Hospital still “requires improvement”. Goole and District Hospital is rated “good.”

The hospitals were inspected in April and May under the CQC’s new regime. The team included doctors, nurses, midwives, hospital managers, trained members of the public, a variety of specialists, CQC inspectors and analysts, who spent three days at the trust.

The CQC gave individual ratings to each core service at the hospitals, including Accident and Emergency, Medical care (including older people’s care), Surgery, Critical care, Maternity and family planning, Services for children and young people, End of life care, and Outpatients.

Chief Inspector, Professor Sir Mike Richards, said: “It is clear that Northern Lincolnshire and Goole NHS Foundation Trust has worked hard to improve since being placed in special measures last year.

“The trust has made real progress to meet the requirements of the Keogh Review, with the way that it is led changing significantly. Staff told us the culture of the trust was changing and this was backed up by what we saw, an engaged workforce who were increasingly proud of where they worked.

“While there are signs that this trust is improving, a number of these improvements are new and need time to become fully ingrained in the service. The trust still needs to take action to make sure that people using its services receive good quality treatment and care all the time.

“Special measures are designed to provide intensive support to struggling trusts and Northern Lincolnshire and Goole NHS Foundation Trust has clearly gained from this support. There is no doubt that the trust is heading in the right direction and will continue to benefit from the ongoing support from Monitor as they come out of special measures. We will return in time to check that the improvements we have identified on this inspection have been made.”

The inspection team identified two particular areas of good practice: the maternity service at Scunthorpe General Hospital won a national award for promoting a natural birth experience. A midwifery-led vaginal birth after caesarean-section clinic was introduced which worked with women who had previous caesarean sections. This meant women were given increased opportunities to have natural births.

The facilities team received the National Annual Hospital Estates and Facilities Management Association Team of the Year Award, with the Hotel Services Manager being awarded Project Manager of the Year for improving patient and staff experience. This included the creation of a multi-skilled role – ward caterer, ward domestic and nursing support.

The trust has been told it must improve in 21 areas, including to:

Ensure that there are sufficient qualified, skilled and experienced staff, particularly in A&E, medical and surgical wards. This is to include provision of staff out of hours, bank holidays and weekends.

Review the skills and experience of staff working with children in the A&E to meet national recommendations.

Review the environment and lay out of the accident and emergency department at Scunthorpe General Hospital so that it can meet the needs of children and patients with mental health needs.

Review the consistency of care and level of consultant input, particularly out of hours and at weekends in the High Dependency Unit at Diana Princess of Wales Hospital.

Ensure that the Intensive Therapy Unit uses nationally-recognised best-practice guidance.

Ensure that all staff complete mandatory training, particularly for safeguarding children and resuscitation.

Review the effectiveness of handovers, particularly in the medical services.

The Care Quality Commission has already presented its findings to a local Quality Summit, including NHS commissioners, providers, regulators and other public bodies. The purpose of the Quality Summit is to develop a plan of action and recommendations based on the findings.