University Hospitals of Morecambe Bay NHS Foundation Trust rated as ‘Good’ by the CQC
England’s Chief Inspector of Hospitals has rated the University Hospitals of Morecambe Bay NHS Foundation Trust as Good, following its latest inspection by the Care Quality Commission (CQC).
The trust was placed into special measures in June 2014 after a CQC inspection identified concerns surrounding the safety and management of its services. In December 2015 the trust was taken out of special measures after an inspection found that, while further work was needed, improvements had been made.
In October 2016 CQC returned to inspect again and found further significant improvements had been made. As a result the trust is now rated as Good overall. It is rated Outstanding for whether services are caring Good for whether services are effective, responsive and well-led and Requires Improvement for safety.
Professor Sir Mike Richards, CQC Chief Inspector of Hospitals, said: “Our inspectors found that further significant improvements had taken place across the trust and it had clearly benefitted from the support provided by the special measures regime.
“When the trust was placed into special measures its board and management faced a number of challenges. There were issues relating to staffing and improvements were needed with regard to the culture within some of its teams.
“Since that time the trust has made steady progress and, on our return, improvements were particularly evident in maternity, gynaecology and end of life services. The trust had implemented recommendations made by Dr Bill Kirkup following his enquiry, to its maternity department and it was clear there was now a more joined up approach at the service.
“Improvements had been made to the trust’s record keeping, compliance with mandatory training for staff and appraisal targets. The support and supervision of junior staff had improved as had the number of available nursing and medical staff. I was particularly impressed by the development of ‘cross bay’ working. Communication between the different hospital sites is now very apparent.
“There were still a number of vacancies across the trust, especially in medical care services and the emergency departments, but the trust had robust systems in place to manage staffing shortfalls.
“We also found a number of outstanding areas of practice. Medical, critical care and end of life care services were found to be compassionate. The services provided emotional support to patients with staff who regularly ‘went the extra mile’ for people in their care and their loved ones.
“Overall, the University Hospitals of Morecambe Bay NHS Foundation Trust has made real progress. This is a truly remarkable turnaround for a trust that has faced very significant difficulties. Senior management and staff deserve huge credit for this.
“There are still some areas where further work is needed and the trust board knows what it now needs to do to ensure those improvements are made. We will return to check on progress at the trust.”
Inspectors identified several areas of outstanding practice at the trust, including:
- There were many examples of public engagement in the development and delivery of maternity services. For example, members of the public, users and staff members had been involved in the co-designing of the new maternity unit. Engagement personnel had also been involved in the process of interviews for the recruitment of new staff, including midwives and matrons, and the development of guidelines and strategies.
- In end of life care an innovative ‘death café’ had been introduced to provide people with an opportunity to talk more openly about death and dying. The trust held the cafés as part of Dying Matters Week; They were used to support staff and to promote better communication with patients reaching the end of life and their relatives.
- The trust had successfully secured funding to pilot a project to look at improving communication in maternity services. The pilot, promoted by NHS England, will use patient feedback to help make improvements across maternity services. The project had the potential to be adopted nationally if learning outcomes and measurable improvements could be demonstrated for women
There are areas where the trust must make improvements, including:
- Urgent and emergency care services must monitor performance information to ensure 95% of patients are admitted, transferred or discharged within four hours of arrival at emergency departments across the trust.
- Ensure patients receive assessment and treatment at the trust’s emergency departments in a timely manner.
- Ensure there are sufficient nursing staff at the Royal Lancaster Infirmary to comply with the British Association of Perinatal Medicine and Royal College of Nursing guidance.