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Worcestershire Acute Hospitals NHS Trust response to the CQC inspection reports

Tuesday 8 August 2017

The Care Quality Commission (CQC) has today published its reports on Worcestershire Acute Hospitals NHS Trust following their focused inspection in April 2017. The inspection was to assess whether the Trust had made the necessary improvements in the six weeks from 27 January to 10 March 2017 as required by the Care Quality Commission.

The Trust’s Chief Executive, Michelle McKay, said: "We are disappointed with, but fully accept, the shortfalls the Care Quality Commission has identified in their focused inspection in April. I am sorry the Trust did not make all the necessary improvements in that period and have continued to let down our patients, their families and carers by not meeting the quality standards they rightly expect.  We want all our patients to get the best care possible and regret that this isn't always happening but we’re determined to put things right.”

In their warning notice the CQC has identified nine areas that require urgent improvement, they are:  learning from incidents, assessing and responding to patient risks, medicines management, infection prevention and control, safety of premises and equipment, bed capacity and patient flow management, safeguarding, fit and proper persons and fitness of equipment.

The reports published today highlight some improvements the Trust has made since the last inspection in November and December 2016. However, recognising the requirement to make urgent changes the Trust has continued to make improvements since the April inspection.  For example:

·         We are addressing concerns identified and we have submitted evidence to the CQC – regarding our mental health assessment room in the Worcestershire Royal Hospital which now meets national safety guidance and our Director appointments processes now fully meet the Fit and Proper person regulations (this ensures staff employed by the Trust are suitable to carry out their role)

·         Our infection control procedures have improved, following a review by our regulator NHS Improvement last month, our rating has moved from red to amber which means that we have responded to concerns and are addressing them in a timely manner. The review found there was good hand hygiene, clean and tidy environments and that staff were using appropriate protective equipment

·         Our daily audits are now showing we appropriately assess and respond to potential risks to our patients, for example, each morning our matrons audit compliance in areas such as assessments for venous thromboembolism (formation of blood clots) and ensuring deteriorating patients’ care is escalated, and our pharmacy team undertake audits to ensure variations in fridge temperatures are escalated and missed medication is reviewed. Our most recent audit found that:

  • 100% of infants and children admitted to our hospitals received regular clinical observations which were completed accurately to ensure early detection of deterioration and 100% were escalated appropriately, this is completed through a specialised tool called the Paediatric Early Warning Score (PEWS)
  • 98% of adults had their vital signs recorded accurately to ensure early detection of deterioration and 100% were escalated appropriately, this has improved from 86%. The assessments were made using a specialist tool called the National Early Warning Score (NEWS)
  • 94% of patients have been risk assessed for venous thromboembolism (formation of blood clots) and we have implemented a new process to ensure we improve our re-assessment rates
  • 98% of patients have a falls assessment in place to reduce the likelihood of falls during their hospital stay
  • 93% of patients have been nutritionally screened and 76% of patients requiring referral to a dietitian have been referred, this has improved from 56%

·         Since May we have recruited 43 consultants and doctors, with a further 34 doctors offered posts following a recent recruitment trip to India. A range of recruitment strategies are underway to further reduce our medical vacancies over the coming months.  Permanent staff are critical to improve the quality and safety of care, and provide a better experience for our patients

·         We have strengthened our serious incidents processes and they now comply with national guidance. A system is in place to ensure all learning from serious incident investigations is disseminated across the Trust to improve care and to prevent the likelihood of similar incidents happening again, a recent example includes: the introduction of safety huddles, where staff ‘huddle’ together to discuss safety issues

·         We will have expanded Ambulatory Emergency Care and the Medical Assessment Unit and purchased additional monitoring and diagnostic equipment for the Medical Assessment Unit at the Worcestershire Royal Hospital by winter 2017.  This will allow more patients to receive ongoing assessment of their needs and to receive short stay care as well as improving the experience of patients requiring care in the Hospital’s A&E

Chief Executive, Michelle McKay said: "We are determined to move forward with pace and focus, so we can consistently deliver high quality standards for patients across all our services all of the time. Patients should still come to our hospitals for appointments, treatment and operations as planned. Whilst we have improvements to make we are working hard to urgently address them."

You can read a letter to our patients here.

You can read some FAQs on the report here.

4ward is our Trustwide culture change programme which is helping us build a more positive, supportive workplace for the benefit of our patients and colleagues. At its heart are our four 4ward Behaviours.