The Care Quality Commission (CQC) has found improvements at the QEH following an inspection although it said that more work is needed to ensure patients receive the care they should be able to expect.
In July 2019, the Queen Elizabeth Hospital was rated ‘Inadequate’ by the CQC following an unannounced inspection. This resulted in the Trust remaining in ‘special measures’ following its entry in 2018. Following the 2019 CQC report there were 206 ‘must do’ and ‘should do’ actions. As a result, the Trust embarked on a programme of improvement to complete all actions set out by the CQC, which remains ongoing.
In line with the CQC inspection regime, the CQC returned to the Trust in September 2020 for two unannounced inspections of six core services. The CQC did not carry out a full inspection due to COVID-19 restrictions. This means that while the individual services that the CQC re-inspected have seen a change in ratings, the overall Trust rating will remain as ‘Inadequate’. However, the Trust is hopeful that in 2021 the CQC will return to complete a full inspection, resulting in a positive rating change that reflects the hard work of staff.
The report can be read here https://www.cqc.org.uk/location/RCX70 and concludes that:
- None of the Trust’s core services are now rated ‘Inadequate’ compared to 19 areas in the same services rated ‘Inadequate’ in the Trust’s 2019 inspection
- All of the Trust’s core services are now rated ‘Good’ for caring – marking a further significant improvement
- The Trust has three ‘must do’ and 34 ‘should do’ actions from its 2020 inspection, all of which already feature in the Trust's Integrated Quality Improvement Plan (compared to 206 in total in 2019 marking an 82% reduction in ‘must do’ and ‘should do’ actions)
- As a result of the latest reports, the Trust will be applying to the CQC to have 17 out of the 22 Condition Notices put on the Trust at the July 2019 inspection removed
In addition to the above, the CQC identified several key areas where the Trust has made improvements since their last inspections, stating:
- Patients were treated with respect and dignity. Staff are compassionate and include patients and their relatives in decision-making
- Infection control and prevention is well managed
- Where possible, services are developed with patients in mind
- Local leadership teams are passionate about their services and are visible and respected
- Staff are largely positive about their roles and the services in which they work. They spoke positively about their peers and the support they received
- Staff felt able to escalate concerns
CQC has told the trust it must make the following improvements:
- The trust must ensure that anaesthetists in maternity complete PROMPT (Practical Obstetric Multi-Professional Training) training
- The trust must ensure that staffing levels in diagnostic imaging are adequate to provide safe care and treatment to patients in a timely way.
- The trust must be assured that the out of hours staffing arrangement is sustainable and robust to provide safe care and treatment to patients in diagnostic imaging.
This inspection did not look at the key question of whether the trust is well-led and, while this means the trust’s overall rating of Inadequate is unchanged and it remains in special measures, inspectors found clear evidence that progress was being made.
Commenting on the CQC inspection report for QEH, James said:
“This positive report and the improved ratings are well deserved recognition of the determination and commitment of QEH’s staff to deliver better care for patients. It is particularly welcome that the Trust’s core services are now rated as good for caring and everyone at QEH should be proud of what they have achieved. The challenge now is to maintain these standards and to deliver further improvements and I’ll continue to support the hospital’s efforts in doing so.”
CQC’s Chief Inspector of Hospitals, Ted Baker, said:
"Our inspectors found improvements at The Queen Elizabeth Hospitals King’s Lynn NHS Trust, but more work is needed to ensure patients always receive the care they should be able to expect. We have told the trust it must take immediate action to ensure anaesthetists have the right training in maternity services and that staffing levels are sufficient to provide safe care in diagnostic imaging. We have also highlighted a number of other areas where the trust should make improvements including ensuring all mandatory staff training is completed.
However, we found real cultural change had taken place across the trust and staff were demonstrably more positive and engaged. Our inspection team particularly noted how caring staff were and found examples of staff who exceeded expectations to help people. The trust had also successfully implemented a number of positive changes in the emergency department. Changes had been made to the department’s physical environment to improve patient safety and experience, infection control and prevention was maintained, the service collected information about performance so it could improve, and patients were treated respectfully, with compassion and kindness. The dedicated work of staff deserves recognition, a number of improvements have been made at the most challenging time for hospital services, and this is to be commended.
The trust’s leadership team is clear about the steps it needs to take to ensure further improvement takes place. We will continue to monitor the trust’s progress closely and will inspect again to check on whether necessary improvements have been made.”
Trust Chief Executive, Caroline Shaw CBE said:
"I am incredibly proud of the significant progress that the Trust has made. These results show that the hard work, focus and determination of our staff is very much paying off and our job now is to work together to build on this progress further in 2021, and ensure we consistently deliver the compassionate care and high quality services that our patients and local community deserve.
“We see the Trust’s latest inspection report as a real learning opportunity, and one which we will ensure shapes the next phase of our improvement journey. There is no prospect of complacency. We all absolutely know there is more to do to sustain and embed the improvements we have made and become the ‘Outstanding’ Trust our patients, their families, our staff and community deserve.
“The timing of the publication of this report couldn’t be better as we head into Christmas and our busiest months of the year, and we hope will give our staff even more motivation going into 2021 that we can do this. This is an important moment for QEH, which we will use as a catalyst for the next phase of our improvement journey.”