THE hospital trust in charge of Redditch’s embattled Alexandra Hospital will remain in special measures, after yet another damning report by a health watchdog.

A Care Quality Commission (CQC) report published today reveals that Worcestershire Acute Hospitals NHS Trust is still rated as ‘inadequate’ with a recommendation to extend the special measures it was placed in back in December 2015.

Inspectors said urgent action is needed to be taken to improve the situation at the troubled trust.

Hospital bosses admitted they were disappointed but accepted the findings and said they would continue to work on improvements the trust has already started to implement.

The CQC has recommended a three to six month extension of the special measures to allow the new management team – which started coming in from September last year – more time to drive the urgent improvements needed.

Unannounced inspections were carried out at the Alex, as well as Kidderminster Hospital and Worcestershire Royal - which were all rated as inadequate - on December 7, 8 and 15.

These followed an inspection of the trust from November 22-25.

It was given an overall rating of inadequate with serious concerns being raised for it being safe, responsive and well-led.

It also rated the trust as ‘requires improvement’ for being effective but did say the area of caring was ‘good’.

The CQC had also issued a warning notice as significant improvements were required in relation to staffing levels, governance, investigation of clinical incidents and culture.

Inspectors have been back to review and a report is expected in late July.

Professor Sir Mike Richards, the Chief Inspector of Hospitals, said: “We found a number of serious problems when we inspected the services run by Worcestershire Acute Hospitals NHS Trust. Rather than getting better, our latest inspection shows a noticeable decline in ratings.

“The trust has been in special measures since December 2015 with little evidence of improvement to date. For this reason I have recommended an extension of special measures as a new executive team has recently been put in place.

“During our December inspection, we rated the trust inadequate for safety, responsiveness and being well-led.

“This is extremely concerning, both in terms of the quality of care that people can expect from the trust, and for what it says about the trust’s ability to improve.

“This situation must not be allowed to continue and we are considering, along with partner agencies, the best option available in order to improve services rapidly for the local population.”

One of the problems identified by the CQC was a lack of permanent leadership, an issue which Mrs McKay says has now been resolved.

"We are disappointed with the CQC's findings, but we fully accept them," she said.

“I am sorry our patients, their families and carers have been let down. We want all our patients to get the best care possible and regret that this isn’t currently always happening, but we’re determined to put things right.

“Whilst we have made improvements since the last inspection - our children’s and maternity services have improved - we recognise we still have some way to go.

“I am pleased that the reports acknowledge that we are a caring organisation, rating care across our hospitals as ‘good’, and our end of life care as ‘good’. Our staff continue to deliver compassionate care to the thousands of patients who use our services every day.”
 

The CQC's main criticisms of the trust

  • Since May 2016 the trust has regularly breached the 12 hour target for patients remaining in the emergency department and many continued to be cared for in the corridor at Worcestershire Royal Hospital.
  • Staffing levels within the emergency department were not planned and reviewed in line with national guidance.
  • There were not enough consultants there to meet the Royal College of Emergency Medicine’s workforce recommendations.
  • There was no privacy and little confidentiality for patients being cared for on trolleys in the corridors of the emergency departments at Worcestershire Royal Hospital and the Alexandra Hospital.
  • Patients were sometimes waiting by external doors in cold conditions or out of staff view.
  • Patient risk assessments were not fully completed on admission and generally not reviewed at regular intervals throughout the patient’s stay in hospital and records were not always stored securely. This occurred in various hospital services including the emergency department, medicine, surgery and critical care.
  • Ageing and unsafe equipment was used in the radiology departments across the trust that was being inadequately risk rated.
  • Poor governance arrangements and over reliance on the assistance of others to highlight areas that require significant improvement.
  • Cultural and behavioural change is key to driving and sustaining the required improvements.

Areas that must improve at the trust

  • Patient documentation, including risk assessments, must always completed accurately and routinely to assess the health and safety of patients.
  • The trust must improve performance against the 18 week referral to treatment time, with the aim of meeting the trust target • Flow in the hospital must be maintained to prevent patients being treated in the emergency department corridors for extended periods of time • Patient privacy, dignity and confidentiality must be maintained at all times. For example, patients staying overnight in the gynaecology assessment unit.
  • The trust must improve performance against the national standard for cancer waiting times. This includes patients with suspected cancer being seen within two weeks and a two week wait for symptomatic breast patients.
  • There must be access to 24-hour interventional radiology services.
  • Patients under child and adolescent mental health services must receive care from appropriately trained staff at all times.
  • There must be an appropriate mental health room in the emergency department to care for patients presenting with mental health conditions that complies with national guidance.
  • There must be a robust system in place to ensure that all electrical equipment has safety checks as recommended by the manufacturer The trust must ensure that there is clear oversight of the deterioration of patients and that this is documented appropriately.