Agenda item
CARE QUALITY COMMISSION REPORT
Lead Officer: Somen Banerjee/Karen Breen
The report provides the Board with a briefing on the outcomes of the CQC report on Barts Health, the response of the trust and implications for the Board.
Recommendation:
To note the report
Minutes:
Dr Somen Banerjee, Director of Public Health introduced the report. He reported that the Chief Inspector of Hospitals had rated the services provided by Barts Health NHS Trust as inadequate following inspection of the trust’s three main hospitals in London.
The Trust had already been placed in to Special Measures following the Care Quality Commission’s report on Whipps Cross University Hospital which was published in March 2015.
Following that inspection, CQC decided to inspect both the Royal London Hospital and Newham University Hospital. Both were also been found to be inadequate.
The CQC had identified 65 areas where the Trust must make improvements. The areas of concern included the following:
· Safety and quality of services. “
· Leadership issues found at Whipps Cross were replicated at the other hospitals. There was a lack of engagement with the staff, low morale, high levels of stress and confusion among the workforce about who was in charge.
· Across the trust there was too little attention paid to safety, with failures in incident reporting and auditing,
· There were failures in dealing with and learning from complaints.
· The Trust’s directors didn’t seem to have confidence in their own data – a basic requirement in assessing their performance.
· There were unacceptably long waiting times and often, operations were cancelled.
Although many individual services required improvement, examples of good services were found at both Royal London Hospital and Newham University Hospital. There was a very committed workforce who although felt undervalued by the Trust leadership, they were valued by their patients and colleagues, and their local managers.
Barts Health NHS Trust as a whole had not made the progress in dealing with the findings of their previous inspection in 2013. The Inspector’s conclusion was that if the trust was to turn round – then it must focus first on the culture and on the leadership issues so that it could effectively deal with all the individual concerns which we had been identified on the inspection.
The Royal London Hospital and Newham University Hospital were inspected in January 2015 over a period of three days by two inspection teams which included doctors, nurses and other specialists, hospital managers, CQC inspectors and experts by experience (people with personal experience of using or caring for someone who uses the type of services being inspected). They also made unannounced visits as part of the inspection.
The inspectors concluded that the trust lacked strategy and vision. The
Inspectors rated Newham University Hospital as Good for Urgent and Emergency Services. Patients felt well cared for and staff felt supported and there were excellent outcomes for people who had suffered a stroke. Royal London hospital was rated Good for Critical Care with patients positive about the treatment received.
Staffing levels in some areas were significantly below recommended levels and did not provide consistently safe care.
Bed occupancy was so high that patients were not always cared for on the appropriate wards, and the high occupancy was affecting the flow of patients through the hospitals.
Some patients faced delays of more than 18 weeks from referral to treatment and some patients had their surgery cancelled on several occasions due to a lack of beds.
During the previous inspection, in November 2013, inspectors had identified a culture of bullying and harassment. Although the trust commissioned an independent review, CQC found that the response had not been timely enough; the inspection team still had concerns
Members expressed disappointment about the extent and level of concerns in all three hospitals, particularly in safety and leadership, given that Barts Health NHS Trust was the largest NHS trust in England, serving a population of well over two million people, and home to some world-renowned specialities.
It was noted that the Trust Development Authority was working with the Trust to support improvements. Members considered that there was a need for officers to come up with proposals on how the Health and Wellbeing Board could influence the improvements at the Bart’s Health NHS Trust.
Action: Dr Somen Banerjee, Director of Public Health
RESOLVED –
1. That the report be noted.
2. That officers be requested to consider proposals on how the Health and Wellbeing Board could influence /support the improvements at the Barts Health NHS Trust.
Supporting documents:
- ITEM 3 - APENDIX 1 CQC report, item 9. PDF 102 KB
- ITEM 3 - APPENDIX 1 CQC report, item 9. PDF 106 KB