Triple 'Good' and out of special measures for Harlow-based Trust in latest CQC Inspection
Patients, volunteers and staff from the Princess Alexandra Hospital NHS Trust are celebrating not only the results of the latest inspection by the Care Quality Commission (CQC), but also the announcement that the Trust is out of 'special measures' within the space of less than 18 months.
NHS Improvement's decision to remove the Trust from the 'special measures' regime is a direct result of the quality improvements achieved over the past year. The significant progress made by hospital staff was recognised in the CQC's latest report following their recent inspection in December 2017. Having clearly demonstrated that the Trust can operate effectively under standard NHS arrangements, CQC's Chief Inspector of Hospitals, Professor Ted Baker, recommended that special measures are no longer necessary.
The latest CQC report reflects the many positive changes made throughout the Trust since its previous inspection report published in October 2016. As a result, we are now rated as 'Good' for Effective, 'Good' for 'Caring', and 'Good' for Well-led. Our Trust's overall rating has risen from 'Inadequate' to 'Requires Improvement', which reflects the programme of quality improvement underway.
We are now among the best performing Trusts in the country for many aspects of care, for example, cancer waiting times (number 1 Trust in December 2017), maternity services (rated as 'outstanding' by the CQC and some of the lowest rates for still birth), 'End of Life' and dementia services (specialist facility and practitioners for people with dementia at the end of their lives, enabling patient choice), infection control (some of the lowest MRSA, MSSA and CDiff rates in the country), falls and pressure ulcers in hospital (below national average), delayed transfer of care from hospital rates (now a top 10 Trust), access to diagnostics (achieved standards every month for the last two years), and patients being treated within 18 weeks of referral from their GP (delivered consistently since August 2016, except in January 2018 owing to the national directive to stop operating during winter pressures).
Lance McCarthy, Trust Chief Executive, said: "People have worked tremendously hard over the past twelve months to deliver major improvements in quality across our hospital services. These efforts are reflected in our triple achievement of 'Good' in the areas of 'Effective', 'Caring' and 'Well-Led', which is fantastic news for patients and the people who work here. The removal of the Trust from 'special measures' is something that I'm sure people will be celebrating today. I am enormously proud of everyone and have personally thanked our staff and volunteers across the Trust today. Together we have shown that we've got what it takes to make this Trust outstanding."
"The momentum we have created continues and, whilst this is a moment to be celebrated, we all remain committed to delivering our ambitious, but achievable quality improvement programme. At the moment we're not getting it right for allof our patients allof the time, and we are not going to be satisfied until we do - our ambition is to transform Princess Alexandra Hospital into an 'outstanding' Trust. With the scale of change we have delivered in such a short space of time, and with three out of five areas now rated as good by the CQC, the next jump to becoming a 'Good' Trust overall is clearly within our grasp.
"I am pleased to say that there were no surprises within the CQC report. We know and understand the areas where we need to make more progress. Our quality improvement plan reflects the findings of the most recent inspection and work continues to build on the good practice we have achieved so far. Our services have benefited greatly from the £7.5million we have invested into our estates this year, and we are actively pursuing our plans for a new, modern hospital at Harlow."
The CQC report recognises a number of areas of outstanding practice at the Trust, including the way in which we discharge babies from the Neonatal Unit, and our approach within critical care to recycling and disposing of unused medicine which has also saved money. Our Neonatal Unit Manager and senior nurse, Janelle Gardner, received personal recognition from the CQC as having undergone our leadership programme and winning an award for outstanding commitment to her work. The CQC report also reflects on feedback from our patients, and a consistent message is that our staff are compassionate and kind, and that we treat concerns and complaints seriously so that we can continue to improve.
As expected for a Trust in the middle of delivering an ambitious programme to improve quality, there are a number of aspects identified within the report where we need to do better. These are reflected within our operational plans, and we have already made significant progress in a number of these areas. We continue to address performance against the 4-hour emergency care standard and are focusing on increasing the flow of patients through our hospitals, for example by discharging patients more efficiently and earlier in the day. Other areas noted by the CQC include addressing the way in which we record certain information about patients at the end of their lives, reducing the numbers of patients moved around the hospital following an operation, and tackling the significant number of nursing vacancies we continue to face. We are absolutely committed to enhancing the experience of our patients in all these areas and more.
The Trust attributes some of the successful progress made to the collaborative arrangements in place which involve patients in identifying where change is needed and evaluating progress underway. The 20-strong patient panel is very active and serves as a 'critical friend' to the Trust. Ann Nutt, Patient Chair said: "Members of the panel are as passionate as staff about making sure that patients have a good experience, and so we were equally dismayed when the Trust was placed in special measures. We are therefore delighted with the transformation achieved since the CQC inspection in 2016, that the latest report recognises the significant progress made, and that the Trust can successfully put 'special measures' behind us. Over the past year the cultural change in the Trust hasbeen palpable, with staff clearly focused on delivering kind and compassionate care an
being supported to make improvements happen. The leadership at the Trust has become far stronger and more visible and this has had a really positive influence on staff who have welcomed the genuine interest and support received. Board members are no longer just a name and a photo on a noticeboard, and that is really important.
"I am particularly proud of the Emergency Department and delighted that the significant improvements achieved across the Trust's emergency and urgent care services in the last year have been recognised within the report. I observed a 12-hour shift in A&E last month and saw for myself the high standard of care being given despite staff being under enormous pressure from so many patients coming through the door."
In a joint statement, Daniella Pritchard, Staff Side Secretary, and Nicola Maguire-Smith, Staff Side Chair, said: "Staff were truly shaken when the Trust was placed in special measures but our response was: 'We will show everyone that we work together well and can do much better.' In just over a year we have done exactly that, and it has been a collaborative effort between staff at all levels, volunteers, patients and others. There has been incredible tenacity and everyone has worked very hard together with the common aim of delivering the best possible services for our patients. Everyone should feel very proud of this result - it confirms we have come a long way since the previous CQC inspection in 2016. But we also know the report marks the end of the first step in our improvement programme. Despite the challenges that lie ahead, we know that staff here have got what it takes to be the best we possibly can be."
To view the full report, please visit www.pah.nhs.uk