Shrewsbury and Telford Hospital NHS Trust still rated inadequate, but latest inspection identifies some progress

The Care Quality Commission (CQC) has rated Shrewsbury and Telford Hospital NHS Trust inadequate following an inspection, but it found some progress which - if sustained - would lay the foundations to considerably improving patient care.

CQC inspected the trust's urgent and emergency care, medical care and end of life care at the Royal Shrewsbury Hospital and the Princess Royal Hospital, Telford, in July and August. It also inspected the trust's maternity services at the Princess Royal Hospital.

Following the inspection, the trust has again been rated inadequate overall. It has been rated as inadequate overall following each CQC inspection since 2018.

The trust is rated inadequate again for being safe and responsive to people's needs and requires improvement for being caring.

It has been rated requires improvement for being effective and well-led, which represents progress on its previous inadequate ratings for these performance measures.

Ted Baker, CQC chief inspector of hospitals, said:

"I recognise the enormous pressure NHS services are under across the country and that usual expectations cannot always be maintained, but it is important they do all they can to mitigate risks to patient safety while facing these pressures.

"Despite these pressures, the trust has made progress. It has benefited from more effective leadership that has helped drive improvements, and it has a much better understanding of the challenges it faces.

"While the trust continues to have significant work to do to provide care that meets standards people have a right to expect, it is providing more effective care overall.

"However, its risk management remains inconsistent and we are not assured it is doing all it can to ensure people's safety.

"This is particularly concerning in urgent and emergency care at the Royal Shrewsbury Hospital, where people did not always receive timely assessment to identify their needs, meaning staff were not aware whether people needed urgent treatment or not.

"The trust understands what it must do to improve, and we will continue to monitor its progress.

"There have been some areas of improvement, but work must happen at pace to build on this, embedding and sustaining the progress. We will return to inspect to assess whether this is happening."

Although CQC's latest inspection of Shrewsbury and Telford Hospital NHS Trust found the trust continues to fall significantly short of offering good care overall, it has made some progress which, if sustained, could help it considerably improve the quality and safety of care it offers to people.

Behind this is more effective leadership, which is helping the trust have a better view of where it needs to target its resources so that it delivers for its patients.

As it grasps the challenges it faces, the trust must address issues in its end of life care - which suffered from a shortage of staff with the right skills, and poor use of risk assessments to manage patients at risk of deterioration.

Improvement was seen in urgent and emergency care, particularly at the Princess Royal Hospital where improved staffing arrangements and collaborative working between teams supported people to have better outcomes compared to findings from previous inspections. However, at the Royal Shrewsbury Hospital inspectors found people waited too long for initial assessment in unsuitable premises where infection prevention was not always well managed.

Inspectors also saw improvement in medical care, which includes older people's care, at both sites. Staff were caring and compassionate, which helped people manage their circumstances, but treatment was not always delivered according to national guidelines.

Inspectors' assessment of maternity at the Princess Royal Hospital found a shortage of midwives worsened the pressure the service faced. However, they recognised the exceptionally dedicated and caring approach of its staff, despite being under considerable scrutiny, which benefited both new mothers and babies.

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