CQC - Care Quality Commission

03/03/2021 | Press release | Distributed by Public on 03/03/2021 03:33

CQC carries out focused inspection of critical care services at The Princess Royal Hospital

The Care Quality Commission (CQC) has published a report following a focused inspection of critical care services at The Princess Royal Hospital, part of Shrewsbury and Telford Hospital NHS Trust.

The inspection was carried out on 8 January due to concerns the CQC had received about the safety and quality of the provision of out of hours anaesthetic cover at The Princess Royal Hospital.

Inspectors focused only on the provision of out of hours anaesthetic cover. Wards and services visited included; critical care, the critical care outreach team, the maternity delivery suite, the children's ward, the emergency department, the head and neck surgical ward, the acute stroke unit, a general medical ward and a respiratory ward.

At the time of inspection, the critical care service had anaesthetic staff vacancies meaning there were not always enough skilled staff to carry out the right care and treatment. This was mitigated by cross site working and using general anaesthetic staff out of hours.

Inspectors reported that some anaesthetic staff did not always feel respected, supported or valued by senior staff. The issue around the provision of the out of hours service was well known and had been raised several times but had not been fully or appropriately addressed.

Some general anaesthetic consultants who had been providing cover for many years felt that they did not have the up-to-date skills and knowledge to care for patients with more complex needs.

Inspectors also found some examples of good care. Doctors, nurses and other healthcare professionals worked together as a team to benefit patients and provide good care. Leaders operated effective governance processes meaning staff at all levels were clear about their roles and accountabilities.

This targeted inspection did not result in a rating change for critical care services overall, therefore the previous rating of Requires Improvement remains. The Princess Royal Hospital and Shrewsbury and Telford Hospital NHS Trust remain rated Inadequate overall.

CQC's Interim Deputy Chief Inspector, Fiona Allinson, said:

'When inspectors visited The Princess Royal Hospital, they found some areas where improvements were needed to ensure enough anaesthetic staff are not only available but sufficiently supported and respected in their roles.

'Staff told us they no longer reported all incidents and near misses due to time constraints and because of past experiences where they felt action was not always taken in response.

'Managers should continue to explore ways of recruiting to vacancies in critical care. They should consider how they listen to staff supporting the existing critical care service to ensure they are confident to undertake the role.

'Hospitals are facing a particularly challenging time, so it was pleasing to see some examples of good practice too. All leaders were aware of current challenges and the clinical director had improved governance processes and strengthened this through the encouragement of cross directorate working.

'We have reported our findings to the trust leadership, which knows what it must do to bring about further improvements and ensure it maintains any already made.

'CQC's immediate focus will be on supporting the trust to keep people safe during the COVID-19 pandemic, working with NHS England and NHS Improvement to ensure additional support is in place where needed.'

During the inspection, CQC found:

  • Staff did not always recognise and report incidents relating to anaesthetic staffing. This meant managers could not effectively identify and take action to respond to anaesthetic staffing risks.
  • Some medical staff at the Princess Royal Hospital did not always feel respected, supported and valued. However, they were focused on the needs of patients receiving care. Some medical staff did not always feel that the service had an open culture where staff could raise concerns without fear.
  • People could access the service when they needed it and received the right care promptly.
  • Leaders operated effective governance processes. Staff at all levels were clear about their roles and accountabilities and had regular opportunities to meet, discuss and learn from the performance of the service.

Full details of the inspection are given in the report publihed online here.


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