The Queen Elizabeth Hospital (QEH) in King’s Lynn has made substantial improvements – with all of its core services now rated ‘Good’ for caring – following two focussed Care Quality Commission (CQC) inspections which took place in September 2020.
The CQC made two unannounced visits to the Trust between 14-23 September 2020 and focused on the core services which had been rated either ‘Inadequate’ or ‘Requires Improvement’ in the Trust’s 2019 inspection.
The core services inspected by the CQC during their visits were: Medicine, Urgent and Emergency Care, Maternity, Diagnostic Imaging, End of Life Care and Surgery.
The main headlines from the reports are summarised as:
- None of the Trust’s core services inspected are now rated ‘Inadequate’ compared to 19 areas in the same services rated ‘Inadequate’ in the Trust’s 2019 inspection
- All of the Trust’s core services (listed above) are now rated as ‘Good’ for Caring – marking a further significant improvement
- The Trust has three ‘must do’ and 34 ‘should do’ actions from its 2020 inspection, all of which already feature in the Trust’s Integrated Quality Improvement Plan and have work underway (compared to 206 in total in 2019 and marking a 82% reduction in ‘must do’ and ‘should do’ actions)
- As a result of the Trust’s latest reports, the Trust will be applying to the CQC to have 17 out of the 22 Condition Notices placed on the Trust at the July 2019 inspection removed
CQC’s Chief Inspector of Hospitals, Ted Baker, said: “Our inspectors found improvements at Queen Elizabeth Hospitals King’s Lynn NHS Trust, but more work is needed to ensure patients always receive the care they should be able to expect.
“We have told the Trust it must take immediate action to ensure anaesthetists have the right training in maternity services and that staffing levels are sufficient to provide safe care in diagnostic imaging. We have also highlighted a number of other areas where the trust should make improvements including ensuring all mandatory staff training is completed.
“However, we found real cultural change had taken place across the Trust and staff were demonstrably more positive and engaged. Our inspection team particularly noted how caring staff were and found examples of staff who exceeded expectations to help people.
“The Trust had also successfully implemented a number of positive changes in the emergency department. Changes had been made to the department’s physical environment to improve patient safety and experience, infection control and prevention was maintained, the service collected information about performance so it could improve, and patients were treated respectfully, with compassion and kindness.
“The dedicated work of staff deserves recognition, a number of improvements have been made at the most challenging time for hospital services, and this is to be commended.
“The Trust’s leadership team is clear about the steps it needs to take to ensure further improvement takes place. We will continue to monitor the Trust’s progress closely and will inspect again to check on whether necessary improvements have been made.”
Chairman of the Trust, Professor Steve Barnett said: “These results are an incredibly important milestone in the Trust’s improvement journey which started 18-months ago. This latest inspection report is important external endorsement and recognition of the substantial improvements to patient and staff experience the Trust has made.
“I hope that these impressive results, which show a step change in the quality of care and standards at our hospital give our patients, their families, and our local community pride, and instil confidence in the services we deliver at our hospital.”
Trust Chief Executive, Caroline Shaw CBE said: “I am incredibly proud of the significant progress that the Trust has made. These results show that the hard work, focus and determination of our staff is very much paying off and our job now is to work together to build on this progress further in 2021, and ensure we consistently deliver the compassionate care and high quality services that our patients and local community deserve.
“We see the Trust’s latest inspection report as a real learning opportunity, and one which we will ensure shapes the next phase of our improvement journey. There is no prospect of complacency. We all absolutely know there is more to do to sustain and embed the improvements we have made and become the ‘Outstanding’ Trust our patients, their families, our staff and community deserve.
“The timing of the publication of this report couldn’t be better as we head into Christmas and our busiest months of the year, and we hope will give our staff even more motivation going into 2021 that we can do this. This is an important moment for QEH, which we will use as a catalyst for the next phase of our improvement journey.”
The CQC identified several key areas where the Trust has made improvements including:
- Patients were treated with respect and dignity. Staff are compassionate and include patients and their relatives in decision making.
- Infection control and prevention is well managed.
- Where possible, services are developed with patients in mind.
- Local leadership teams are passionate about their services and are visible and respected.
- Staff are largely positive about their roles and the services in which they work. They spoke positively about their peers and the support they received.
- Staff felt able to escalate concerns.
Due to COVID-19 restrictions, the CQC could not carry out a full inspection of the Trust. This means that while the individual services that the CQC re-inspected will see their ratings change, the overall Trust rating will remain as ‘Inadequate’ until a full inspection of all areas can take place. It is hoped this will happen in 2021.
Alex Stewart, Healthwatch Norfolk CEO, said “The CQC report demonstrates that QEH has made vast progress in extremely trying times and all the staff should be commended for their hard work.
“It’s a shame that due to COVID-19 that the CQC have been unable to undertake a complete inspection but we will look forward to the results when the final part of the inspection is undertaken in 2021. We are very fortunate to have such a dedicated team of professionals working with us in Norfolk.”
While the Trust has made strong progress, there are some clear areas it must give even greater focus to in the next stages of its improvement journey, building on the work already underway in each of these areas, including:
- Staff support, including mandatory training
- Record keeping
- Consistency of performance against national targets
- While it was recognised that staff engagement and communication with staff has improved, there is further work to do to engage effectively with all staff groups and improve organisational culture
Caroline Shaw CBE continued: “We very much look forward to welcoming back the CQC to the Trust in 2021 and we are hopeful that a full inspection of all our services will result in the Trust leaving ‘Special Measures’ and the removal of our overall ‘Inadequate’ rating. In the meantime, we remain very much focussed on making the further improvements required of us, including the areas identified by the CQC following their latest inspection.”