United Lincolnshire Hospitals Trust has been placed into “special measures” after a report into care and mortality rates at 14 health trusts.
Out of the 14 trusts, 11 of them, including ULHT, have been placed under special measures by the Health Secretary Jeremy Hunt.
The special measures mean a task force will be placed within ULHT to help improve patient care.
The trust then be reviewed again at a later date. If conditions do not improve, the trust’s chief executive, board of governors and medical directors could all risk losing their roles.
The Keogh review
The measures were put into effect after a report led by Sir Bruce Keogh, in which a panel visited ULHT to access the quality of care within the trust’s three hospitals (Lincoln County Hospital, Pilgrim Hospital and Grantham Hospital).
The visits were part of a nationwide review into 14 NHS trusts with high mortality rates between 2010 and 2012, after the Mid-Staffordshire Hospitals scandal.
The report has noted it found a number of good points about care and they way in which hospitals were managed in Lincolnshire, but also saw a number of issues that needed urgent action.
This included:
A lack of communication between leadership at board level and leadership at clinical levels
A lack of clear management dealing with deteriorating patients and patient flow
A confusing patient complaints system
A lack of interest in patient experience
Low staffing levels at certain times of the day
Workforce planning is poor with no recruitment plans and no plans in place to cover maternity leave, sickness and annual leave
Quality strategy is not consistently articulated by staff
In regards to treatment of elderly patients, there was a lack of awareness of the Mental Capacity and Deprivation of Liberty Act 2005. This is in relation to the Trust’s responsibilities in allowing patients to leave wards if deemed capable or wish to do so.
Poor pain control
Issues in completing patient DNAR (Do Not Attempt Resuscitation) forms
A number of these issues were considered in urgent need of response by the trust, or something that the trust should start developing an action plan for.
Some issues were more ingrained into certain hospitals over others. For instance, A&E in Boston displayed good examples of the escalation process, but Lincoln A&E did not make use of the ambulance inbound information to plan capacity needs due to “IT issues”.
This was also leading to improper use of certain wards when patients were transferred. The panel saw one example of an elderly orthopaedic patient being transferred to a ward where staff were not familiar with a brace being worn, leading to another move for the patient.
At a bed management meeting in Lincoln County Hospital, there was no discussion regarding capacity required for the next 12 hour period and no evidence of forward planning to ensure capacity planning for overnight.
The trust had a written escalation plan, but this was not used at the meeting, despite not having enough beds available. This led to the outlying of patients — a primary option for the trust.
Staffing within the trust was also a concern for the panel, after witnessing a lack in nurses in all hospitals, meaning patients who require one-on-one care might not be able to receive it.
In one instance, there were three members of staff to cover a ward of 32 patients.
Some members of staff were also working past their shifts to make sure patients received the correct care they needed.
Full acceptance
ULHT has stated it fully accepts the findings within the review on its care within hospitals.
ULHT’s Chief Executive Jane Lewington said: “The safety and quality of patient care is our top priority. We have always seen the review as an opportunity to continue our journey of improvement.
“The review has helped to ensure that our efforts are targeting the changes that will make the most impact on patient care. Therefore we fully accept the findings.
“Patients are the very heart of everything we do, but others are doing better and therefore we need to learn from them.”
The trust is currently working to improve measures it has been flagged up on, with a focus on the level of staffing.
Recently, the trust pledged to spend £7 million on around 200 more nurses to meet with the demands of patients.
Jane Lewington added: “We will be unrelenting in our efforts to improve in the areas which the review panel have identified.
“But it also important that the review has recognised the excellence of much of what we do, and the commitment of so many of our staff.”
Other actions the trust are aiming begin are public listening events, a patient-focussed overhaul of the complaints system with patients and experts in the field involved in the review, and internal campaigns to promote staff awareness of best clinical practice.
David Harding-Price, Secretary of the North Lincolnshire Branch of the Royal College of Nursing, said “We take this review incredibly seriously and nationally the RCN have detailed examples of where we have raised concerns about patient safety in trusts.
“There is an undeniable link between nurse staffing levels and patient mortality and we cannot keep failing to address this issue. Only with the right numbers of nurses, with the right skills, can we ensure patients are looked after with dignity and compassion.”
He added “Sir Bruce Keogh’s review identifies key risk factors and warning signs to show where, and why, some trusts are underperforming including United Lincolnshire Health NHS Trust and the steps that urgently need to be taken to improve standards of patient care and safety.”
In a statement at the beginning of the review, Sir Bruce Keogh said: “We found pockets of excellent practice in all 14 of the trusts reviewed. However, we also found significant scope for improvement, with each needing to address an urgent set of actions in order to raise standards of care.
“These organisations have been trapped in mediocrity, which I am confident can be replaced by a sense of ambition if we give staff the confidence to achieve excellence.
“This is consistent with the ambitions that I know the new clinical commissioning groups have for their local populations and the legal duties they have to secure continuous improvements in the quality of services provided to patients.”
Areas of good care in Lincolnshire included:
Dedicated, committed and loyal staff
Monthly mortality reviews with good staff attendance
The Interim Director of Nursing has provided strong leadership to the nursing team and Matrons at all sites displayed strong leadership
Many wards displayed safety thermometer data sets
Plan for every patient on wards
Evidence of innovation e.g. Red Lid Scheme for Hydration/medication; phlebotomy service at weekends which takes pressure off junior doctors
Annual patient listening event in Lincoln, and patient experience and stories are part of Trust Board meetings
Safety and quality dashboards displayed on the wards
Proactive work around dementia in particular wards
To read the full report, visit The Keogh Mortality Review NHS page.
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A trial hearing has been set for the seven people charged with the murder of Sam Davies in Lincoln.
Sam, 23, died after being found with multiple stab wounds at a property in Coleridge Gardens on Thursday, May 27.
Three men were initially arrested and charged with his murder, and they were then joined in custody by four others.
All seven men appeared at Lincoln Magistrates Court on Friday, June 18, and a Crown Court hearing date has now been set.
The seven men charged with Sam’s murder are:
Joe Jameson, 23, of Whitehall Terrace, Lincoln
Daniel Heydari, 24, of Chestnut Street, Lincoln
Eric Kesel, 18, of Browning Drive, Lincoln
Eimantis Gochman, 19, of Sturton Close, Lincoln
Charlie Wakefield, 20, of Broxholme Gardens, Lincoln
Billy Gill, 20, of Beaufort Close, Lincoln
A 17-year-old Lincoln male who cannot be named for legal reasons
All seven will appear before Lincoln Crown Court on June 28 ahead of the trial of the murder of Sam Davies, and have been remanded in custody until that date.
A petition has been launched to fully re-open the toilets on Lincoln’s Westgate car park after council leaders announced they would only be opening the facilities for events.
The City of Lincoln Council’s executive will examine the plans later this month, which will also see the Victorian urinals at The Lawn on Union Road and Newport Arch closed permanently, and facilities at Lucy Tower opened for special events only in a bid to save £86,000 per year.
However, Fiona Purkiss of Midas Art in the Bailgate, along with other business owners, said the Westgate facilities need to be open and accessible to all on a daily basis.
Fiona said it was good that the disabled facilities would remain accessible, but that the walk to the Castle Square facilities — the closest public toilets to remain open — was too far for some of those without radar keys.
According to Google Maps, the distance between the two facilities is 450-550m depending on whether users go via the castle or the Bailgate.
A screenshot of Google Maps showing two routes people could take from the Westgate toilets to Castle Square. | Image: Google
She said that since the toilets closed at the beginning of the first COVID-19 lockdown, she had already seen people caught short, having to take drastic action or have an accident.
“I have had people come into the shop a bit anxious about needing the toilet. I would not say “no” [to them using my toilet] but it’s not actually suitable for the general public,” she said, adding she also had security concerns due to her own loo being accessed through a stockroom.
“I witnessed three men stood there. They got out of their car, tried the door and shouted back before weeing up against the wall.
“It’s been going for some time, we have had some very embarrassed, middle-aged women arrive who would not make it to Castle Square. They have been forced to wee in a carrier bag or a tissue box they kept in their side door.”
“It’s mortifying for them,” she said.
Fiona Purkiss, of Midas Arts. Photo: Daniel Jaines
She said a suggestion that people use the toilets of pubs and restaurants could leave people feeling uncomfortable if they did not wish to purchase anything while there – particularly during lockdown when patrons are required to queue during busy times, and must have tables pre-booked.
She added that a lack of facilities could put visitors off coming to the city and that it was disruptive to delivery drivers, taxi drivers and others, including parents waiting to pick their children up from Westgate Academy.
The council, however, feels its proposals have been misrepresented by opponents.
It has denied the toilets will be closed permanently – but says that they have been “mothballed”.
Councillor Bob Bushell, Portfolio Holder for Remarkable Place at City of Lincoln Council, said: “The city council welcomes petitions and recognises they are a good way for people to convey their concerns to us.
“However, it is essential that people who are considering signing any petition are presented with the full and correct facts so they can make a judgement on whether to sign or not.
“Following consultation with the public, we are proposing to keep open the disabled toilet and allow the main facilities to be available during events such as Lincoln Christmas Market.
“At other times, alternative facilities are available on Castle Square, a short five minute walk away.”
“We have also never suggested that people use toilets in cafes and bars to supplement our provision, we have merely highlighted that paying customers have these facilities at their disposal and should use them if needed.
He said the proposals would also keep the toilets open at Tentercroft St and the bus station.
“Add to this the upcoming refurbishment of toilets at the Central Market and we feel there is a significant spread of facilities across the city, uphill and in the city centre, to serve the needs of shoppers and tourists alike.”
“Good food doesn’t have to be dull.” That’s what Ben Jennings at Twisted Street Food told The Lincolnite when we went to try out his now famous potato skewers, as well as a brand new item on the menu.
Ben Jennings, 48, is originally from London but has lived in Lincoln for 13 years, and he has worked in and out of the hospitality sector for almost a decade.
Twisted Street Food was an idea he had around two years ago, and after COVID-19 postponed the launch, he is now up and running selling street food delights in the city since October 2020.
Ben is meticulous with his food prep. | Photo: The Lincolnite
“I just love food, I am so passionate about it and always have been,” Ben told The Lincolnite. “Street food suits me down to the ground, it’s far better than being static in a kitchen.
“For me, the experience is of equal importance to the quality of the food, so it has to be fun as well as tasty.”
Here is where you can find Twisted Street Food, outside The Victoria pub on Union Road, Lincoln. | Photo: The Lincolnite
You can find Twisted Street Food outside The Victoria pub on Union Road, as well as his monthly pop-ups at Lincoln Castle.
Ben’s big hit so far have been his twisted potato skewers, which are twice fried and served with seasoning and sauce.
The potato skewers start off pretty routinely. | Photo: The Lincolnite
He has developed sixteen different seasoned salts and offers them in batches of four to six depending on demand, varying from cajun spice to Spanish onion and Cornish salt.
“This is where the magic happens.” | Photo: The Lincolnite
Ta-da! | Photo: The Lincolnite
The potato becomes twisted with a spiral cutter, before they are fried and dosed with a choice of Twisted’s various spices and sauces.
The skewers are then fried before being seasoned and prepped for serving. | Photo: The Lincolnite
His latest invention is a wonderful chilli dog, based on a 1950s recipe from Coney Island in Brooklyn, New York.
Ben has added a local twist to this legendary dish, offering Lincolnshire sausages, supplied by local butcher Foster’s on Monks Road, instead of the traditional Bratwurst.
The chilli dog looks mesmerising. | Photo: The Lincolnite
The chilli dog will come with caramelised onion, nine hour slow cooked beef chilli mix, blow torched mature cheddar and then garnished with fresh chillies, spring onion and American mustard.
The gourmet burger is a sight to behold. | Photo: The Lincolnite
Adding this to the menu alongside the already popular skewers and gourmet burger is part of the next step in Ben’s development with Twisted.
With a menu this good, how can you go wrong? | Photo: The Lincolnite
Ben added: “Street food is taking off, and with table service looking to be the route forward it’s cause for me to be excited, everything is just so much more civilised.
“The uptake has been massive since we started, people seem really interested in it, I think above all else the public are just delighted to be back out and about.
The gourmet burger comes with onions, molten cheddar, lettuce, gherkins, onion rings, tomato and a prosciutto crisp. | Photo: The Lincolnite
“As for myself, I’m hoping to be able to reach the festival and events circuits soon enough, as well as doing a few private events and carrying on with the success we’ve had at The Victoria and the castle.”
The twisted potatoes will cost £3.50 with seasoning and sauce, while the gourmet burger and chilli dog cost £8.50 with French fries and sauce.
Great options at Twisted Street Food. | Photo: The Lincolnite
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