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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There have been 353 new coronavirus cases and 17 COVID-related deaths across Greater Lincolnshire on Thursday.
There were 293 new cases in Lincolnshire, 42 in North Lincolnshire and 18 in North East Lincolnshire. North Lincolnshire’s cases have now surpassed 7,000 since the pandemic started.
On Thursday, 15 deaths were registered in Lincolnshire and two in North East Lincolnshire. These figures include deaths both in and out of hospitals, as well as residents in hospitals outside the county.
NHS England reported 12 new local hospital deaths on Thursday, including nine at United Lincolnshire Hospitals Trust, two at Northern Lincolnshire and Goole NHS Foundation Trust (NLAG) and one at Lincolnshire Community Health Service hospitals.
On Thursday, national cases increased by 37,892 to 3,543,646, while deaths rose by 1,290 to 94,580.
New NHS England figures show that almost 50,000 doses of the COVID-19 vaccine have been administered in Lincolnshire, with nearly five million nationally.
The weekly data released on Thursday show 49,633 jabs between December 8 and January 17. It’s the first time localised figures have been released.
Residents in East Lindsey are at the highest risk of death from COVID-19 nationally according to the latest figures — with health bosses putting the figure down to the age and health of the population.
According to the government’s latest coronavirus statistics on January 20, the authority’s total death tally since the start of the pandemic is equal to 6.16% of its 3,660 case total, the highest national deaths percentage.
In national news, coronavirus infections did not slow down and may have increased instead in the first days of the latest national lockdown, a major ongoing study has found.
Education Secretary Gavin Williamson said pupils could be told in a week’s time if they will be returning to classrooms after the February half-term.
Appearing on Sky News, Mr Williamson said his Department for Education would “want to give all schools a clear two weeks’ notice period” ahead of their full reopening.
Here’s Greater Lincolnshire’s infection rate up to January 20, according to the government dashboard:
Greater Lincolnshire’s infection rates from Jan 13 to Jan 20. | Data: Gov UK / Table: James Mayer for The Lincolnite
Lincolnshire’s COVID cases up to January 21.
Coronavirus data for Greater Lincolnshire on Thursday, January 21
Greater Lincolnshire includes Lincolnshire and the unitary authorities of North and North East (Northern) Lincolnshire.
45,341 cases (up 353)
31,562 in Lincolnshire (up 293)
7,039 in North Lincolnshire (up 42)
6,740 in North East Lincolnshire (up 18)
1,743 deaths (up 17)
1,241 from Lincolnshire (up 15)
271 from North Lincolnshire (no change)
231 from North East Lincolnshire (up two)
of which 1,036 hospital deaths (up 12)
632 at United Lincolnshire Hospitals Trust (up nine)
31 at Lincolnshire Community Health Service hospitals (up one)
1 at Lincolnshire Partnership Foundation Trust (no change)
372 in Northern Lincolnshire (NLAG) (up two)
3,543,646 UK cases, 94,580 deaths
DATA SOURCE — FIGURES CORRECT AT THE TIME OF THE LATEST UPDATE. POSTCODE DATA INCLUDES DEATHS NOT IN HEALTHCARE FACILITIES OR IN HOSPITALS OUTSIDE AUTHORITY BOUNDARIES.
Police have been given powers to issue £800 fines for those attending house parties during the coronavirus lockdown, doubling for each incident to a maximum of £6,400 for repeat offenders.
Home Secretary Priti Patel announced the measures, which will apply to those who attend illegal gatherings of more than 15 people in homes, at a press briefing on Thursday.
At the same meeting, health bosses hit out at “morally reprehensible” people who tried to fraudulently get a vaccine.
Ms Patel said there was still a “small minority” of people breaching coronavirus lockdown rules.
“Such irresponsible behaviour poses a significant threat to public health, not only to those in attendance, but also to our wonderful police officers who attend these events to shut them down,” she said.
“From the outset, we have given the police and necessary powers to enforce the rules, which are in place to stop the spread of this virus and, as these latest measures will demonstrate, we will not stand by while a small number of individuals put others at risk.”
Ms Patel was backed by Martin Hewitt, chairman of the National Police Chiefs’ Council.
He said that since regulations were introduced in late August, to January 17 this year, 250 large party fines fines had been issued across England.
He outlined some of the worst incidents including a party of more than 40 in London and one of 150 in Hartfordshire.
Martin Hewitt, chairman of the National Police Chiefs’ Council.
“These are just a few examples where our officers are not only exposing themselves to the risks of COVID, but in some cases are also facing abuse and physical assault, from those who are wilfully breaching the regulations and endangering all of those present,” said Mr Hewitt
“We have repeatedly made it clear that house parties and other large gatherings shouldn’t be happening,” he added.
“They’re dangerous irresponsible and totally unacceptable and I hope that the likelihood of an increased fine acts as a disincentive for those people who are thinking of attending or organising such event.
“This is about saving lives. When we see people that are putting others, and themselves in danger we will not waste time trying to reason with them. They’re demonstrating no regard for the safety of others, or even themselves.”
NHS England’s regional medical director for London, Dr Vin Diwakar
At the same meeting, Dr Vin Dawakar, the NHS England Regional Medical Director for London reported that “some unscrupulous people” were using links shared with them to “falsely book a vaccination appointment”.
“To do this is denying some of the most vulnerable people in our community a life saving vaccine.
“Let me be really clear about this, it is morally reprehensible to try and jump the queue at anyone who books to get the vaccine fraudulent they will be turned away.”
A Danish homeware retailer will open a brand new store at Marshalls Yard in Gainsborough, replacing the former DW Fitness unit.
JYSK, the largest Danish retailer in the world, will open the 12,570 sq. ft. store at the Gainsborough shopping complex this August.
It will be on the ground floor of the old DW Fitness unit, which closed down after the company went into administration in August 2020. A new gym opened upstairs.
The new store will be located at Marshall’s Yard in Gainsborough.
The shop will be just the third JYSK store to open in Lincolnshire, joining branches in Lincoln and Grantham.
Charlotte Toplass, of the Marshalls Yard Centre management team, said: “JYSK will be a fabulous addition to Marshalls Yard and we are looking forward to their launch in August this year.
“With home improvements proving really popular in the current climate, it is the perfect time to introduce a homeware store where our shoppers can pick up on trend furniture and décor.”
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