Lincolnshire hospitals improving, but special measures remain

Health bosses at Lincolnshire’s hospitals say the trust is moving forward — however, the trust has yet to get out of special measures.

United Lincolnshire Hospitals Trust received an overall rating of ‘requires improvement’ following inspections from the Care Quality Commission (CQC) between February and April.

Trust bosses say the report shows the trust is ‘moving in the right direction’ and have praised dedicated staff for helping to improve the standards of the trust, resulting in 72% of inspection areas being rated as ‘good’.

However, the trust remains in special measures, something Chief Executive Jan Sobieraj says was not unexpected.

Yet he remained optimistic, saying: “Special measures has all sorts of negative connotations, but it’s the system saying we need more support, so in my head special circumstances mean special measures.

“The trust has been challenged for getting on for a couple of decades now; the flag of special measures for finance and quality means we get additional help, we get more people in, a bit of extra cash and support generally across a whole range of activities.

“I’m not unhappy that work continues over the next 12 months, because I think an organisation this big we need all the help we can get to continue the progress we’ve made.”

Mr Sobieraj points to a number of successes at the trust, which has been beset with campaigns calling for services to be retained, improved and reopened.

They include children and young persons services at Boston Pilgrim facing substantial changes and Grantham Accident and Emergency being reopened due to staffing shortages.

The trust points to a number of improvements including progress on recruitment of staff, and a ‘back to basics’ approach to quality of care.

In its report CQC said it felt that the trust should remain in special measures so it can receive the support it needs to make further progress.

CQC told the trust to make a number of changes, including improving the quality of data, ensuring there are effective governance processes around locum staff procedures and assuring the board of the quality and delivery of surgical care for children.

It was also told to take immediate action to address the significant levels of violence and abuse experienced by staff.

Notable points for each hospital include:

Lincoln County Hospital – Overall ‘requires improvement’

  • Outstanding practice was found including the emergency department at Lincoln County Hospital which had developed a quality improvement project which helped staff identify and diagnose aortic dissections and ensured patients received appropriate care and treatment.
  • The trust was told however that it must ensure emergency department patients were triaged within 15 minutes and that ambulances are handed over within 30 minutes.
  • It must ensure patients run from admittance to discharge within four hours.

Boston Pilgrim Hospital – Overall ‘inadequate’

  • Particular praise was given to medical care, with the stroke ward and mental health provision coming under the spotlight. Outpatients were also praised, with a project to sew bras for cancer patients highlighted.
  • Pilgrim saw a number of improvements listed for outpatients including recording outcomes, mandatory training and ensuring data is used in a way to improve services
  • Urgent and Emergency Care also saw a number of improvements needed including ensuring an effective escalation processes were in place for the front door of emergency departments

Grantham – Overall rated as ‘good’

  • The trust was told to improve in medical care where it needed to increase compliance and review systems for identifying expired medicines.
  • It was also told to improve in surgery where it needed to ensure equipment is serviced in a timely manner, and ensure each page of a patients medical records were signed and dated as well as make sure infection guidelines were up to date on the surgical  ward at Louth Hospital

Louth – Overall rated as ‘good’

  • Improvements were suggested to, like Grantham, ensure equipment was serviced as soon as possible and to make sure the medicine cupboards remained locked at all times.