The Northern Lincolnshire and Goole NHS Foundation Trust will remain in special measures after it was told by Care Quality Commission (CQC) inspectors that its services must improve.
CQC visited the trust’s three hospitals and community services – Diana Princess of Wales Hospital in Grimsby, Goole & District Hospital and Scunthorpe General Hospital – between September 24 and October 10, 2019, to assess 12 core services.
As a result of the inspection the trust remains rated as ‘Requires Improvement’ overall.
Caring levels were rated as ‘Good’ and a ‘Requires Improvement’ rating was given for effectiveness, responsiveness and leadership.
It is rated as ‘Inadequate’ for the safety of the services, which the trust said is due to waiting list backlogs in some specialities, the backlog in diagnostics reporting, end of life care and some issues in the trust’s two emergency departments.
Inspectors have told the trust it must make a number of improvements in various areas, including the following:
- The trust must ensure it meets the 62-day cancer diagnosis waiting time target
- The diagnostic imaging service must continue to address challenges regarding waiting lists for treatment, delays in reporting results and ensure patients receive appointments and results in a timely way
- Learning from serious incidents must be shared with staff and embedded to prevent similar incidents occurring in the future
- The trust must ensure safe medical staffing levels are maintained. Every effort must be made to recruit to vacancies to protect people from avoidable harm
- In end of life care, the trust must ensure staff treat patients with compassion, kindness and respect and take account of people’s individual needs
It was not all bad news for the trust as inspectors also found improvements in the following services:
- Goole and District Hospital is now rated as ‘Good’ for whether its services are effective and ratings for medical care at the hospital improved. This resulted in that service being rated as ‘Good’ overall
- Community health services for adults and community dental services were found to have improved, with both now rated as ‘Good’ overall
‘Improvements needed across the trust’
Ann Ford, Deputy Chief Inspector of Hospitals, said improvements are needed across the trust, notably in relation to the safety of services, and is “something that the trust must address swiftly.”
She said: “We are aware that the trust has faced a number of challenges over a number of years but we found a number of areas where improvements had been made and a strengthening of the leadership team begun to have a positive impact. Nevertheless significant improvements to a number of services were still required and those improvements needed to be delivered at pace.
“The trust knows what it must do to ensure the necessary improvements are made and it will continue to receive the support of special measures to help drive through those improvements. We will continue to monitor the trust and will return to check on its progress.”
Peter Reading, Trust Chief Executive, said retaining the ‘Requires Improvement’ rating “shows the changes we are making are being maintained, giving us a strong base to build on”.
However, he acknowledged that the report also shows “we still have a huge amount to do to get better, day in and day out”.
He said: “We are working hard to make sure that happens. I have always said we need five years to bring our trust up to where our staff and our local communities want it to be and this report shows where we stand two years in.”
He added that since the inspectors visited last autumn the trust has made changes in a number of areas they have highlighted, including investing more than £1.1 million for extra nursing staff to introduce a twilight shift for registered nurses, increased staffing at weekends and put more senior nurses into its A&Es overnight. It has also made sure there are more doctors in the A&E department overnight.
Its overall waiting list has been reduced by around 5,000 patients since the peak in summer 2018 and the trust said it is on target to have no one waiting more than 40 weeks by the end of March. It has also tackled the issue of the radiology reporting backlog, which has reduced by 8,000. In terms of end of life care, it has introduced new leadership arrangements with a new team in place.
The chief executive also said that any findings in the reports “reflect how we manage our services not the care they (the staff) give, they do an incredible job.”
CQC also published the trust’s Use of Resources report, which is based on an assessment undertaken by NHS Improvement. The trust has been rated as ‘Requires Improvement’ for using its resources productively.
Once the full inspection report is published, it will be available to read online here.