'˜Safety is our number one priority': Hospital trust's response to damning CQC report

The report, produced following inspections at Lincoln County Hospital, Pilgrim Hospital, Boston and the A&E department at Grantham and District Hospital in October last year, identified a range of issues which the Trust is required to tackle, but also many examples of good practice at ULHT.

ULHT Chief Executive Jan Sobieraj said: “The safety and quality of patient care is our number one priority. We’re disappointed with some of the findings in the report but we are taking them very seriously. We are sorry to our patients as we know this isn’t good enough.

“The Trust has already improved on many of the areas of concern that have been raised by the CQC, and we have started to see significant improvements since the inspection last October. Immediate action was taken and many issues raised by the CQC have since been resolved. Further actions are planned to ensure improvements are sustained.

“Following the CQC inspection, many of our services were inspected by the GMC in November. They found a positive patient safety culture at the trust, with learners and educators being encouraged to raise concerns and be open and honest with patients when things go wrong.”

Progress already made in the last six months includes significant improvements in identifying and treating sepsis and bringing in additional senior clinicians and management at Pilgrim hospital. The Trust has also done an extensive piece of work to introduce ligature cutters to all clinical areas, as well as work to improve staff awareness and training around caring for patients with mental health problems and major incident planning. We have launched an anti-bullying campaign and are encouraging staff to raise their concerns through official channels.

In addition, recent national staff survey results, published in March, show the Trust is making improvements in relation to staff morale, with improved results for staff motivation and staff satisfaction with their level of responsibility and involvement. Our staff saying care of patients / service users is our top priority has increased by 28% since 2014 from 57% to 73% in 2016.

Jan said: “I want to reassure people that we are working hard to make our services safer and ensure they stay that way. I’m pleased the CQC rated 56% of our services as “good” including surgery at Lincoln and Pilgrim hospitals and critical care at Pilgrim hospital. I want to publicly thank our staff, who the CQC found to be caring and treating patients with kindness and respect. It’s also worth noting that some services weren’t rated and these are generally those that were rated good or outstanding at the last inspection.

“We know we still have more work to do, and we have been very open about the long-term challenges we face in making our services safer and sustainable. Our biggest challenges are around our shortages of permanent staff and we struggle to meet some national quality standards.

“We’re working hard to recruit staff locally, nationally and internationally but the reality is we rely on locum and agency staff, and this sometimes affects the quality of our services. ULHT has a five year plan in place to improve long-term quality and safety of our services - our share of Lincolnshire’s STP – and we’re working hard to quicken the pace of these changes.”

The inspection team highlighted many areas of good practice in their report. These include:

- Patients were treated with kindness, dignity, respect and compassion while they receive care and treatment.

- Staff told the CQC they felt the hospitals were much safer than they used to be.

- The carer’s badge, which helps family members and trusted friends to be involved in the care of their loved ones.

- Staff on the children’s ward at Pilgrim who’ve learnt sign language.

- The Trust has been chosen as a national pilot site for the nursing associate role.

- Initiatives in place to aid the retention of nursing staff.

- The Trust has a lower than expected re-admission rate of patients.

- Dementia practitioners in place providing support for patients at Pilgrim and Lincoln

- Praise for the chaplaincy service.

T- he Trust having a clear vision and a set of values, which staff knew about.

- The Chairman was very supportive of the Chief Executive and they appeared to work well together.

- The Chief Executive is also described as listening and approachable.

Dean Fathers, chairman of ULHT, said: “The Trust Board is fully committed to delivering high-quality care for patients. I’d like to echo the CQC’s praise for our caring staff who treat patients with dignity, compassion and respect.

“We have a very detailed plan in place to address all the areas for improvement raised by the CQC, which have addressed many of the issues already. With the support from NHS Improvement and our partners in Lincolnshire I’m confident we can make long-term improvements for the benefit of all our patients.”

Jeff Worrall, Delivery and Improvement Director at NHS Improvement, said: “Patients will be reassured that the trust has been rated ‘good’ for caring. Ensuring that improvement is sustainable from this point onwards is our primary focus.

“The trust has already demonstrated once that it can make positive changes. We will be working closely with the team to make sure those changes are lasting ones.

“We have already put an improvement director and programme of support in place in response to the concerns raised and will be working alongside trust staff to address the specific areas outlined in the report.”