THE Care Quality Commission (CQC) inspection of Wye Valley NHS Trust was carried out over four days in June.

At that time the trust had a new chief executive and a new board chairman with A&E demand reaching a record high.

Three announced inspection days were followed up by a fourth which was unannounced.

The trust was targeted for inspection as a “high priority” based on long-running concerns.

While the trust is willing to accept the resulting findings, it says those findings reflect services under severe pressure over the inspection period.

The trust was judged as “inadequate” with regard to whether services were safe, well-led and responsive.

It was rated as “requires improvement” for whether services were effective and “good” with regard to whether services were caring.

The inspection highlighted a number of concerns and the CQC has told the trust it must improve. Areas include:

  • That the trust continues to improve mortality rates.
  • That action is taken to improve the flow of patients into, through and from the trust and that patient reviews are undertaken in a timely manner.
  • The trust was failing to meet the four-hour target for patients attending A&E. There were instances when patients remained on a trolley for 12 hours.

Ledbury Reporter:

 

 

  •  All environments needed to support the privacy and dignity of patients.
  •  Patients must have access and support, if required, to appropriate foods and fluids.
  •  Staff must be able to report incidents and risks recorded, escalated and acted on.
  •  Discharge planning and arrangements, so that patients were able to leave hospital when ready.
  •  Medicines must be managed in line with the trust’s medication policy.
  •  End-of-life care at both the hospital and in the community.
  •  Systems for mandatory training and training of staff so the trust can assure itself employees have the necessary skills to effectively care for patients.

Inspectors did find examples of outstanding practice at the trust, including:

  1.  Dedicated and committed staff who would go above and beyond the call of duty for patients.
  2. Established schemes – such as “virtual wards” and “hospital at home” which prevent patients having to come into hospital and promote timely and effective discharges.
  3. Excellent preoperative assessments, which included public health initiatives.
  4. A midwifery academy, which had been developed to aid recruitment and promote retention among new and existing midwifery staff.

READ THE REPORT IN FULL.....http://www.cqc.org.uk/provider/RLQ

Wye Valley NHS Trust is the latest of seven trusts now in special measures following the introduction of the Care Quality Commission’s new inspection regime. The others are in London, Essex, Norfolk, Berkshire, Kent and Lancashire/ Cumbria.

 

Better services already in place across the trust...

SERVICE improvements identified by the Care Quality Commission in June were already under way as the inspection report was prepared. These include:

  • The Trust Board agreeing to a £1 million investment in A&E.
  • Seven new nurses and a third consultant recruited to A&E.
  • New refreshment facilities introduced at A&E for patients waiting for treatment.
  • WVT working with partners to deliver £1.3 million investment for new stroke services.
  • New systems in place for managing controlled drugs.
  • l Introduced improved systems for recording and reporting of staff training to ensure staff have the appropriate skills.
  • Real-time patient tracking system introduced.
  • Plans being drawn up for expansion of outpatient areas/planned reconstruction work in A&E will ensure patients’ privacy and dignity are respected.
  • New process to look after patients in their last days of life introduced in July supported by training and major awareness campaign.
  • £500,000 investment in new midwifery-led unit.

FACTFILE...

  •  Wye Valley NHS Trust (WVT) provides community services and acute hospital care to Herefordshire and some patients in Mid-Wales. It was established in 2011 as England’s first integrated provider of acute, community and adult social care services, bringing together Hereford Hospitals NHS Trust, NHS Herefordshire’s Provider Services – excluding Mental Health – and Herefordshire Council’s Adult Social Care services. The arrangement with the council ended in September of last year.
  • Herefordshire Clinical Commissioning Group brings together the GP practices to buy and shape health and care services for the county. The CCG contracts WVT to provide acute and community services.
  •  NHS Trust Development Authority – responsible for overseeing the performance management and governance of NHS Trusts, including clinical quality, and managing their progress towards foundation trust status.
  • Care Quality Commission – inspects hospitals, care homes, GPs, dentists and services over the meeting of national standards.
  • Special measures – special measures apply to NHS trusts and foundation trusts that have serious failures in quality of care and where there are concerns that existing leadership cannot make the necessary improvements without support.