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Sherwood Forest Hospitals Foundation Trust

Inspectors slam hospital trust for 'abysmal' staffing levels

A warning notice has been issued to Sherwood Forest Hospitals Foundation Trust after a highly critical inspection report found “abysmal” staffing levels.

Inspectors from the Care Quality Commission found there were not enough nurses or doctors on the wards and described a string of failures at the trust which is already in significant breach of its license with Monitor.

The trust is already in “special measures” after being one of 14 hospitals criticised in a review by NHS England medical director Sir Bruce Keogh following concerns over high mortality rates.

During inspections in June and July the CQC visited the trust’s accident and emergency department and 16 other wards. Inspectors also spoke to 75 patients and 100 staff.

Inspectors were told by patients that staffing levels were “abysmal” and one relative said: “My wife rang me in tears because she could not get any one to help her, they are so busy.”

Nurses told the CQC staffing levels were “horrendous”, with one saying: “We cannot go on, it’s terrible, nurses are crying because it’s so bad on here.”

Another added: “It feels like we’re being told there’s ‘no agency, no bank [staff available] – get on with it.’”

An analysis by the CQC found the trust had a ratio of nurses to healthcare assistants of 50:50 on most wards. The older people’s wards had one nurse for eight patients during the day and one nurse for 12 patients during the night.

The Royal College of Nursing has previously recommended a minimum registered nurse to patient ratio of 1:5 for older people’s wards and a skill mix of 65:35.

Junior doctors told inspectors working on the medical ward at the weekend was “one of the worse jobs” because of a lack of staff and mistakes had been made with prescriptions due to high workload.

The CQC identified problems with the way outlying patients on wards away from the specialty providing their care were reviewed. One nurse saying part of their role was “having to be a good detective” to identify responsible consultants.

Inspectors also found patients not being helped to eat or drink with poor charts and incorrect or absent risk assessments.

The trust also had a backlog of complaints, x-rays and scans.

Trust chief executive Paul O’Connor said: “We are confident that measures have been put in place to address all findings from these reports and recognise the need to give additional attention to bring further improvements for our patients.”

GMB regional officer Harry Harrison said his union hadraised “serious concerns” over inadequate staffing levels and the standards of patient care for a number of years.

“The the trust have been ‘gambling’ with the ratios of qualified nurses to the number of patients they care for as it was a board game.

“GMB members have time and time again raised serious concerns with nurse managers and service directors alike only to be patronised and seen as troublemakers,” he claimed.

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Readers' comments (25)

  • Of course there's abysmal staffing levels on the front line. All the cash resource is going into endless tiers of bureaucrats and empire-builders! And that's not just SFHFT - that's right across the NHS!

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  • This is the nub of the problem and needs addressing properly.

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  • So all the Trust gets is a rap on the knuckles?? ?
    My belief is that they should be at least heavily fined . I would say shut down but that would affect so many patients that relay on this hospital for SAFE and COMPETANT CARE!!!
    The management have put patients lives at risk all for the sake of saving the dollar. It is an absolute disgrace.
    Nurses need to unite...that's all. And again your union needs to bloody work for the money you are paying them.
    Already had concerns re High Mortality Rates?? Just scary!!!

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  • What a shame Sherwood Hospitals is being
    Scapegoated when in fact this is common throughout the NHS, no-one can accept poor standards and behaviours but honestly when are the powers that be going to recognise that we have crisis on our hands throughout the NHS not just in a few hospitals. Patients are older, frailer, expect more, treatment races ahead, relatives give staff a hard time even when it is clear they can only do what they do and rightly expect there family to be nos one, trouble is everybody thinks that. Stop chasing targets paying for non nurse managers at ridiculous salaries and sort the serious issue of recruitment which is only going to get worse as degree only will stop a large contingent and to be honest if you read the papers and saw all the Stuff written day in day out would you become a nurse? I know I would not. Jobs on the wards become harder by insistence of things such as keeping the charts locked away from the bedside just in case someone may read them... What is that all about, the debacle about this is ridiculous in my trust, this is is supposed to be about privacy and dignity! Confidentiality! I do not have the answers all in one pot but we could make a start about asking what we do well.

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  • Shame on Sherwood Forrest,
    And shame on the rest of hospital trusts who think staffing in 1/8 patients
    And disgrace on the trusts who are working 1/15 patients

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  • michael stone

    This message has got to be trumpeted where it is true ! TELL THE PUBLIC !!!

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  • The staffing levels described in this article are actually better than where I work: CQC please come to my hospital!

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  • Anonymous | 26-Sep-2013 4:15 pm

    If it is so bad, why don't you make a complaint and spark an inspection?!

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  • CQC please don't just inspect and advise.
    Demand that there be change. Please do this job well, otherwise some political fool will decide to get another high profile so called independant person pay them tons of money to do the job that you are suppose to doing.
    INSPECT, ADVISE, WARN, DEMAND and Fire / Fine Incomptent Managers.

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  • How will fining this trust help put enough staff on the wards?

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  • The hidden agenda is that the government are creating situations where Trusts are failing with their plans to sell privatisation to the public

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  • The causes of trusts not doing well is often multifactorial financial constraints, misappropriation of funds, poor staffing levels which has an impact on retention and poor management. This all leads to a downward spiral which impacts patient care and staff morale. Clearly there are huge discrepancies between trusts as some are doing very well and have good staffing levels due to careful management of funds and good leadership.
    Nurses need to continue to report issues, do adverse
    incident reports andsaying nothing will happen if you do tjis or I don, t have the the time is not an excuse. Working in such an environment is very stressful amd does not alone effect patient care but the health
    Of staff. I agree with the previous comment that the senior partnerss in this government do wish to privatize the nhs. So far recruitment of 'degree' nurses has not being effected in response to aprevious comment. Every allied health care professional has a degree. We as nurses continually saying we do not need a degree is not doing the profession any favours. I find the young staff I work with to be intelligent, compassionate and very good nurses and I don' t have a degree. I know this is off the point but we need to be aware of the image we protray in time where our profession is continually being battered and not give the governement any further amunitation againest us.

    of staff.

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  • Anonymous | 26-Sep-2013 5:08 pm

    We've had our CQC visit, it was announced and we were decked-out with staff.

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  • michael stone

    Anonymous | 26-Sep-2013 2:34 pm

    I'm not sure about this - I don't have first-hand info personally - but I strongly suspect that your scapegoating point is valid, and that there is an awful lot of 'there but fro the grace of God ...' involved in who gets the ctiticism, and who avoids it.

    I think there are some 'really bad places' where the quality and attitude of the individual staff is the main problem, but that a much geater problem is the pressure to try and stretch resources too far. Rubber bands only stretch so far, then they snap - so do hospitals and hospital staff.

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  • pile more and more pressure and work on the limited number of staff equates to, poor patient care, errors and mistakes. who gets the blame, not management, but the staff they and their patients are the ones that pay the ultimate price.
    nursing and what it stood for is being slowly eroded away.

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  • So now we have even more evidence that staffing levels and skillmix are appalling, what are the 'experts' going to do about it, all we hear is how bad things are, we never see any solution or improvement.

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  • I work in France where the staffing levels are much worse . In the public sector in which i work, , on the wards there is 1 nurse and 1 HSW for 14 patients. In the private sector there is 1 nurse and 1 HSW for 20. I work in iTU and the ratio is 1 nurse for 3 intubated patients and 1 for 6 in HDU. I have a friend who is a HSW in an nursing home, she works an afternoon shift with a cleaner, 2 of them for 70 residents, they put them in bed and a district nurse comes in at 9 o'clock and gives the poor residents their medication. They start at 3 to get them all in bed by 9. Then they start at 6 in the morning to get them all up for lunch. It is an assembly line.the care in the hospital is haphazard, newly qualified nurses (first day) in charge, first week in charge of Aand E. The HSWs have a years training though, I think that helps for basic nursing care

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  • Sam Alexander | 29-Sep-2013 8:28 pm

    That's interesting Sam. Someone posts here frequently telling us how brilliant and better off the other European countries are in comparison to the UK.

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  • Healthcare in Europe

    The World Health Organization's ranking of Europe's health systems

    Health Consumer Power House
    UK healthcare makes expensive progress, says today’s EU ranking
    (Brussels, May 15, 2012)

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  • tinkerbell

    Sam Alexander | 29-Sep-2013 8:28 pm

    Thanks Sam for sharing your experience.

    Anonymous | 29-Sep-2013 9:10 pm

    I thought that too. Doesn't sound so great after all.

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