Medway Foundation Trust could become the first provider in special measures to face further regulatory action from the Care Quality Commission after inspectors found it had failed to improve during an unannounced inspection.
The threat of further action is revealed in papers prepared for the trust’s August board meeting by Philip Barnes, its acting chief executive.
According to the papers, the CQC had “expressed forcefully” concerns that there had been “no significant improvement” since a visit four months beforehand.
The concerns were raised after an announced inspection of the trust’s Medway Maritime Hospital at the end of July, which focused on its accident and emergency department and surgical services.
This followed an inspection in March that found its A&E was “effectively in a crisis situation” with a shortage of staff “severely impacting” treatment.
While a report on the July visit has yet to be published, the CQC’s deputy chief inspector of hospitals, professor Edward Baker, confirmed “further action” was planned.
He told HSJ: “CQC carried out an unannounced inspection of A&E at Medway Maritime Hospital.
“We still have ongoing concerns about the quality of care and treatment provided there, and are taking further action to reduce the level of risk to people using the service.
“We will report further on our findings in due course.”
Medway has put an action plan in place, which includes measures to strengthen its nursing and medical leadership in its A&E.
It is also introducing a rota of senior clinicians from outside the department to “improve basic standards” including hand washing and note keeping.
Dr Barnes told the board the trust had renewed its “focus on maintaining levels of discharges from the hospital over the weekend” as low levels of weekend discharges were a major factor in “high bed occupancy and consequent problems moving patients who need admission out of the emergency department and into the correct bed”.
The Vanguard unit, a mobile surgical centre where the CQC found blood on the wall during the March inspection, has been closed for clinical use.
Dr Barnes praised the “hard work and energy of members of staff” and said consultants had voluntarily given up their free time to do extra ward rounds.