Plymouth Hospitals NHS Trust has made “encouraging” improvements to services, according to the Care Quality Commission following its latest inspection.
The CQC had previously rated the Devon trust as being “inadequate” for providing responsive services but, in the wake of the new visit, has upped the rating to “requires improvement”.
“Staff have achieved a great deal since our last inspection”
The regulator’s call for more improvements was especially centred on the trust’s accident and emergency department.
For example, the CQC said the department’s four-hour performance must improve, with an ultimate aim to achieve the 95% standard. The CQC’s report on the trust stated that frequent crowding was becoming “normalised” in the A&E department.
It was also told it must continue to work with local commissioners and Plymouth Community Healthcare, which is run as a social enterprise, to ensure mental health patients arriving at A&E received “the care they require in a timely manner”.
In addition, the CQC said the trust must review performance data in A&E to ensure it was accurately captured and reported in order to allow “adequate monitoring and scrutiny”.
At its Mount Gould site, the trust was told it must reduce the number of clinics cancelled with less than six weeks’ notice.
“I promised we would be action-oriented where improvement was required”
Inspectors also identified a number of other areas for improvement, as well for being more responsive.
They said safeguarding training must be completed by all staff in A&E and across all areas, and that all equipment, specifically in A&E, must be maintained in accordance with the trust’s service schedule.
The trust retained its “outstanding” rating for being caring and was still marked as “requires improvement” for providing safe care. Its overall rating also remains “requires improvement”.
The latest inspection took place in July and August, when inspectors re-visited the trust’s Derriford Hospital and Mount Gould Hospital.
As well as the required improvements, they also highlighted some areas of “outstanding practice”.
For example, a new pharmacy technician role had been developed within the acute medical units and the short stay ward to enable medicines for patients discharges to be prepared more efficiently.
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In addition, access to stroke care had improved since its last inspection, said the CQC, noting that staff were “proactive and consistently reviewed their practice to speed up the time from patient arrival to treatment”.
The multi-disciplinary working between the hospital and the community services providing end of life care was also described as “outstanding”, particularly in preventing avoidable admissions.
Professor Edward Baker, the CQC’s deputy chief inspector of hospitals, said: “It is encouraging to see the progress made since our previous inspection in April 2015.
“We have up-graded the ratings within certain areas for Derriford and Mount Gould Hospitals because of the improvements we have found in surgery, maternity, outpatients, diagnostics and services for children and young people,” he said.
But Professor Baker added: “While staff have achieved a great deal since our last inspection, there is still more that needs to be done. The trust rating remains ‘requires improvement’ overall.”
“It is disappointing that the number of cancelled operations has risen, with a corresponding increase in the number of patients not treated within 28 days of the cancellation,” he said.
“Due to pressure for their beds and the demand for their services, some patients have been accommodated in facilities not appropriate for the services being provided,” said Professor Baker.
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Trust chief executive Ann James said: “In 2015, following our last inspection, I promised we would be action-oriented where improvement was required. This latest report is proof that we have been.
“The massive improvements and the many examples of outstanding practice noted by the inspectors reflects the professionalism and commitment of my colleagues to do the very best they can for patients in the face of some unrelenting demand,” she said.
“We remain rated as ‘requires improvement’ overall, partly reflecting the difficulties we face in a challenged Devon healthcare community,” added Ms James.