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Essex acute trust exits ‘special measures’ after improving care

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Regulators have removed the Princess Alexandra Hospital NHS Trust in west Essex from the “special measures” regime for struggling providers following improvements in care, particularly in the children and young people’s service.

The trust was taken out of the regime by NHS Improvement on Wednesday after a favourable report was published on the same day by fellow regulatory body the Care Quality Commission.

“Our inspectors found a dedicated staff at the trust who had worked hard to ensure improvements were made”

Ted Baker

The trust had previously been rated “inadequate” overall by the CQC and placed into special measures following an inspection back in June 2016.

The CQC returned in December 2017 and inspected six core services – urgent and emergency care, medicine, surgery, critical care, children and young people’s services and end of life care.

Inspectors found that, while further work was needed, a number of improvements had been made at the trust and moved its overall rating up to “requires improvement”.

The trust was also rated “requires improvement” for whether its services were safe and responsive, and as “good” for whether services were caring, effective and well-led.

“The removal of the trust from ‘special measures’ is something that I’m sure people will be celebrating”

Lance McCarthy

The organisation has three main sites – at the Princess Alexandra Hospital in Harlow, St Margaret’s Hospital in Epping, and Herts and Essex Hospital in Bishop’s Stortford.

Inspectors found examples of outstanding practice at the trust, notably in children and young people’s service. For example, the neonatal unit had implemented a project to improve nurse-led discharges in straightforward and low risk cases, meaning nursing staff did not have to wait for a doctor.

In addition, the critical care unit had implemented a secure medication return bin, which meant staff could return any unused medicines to the pharmacy for recycling or disposal.

However, the trust was told it must ensure levels of mandatory training improves and that staff annual appraisal completion rates also improve.

In addition, it was told that fridge temperatures in urgent and accident and emergency services must be consistently monitored, and any concerns acted upon.

“Despite the challenges that lie ahead, we know that staff here have got what it takes to be the best we possibly can be”

Daniella Pritchard and Nicola Maguire-Smith

The CQC noted that patients arriving at A&E by ambulance must be appropriately assessed and triaged in a timely manner, and action taken over mixed gender breaches in the critical care unit.

The trust also needed to ensure it met Royal College of Nursing requirements to ensure enough staff, with the correct competencies, were available on the Dolphin ward for children and young people.

Meanwhile, paediatric life support training needed to improve to ensure staff had the required knowledge and competencies to recognise and respond to patients at risk.

In end of life care the trust needed to review “do not attempt cardio-pulmonary resuscitation” forms to ensure they were completed fully and in line with trust policy and national guidance, said the CQC.

Professor Ted Baker, the CQC’s chief inspector of hospitals, said: “Our return to the Princess Alexandra Hospital NHS Trust showed significant improvement had taken place.

“Our inspectors found a dedicated staff at the trust who had worked hard to ensure improvements were made,” he said. “They also witnessed a number of areas of outstanding care, particularly in the children and young people’s service, all of which was fantastic to see.

Ted Baker

edward ted baker

Ted Baker

“We also saw improvements in the ratings for end of life care, critical care and urgent and emergency services,” said Professor Baker.

“However, this trust has to ensure it continues and consolidates this work and makes further changes so that people receive the care they should be able to expect,” he added.

Trust chief executive Lance McCarthy said: “People have worked tremendously hard over the past 12 months to deliver major improvements in quality across our hospital services.

“The removal of the trust from ‘special measures’ is something that I’m sure people will be celebrating,” he said. “I am enormously proud of everyone.

“The momentum we have created continues and… we all remain committed to delivering our ambitious, but achievable quality improvement programme,” said Mr McCarthy.

In a joint statement, staff side secretary Daniella Pritchard and staff side chair Nicola Maguire-Smith noted that staff had been “truly shaken” when the trust was placed in special measures.

“There has been incredible tenacity and everyone has worked very hard together with the common aim of delivering the best possible services for our patients,” they said. “Everyone should feel very proud of this result.

“But we also know the report marks the end of the first step in our improvement programme,” they said. “Despite the challenges that lie ahead, we know that staff here have got what it takes to be the best we possibly can be.”

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