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Critical care improvements at essex hospital recognised by CQC

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Better staffing levels have contributed to an improved critical care rating being awarded to Basildon Hospital by the Care Quality Commission.

The CQC yesterday published a follow-up report on the quality of care provided in critical care at Basildon Hospital, noting a range of improvements.

“Staffing levels for nursing, medical and therapies staff had improved”

Mike Richards

The hospital, which is part of Basildon and Thurrock University Hospitals NHS Foundation Trust, was downgraded to “requires improvement” for its critical care service following an inspection in March 2015.

The inspection was carried out in response to concerns relating to safety, with staffing shortages in the critical care outreach team, areas needing improvement in the effectiveness of the service, responsiveness of patient pathways and pace at which change had been implemented.

CQC inspectors returned to the service on 16 February 2016 to check on whether improvements had been made, focusing solely on the general critical care unit.

In their report they concluded that improvements had been made and gave the service a “good” rating.

Key findings included significant improvements in how safe, effective, responsive and well led the service was since the last inspection in 2015.

Staffing levels for nursing, medical and therapies staff had improved and were at a safe level, said the CQC report.

“This is further endorsement of the dedication and commitment of our staff who work incredibly hard”

Clare Panniker

The mortality ratio for the unit had reduced significantly since the last inspection when it was 1.8. It was now 1.0 on the ICNARC standardised mortality ratio and 0.83 on the APACHE model.

In addition, the unit’s acquired blood infection rates per 100 admissions was consistently in line with or better than the England average of four.

Inspectors also reported observing good use of mental capacity assessments and deprivation of liberty safeguards, and highlighted that completion of “do not attempt resuscitation” forms had significantly improved.

Meanwhile, the regulator said there had been “notable improvements” in the leadership of the critical care and outreach service.

“Morale and culture within the critical care and outreach service had improved significantly since our previous inspection,” stated the CQC.

CQC’s chief inspector of hospitals, Professor Sir Mike Richards, said: “We were pleased to see improvements had been made to the critical care service at Basildon Hospital when we returned.

“A good service was being provided to patients and a number of changes had been made to the service. We found significant improvements had been made to how safe, effective, responsive and well led the service was,” he said.

“Staffing levels for nursing, medical and therapies staff had improved, the mortality ratio for the unit had reduced significantly and morale and culture within the critical care and outreach service had also improved significantly,” said Sir Mike.

Clare Panniker

Clare Panniker

Clare Panniker

But he noted that inspectors had also given feedback to the trust on where it should make further improvements, for example in mandatory training for the critical care outreach team.

The CQC report stated that the unit currently did not meet the core standard of 50% of registered nurses having completed a recognised critical care course, with only 27% having done so.

It acknowledged, however, that a number of staff were currently on the course and the rates by the end of the year were expected to reach over 50%.

Clare Panniker, the trust’s chief executive, said: “We are delighted that the CQC has recognised the continued improvement of Basildon Hospital, reflected in this latest ‘good’ rating for our critical care department.

“This is further endorsement of the dedication and commitment of our staff who work incredibly hard to ensure that our patients receive the very best care,” she said.

The trust was one of those placed in special measures based on concerns around quality of care and high mortality following a review by NHS England medical director Sir Bruce Keogh June 2013.

The CQC undertook a comprehensive inspection of the trust in March 2014 and rated the trust as “good”, after which fellow regulator Monitor said the trust could come out of special measures.

In light of the critical care inspection, the regulator noted that Basildon Hospital’s overall rating was “good” and the overall rating for the trust also remained “good”.

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