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Inadequate staffing levels found at Southend trust

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Staffing numbers at an Essex hospital were not adequate to meet patient needs and shortfalls were compromising safety during a recent visit by Care Quality Commission inspectors.

The CQC said there “must be sufficient and appropriate staff available in medical services to provide care and treatment” at Southend University Hospital NHS Foundation Trust.

“The identified shortfalls compromised patient safety”

Mike Richards

The trust must also take action to “ensure sufficient numbers of suitably qualified, competent, skilled and experienced nurses are available at all times on wards caring for palliative and end of life patients”, said the regulator in its report on the South East Essex provider.

Professor Sir Mike Richards, the CQC’s chief inspector of Hospitals, noted that the trust was on a “high state of escalation” due to an increased number of patients during the inspection in January.

“Staffing numbers were not adequate to meet patients’ needs. The identified shortfalls compromised patient safety,” he said. “However, the trust responded promptly when we identified the concern.”

Sir Mike added that the high level of demand had caused large numbers of elective surgery and outpatient clinic cancellations due to congestion within the hospital.

He said that the trust’s strategy to open escalation beds had put “increased pressure on the whole of the hospital, such as staffing, outliers, and cancelled elective procedures”.

Sir Mike Richards

Sir Mike Richards

Mike Richards

“Cancelled outpatients clinics were an issue due to the capacity and congestion within the hospital; outpatients staff were required to work on the wards which negatively impacted on those waiting for appointments,” he said.

“Patient discharges were not taking place in a timely fashion which was having a knock on effect across other departments,” he added.

Other areas requiring improvement included ensuring that learning from serious incidents in ophthalmology was shared with all outpatient departments, and that there was clinical input into decisions to cancel operations within surgery.

In addition, the trust was told to to ensure all staff completed the required level of safeguarding training.

Overall, the CQC rated core services provided by the trust as “requires improvement”. It was rated as “good” for being effective and caring and “requires improvement” for being safe, responsive and well-led. Urgent and emergency services was rated “outstanding” for being well-led.

The CQC inspection team highlighted a number of areas of outstanding practice, including the emergency department where staff were seen to be “engaged and motivated”.

The rating represents a significant turnaround since June 2014, when the trust was described as having “one of the worst performing” A&E departments in the country by the former regulator Monitor.

The trust was also praised by the CQC for implementing an early rehabilitation and nursing team, which supported the discharge of primary hip surgery and knee surgery patients.

In addition, a new daily initiative – called Safe @ Southend – had been introduced to allow staff to share day-to-day clinical and operational issues with trust executives for “rapid action”.

Southend University Hospital NHS Foundation Trust

Inadequate staffing levels found at Southend trust

Southend Hospital

Stroke service patient outcomes had received the highest rating by Sentinel Stroke National Audit Programme, said the CQC.

Sir Mike noted that the trust had “several areas of good practice” and inspectors were “particularly impressed” by the urgent and emergency service.

“Across the trust, staff went the extra mile for patients and demonstrated caring and compassionate attitudes,” he said. “Patients were aware of their treatment plans and had sufficient information.”

Trust chair Alan Tobias said the regulator’s report “reflects the journey we are on”, especially in developing its clinical leadership structure to ensure high level decisions were informed by clinicians.

He added that many of the “challenges and pressures we face are system wide issues, particularly the recruitment of staff, increased demand and lack of capacity”.

Southend University Hospital NHS Foundation Trust

Inadequate staffing levels found at Southend trust

Sue Hardy

Trust chief executive Sue Hardy, who has a nursing background, said she was “absolutely delighted” that the CQC report had recognised the “fantastic caring and compassionate nature of our staff”.

“The report reflects the things we told the CQC inspection team we were working to change and with no area rated as ’inadequate’ this reflects the hard work of our teams in transforming and improving the services we provide to our community,” she said.

Ms Hardy joined the trust in April 2011 from Northampton General Hospital where she was director of nursing, midwifery and patient services. She was also formerly head of midwifery at Yeovil District Hospital and director of nursing at Hereford Hospitals NHS Trust.

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Readers' comments (3)

  • they are inadequate at every trust in the country not just this one

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  • Perhaps the bloated and inefficient CQC could spend a little less money on fancy hotel rooms and nice lunches and give that money to Trusts to buy some staff with.

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  • until the nhs gets rid of the overpaid "executives"and get to running hospitals as places for patients instead of lucrative businesses there never will be enough money for front line staff

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