A struggling trust in the Midlands has officially been told to improve across a range of workforce safety measures, in particular on ensuring sufficient numbers of midwives.
Shrewsbury and Telford Hospital NHS Trust, which was recently placed in special measures, has now been rated as “inadequate” by the Care Quality Commission.
“There is clearly much work needed at the trust to ensure care is delivered in a way that ensures people are safe”
As a result, according to a report published today, the trust is now rated “inadequate” overall by the regulator, having previously been rated as “requires Improvement”.
It is also rated as “inadequate” for whether its services are safe and well-led, “requires improvement” for whether they are effective and responsive, and “good” for being caring.
The CQC carried out its inspection of services at the trust’s Princess Royal Hospital and Royal Shrewsbury Hospitals between 21 August and 21 September.
Following the inspection, CQC took urgent action to protect the safety of patients using the trust’s urgent and emergency services and maternity services by placing conditions on its registration.
The trust was then placed into special measures on 8 November, in order to give the trust external support to make the significant improvements identified in today’s CQC report.
- Struggling Shropshire hospital trust placed in ‘special measures’
- CQC finds concerns over maternity and sepsis care in Shropshire
- Shropshire trust defends transparency of maternity review
- ‘Fragile’ A&E departments hit by spate of nurse resignations
The CQC has told Shrewsbury and Telford it “must” ensure sufficient and suitably qualified and trained staff are available to care for and protect people from the risk of harm.
In addition, it must review and improve midwifery staffing levels to meet the needs of women and keep women and babies safe.
It was also told to review processes around escalating women at high risk so that those who present at the midwifery led unit or day assessment unit receive a medical review without delay.
“Clearly, Shrewsbury and Telford Hospital NHS Trust is on a journey, but it is heading in the right direction”
The trust should look at its policy on reduced foetal movements as well, so there is a clear and defined pathway for midwives and sonographers to follow, said the CQC.
It must improve rates of giving antibiotics within an hour of identifying patients with suspected sepsis and ensure best practice is followed when preparing, administering and storing medicines.
While the CQC identified a number of areas for improvement inspectors also found outstanding practice in the postnatal ward, which had received the exemplar ward diamond status.
It noted that the ward met high standards in a number of key areas including caring for women and babies, medicine management, nutrition, hydration, cleanliness, safety and record-keeping.
CQC chief inspector of hospitals Professor Ted Baker said: “Our report on Shrewsbury and Telford Hospital NHS Trust gives a detailed account of our inspection and our full findings.
edward ted baker
“While we found staff to be caring and dedicated, there is clearly much work needed at the trust to ensure care is delivered in a way that ensures people are safe,” he said.
“We remain particularly concerned about the emergency department and maternity services at Shrewsbury and Telford Hospital NHS Trust,” said Professor Baker.
He added: “We will continue to work with NHS Improvement with regard to the trust. This trust must take action to ensure it makes all improvements necessary to give patients the standard of safe care they should be able to expect.”
Dr Kathy McLean, executive medical director and chief operating officer at NHS Improvement, said: “The CQC’s inspection report is further evidence that the Shrewsbury and Telford… faces significant challenges and needs intensive support to improve its services.
“Clearly, the… trust is on a journey, but it is heading in the right direction, having been able to secure sufficient middle grade doctors and nurses to allow its emergency department at the Princess Royal Hospital to remain open overnight,” she said.
“The safety and welfare of patients remains ours and the trust’s top priority and so, we will work with them to ensure this progress continues,” she added.
“I know how hard staff are working, how passionate they are about what they do and the care they provide”
In response, the trust urged people “not to lose sight” of the good work that it was also doing, highlighting that a third of all categories inspected by the CQC were rated as “good” by inspectors.
Almost all services were recorded as “good” for being caring, while areas of outstanding practice were found in postnatal maternity care as well as many in support of patients in end of life care.
Its chief executive Simon Wright said: “I’m sorry and disappointed that we have not made as much progress to tackle the issues and challenges that the trust faces as we all want.”
He added: “I know how hard staff are working, how passionate they are about what they do and the care they provide.”