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Trust praised for passing 'ownership' of assessment unit to nurses

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A trust has been praised for cutting unnecessary hospital admissions and easing pressure on medics by putting senior nurses in charge of assessing children and young people.

Inspectors from the Care Quality Commission said the initiative at the Chesterfield Royal Hospital NHS Foundation Trust was an example of “outstanding practice”.

“I hope every member of staff feels proud of our achievement”

Lynn Andrews

The comments were made in a new report published today in which the trust, which runs Chesterfield Royal Hospital as well as community services, was rated “good” overall following its latest inspection in September 2018.

The inspectors noted that the trust had made changes to the management of its children and young people’s assessment unit as part of its winter plan, giving more power to leading nurses. This had resulted in the service becoming more “streamlined”, they said.

“The service developed a winter plan which was reviewed by other care units,” the report stated.

“This included changes to the management of the assessment unit to free up medical staff time and give ownership to senior nursing staff,” it said. 

“This resulted in more streamlined access to direct admissions and reduced the number of unnecessary admissions,” the report noted. 

The watchdog also highlighted that the trust was trialling nurse-led clinics for children’s allergy services to bring down waiting times. In July 2018, 92.6% of cases met the 18-week referral to treatment target.

However, the CQC found that shortfalls in infection control in the medical service, with nursing staff breaking the trust’s rules on wearing jewellery.

“This resulted in more streamlined access to direct admissions”

CQC report

“The service mostly controlled infection risks well,” the report said. “However, not all nursing and medical staff used appropriate control measures to prevent the spread of infection.

“We observed nursing staff not adhering to the trust dress code policy regarding the wearing of jewellery,” it added. 

Overall, the trust’s rating remained unchanged from its previous inspection in 2016. It was deemed to be “good” in all five domains assessed by the CQC – safety, effectiveness, care, responsiveness and leadership.

But the CQC highlighted two areas in which it said the trust must improve in order to meet legal obligations, both of which were in the end-of-life care service.

The trust was told the tighten up its do not attempt CPR (DNACPR) procedures, noting that almost half (49%) of orders viewed by inspectors were not completed properly.

It was also ordered to ensure all staff understood the requirements of the Mental Capacity Act in relation to their role and responsibilities.

Lynn Andrews, director of nursing and patient care at Chesterfield Royal Hospital NHS Foundation Trust, said she was “so proud” of staff and how hard they worked to provide high quality care to patients. 

She added: “I hope every member of staff feels just as proud of our achievement and that they appreciate how each of them has contributed to our success.”

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