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Birmingham first children’s trust to be rated ‘outstanding’

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A top children’s hospital has received the highest possible rating from the Care Quality Commission, the first to do so from the speciality.

England’s chief inspector of hospitals rated Birmingham Children’s Hospital NHS Foundation Trust as “outstanding” following an inspection by the CQC in May 2016.

“Feedback from parents and children was extremely positive”

Mike Richards

It is the first dedicated children’s hospital trust to be rated outstanding, though since the inspection was carried out the trust has merged with Birmingham Women’s Hospital NHS Foundation Trust.

The CQC inspections looked at accident and emergency, medical care, surgery, paediatric critical care, neonatal care, transition services, end of life care, outpatients, and child and adolescent mental health services.

The trust was rated “outstanding” for whether its services were caring, effective and responsive, and “good” for whether they were well led. But inspectors said it “requires improvement” for safety.

The regulator’s report, published today, highlighted particular examples of good and outstanding practice, such as how staff provided outstanding personalised care to learning disability patients.

For example, one learning disability patient had a phobia of wearing a name tag so staff took a photograph of the patient to identify him which staff put above his bed.

Meanwhile, the trust was praised for an “express” MRI scanning service that allowed minimal stays in radiology, which freed up seven beds a day.

“I really want to congratulate and thank every member of staff”

Christine Braddock

In addition, a complex care team had planned a holiday for two long term ventilated patients, and “storytelling therapists” worked with children’s anxiety during their stay in hospital.

However, specific concerns were raised about neonatal services, which were rated as “requires improvement” overall, but as “inadequate” for safety – the only category to be given the lowest rating by the CQC.

Staffing levels for consultants in neonatal care did not meet best practice guidelines and learning from serious incidents in neonatal was not being shared consistently across the trust, the CQC said.

Community mental health services for children and young people aged 0-25 were also criticised.

The contract for these services was awarded to a consortium of providers including Birmingham Children’s Hospital, the Children’s Society, Beacon UK, the Priory Group and Worcestershire Health and Care trust in April 2015. The new service began in April 2016.

Highlighting the overall “outstanding” rating, CQC chief inspector of hospitals Professor Sir Mike Richards highlighted the trust’s culture of support and team work.

He said 100% of children referred to the hospital were seen within six weeks, and no patient waited more than four hours once admitted to the trust.

Sir Mike said: “Feedback from parents and children was extremely positive, with many reporting they were treated with respect and dignity. Bereaved parents were given genuine, compassionate care with clear emotional support if a child died.

Sir Mike Richards

Sir Mike Richards

Sir Mike Richards

“When communicating with children, staff used language that was jargon free and easy to understand, using play, toys and nursery rhymes to maintain engagement,” he said.

The trust needed to “review its governance processes to ensure neonatal services assess, monitor and mitigate risks to all neonates across the trust”, the CQC report said.

The CQC inspected community mental health services last May, a month after they had gone live. Inspectors noted a vacancy rate of 26% in child and adolescent mental health services and a lack of up-to-date care plans in place for CAMHS patients.

Dame Christine Braddock, chair of Birmingham Women’s and Children’s NHS Foundation Trust, said: “This report really shows that when you invest in your people and have a clear strategy you can do great things.

“I really want to congratulate and thank every member of staff at Birmingham Children’s Hospital for the important role they’ve played in delivering great care every day,” she said.

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