The Keogh review has identified “lack of escalation procedures, inadequate staffing levels and disconnected leadership” as some of the key areas of concern at the United Lincolnshire Hospitals Trust.
The review carried by NHS England medical director Professor Sir Bruce Keogh examines the higher than expected mortality rates at 14 NHS trusts. The panel’s findings have been published today.
At United Lincolnshire, the review found that there is a disconnect between leadership at board level and leadership at clinical levels within the organisation and recommended a more joined up leadership approach. It suggests that the trust should “focus on engaging clinical teams rather than specialties or separate professional groups.”
Some of the other key areas of concern flagged in the review are:
- Lack of clarity around escalation procedures, leading to inconsistent application and use across the trust sites.
- Inadequate staffing levels which potentially compromise patient safety and optimal care for patients. The cover at weekends and out of hours is minimal for both medical and the nursing teams.
- Patient experience is not at the heart of the organisation
- At individual site level there was lack of knowledge/awareness of the actual operational data such as readmissions and mortality data
The review suggests that the trust should ensure that patient flow is planned and managed appropriately and it uses the ‘track and trigger’ system effectively across all the trust sites.
Other recommendations include:
- Improving understanding and visibility of complaints methods with staff and patients.
- Educating front-line clinical staff to respond more effectively to complaints and ensure accountability and ownership
- Implementing a patient experience action focussed improvement plan that should include real time patient feedback; evidence of listening and responding; using and working with patients to co-design service.
Chief executive Jane Lewington said: “The safety and quality of patient care is our top priority. We have always seen the review as an opportunity to continue our journey of improvement.
“The review has helped to ensure that our efforts are targeting the changes that will make the most impact on patient care. Therefore we fully accept the findings. Patients are the very heart of everything we do, but others are doing better and therefore we need to learn from them.”
Trust’s interim director of nursing Eiri Jones said: “Historically, it has been difficult to fill all our vacancies, because clinical staff do not necessarily want to live and work in Lincolnshire. Recruiting to the additional posts are therefore a real challenge and we are using best recruitment practice to tackle this issue.”
The trust serves a population of 700,000 across three main hospital sites - Grantham and District Hospital, Pilgrim Hospital, and Lincoln County Hospital.
The trust has a total of 1,187 beds with an overall HSMR of 112 for the period January 2012 to December 2012, meaning that number of actual deaths is higher than the expected level.
The trust recorded a £5m deficit on a turnover of £423m in 2012-13.
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