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Nurse staffing levels 'remains challenge' at trust rated 'good' by regulator

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A trust in Greater Manchester that was previously in special measures has been rated “good” overall following an assessment by the Care Quality Commission, though it found nurse staffing “remained a challenge in a number of areas”.

After a previous inspection in 2015, Tameside and Glossop Integrated Care NHS Foundation Trust was rated “requires improvement” by the CQC and moved out of the support scheme for struggling trusts.

“The trust was working with other agencies to fill rota gaps…Nevertheless, there were times when wards were not fully staffed”

CQC

At the most recent inspection, in August 2016, the regulator found nurse staffing levels had improved but that employees regularly worked overtime or bank and agency nurses had to be deployed to fill the gaps.

In particular, the trust had identified in April 2016 that three medical wards had only between 74% and 79% of the nurses required on day shifts.

Inspectors noted the organisation was actively trying to recruit nurses to improve the situation.

“The trust was working with other agencies to fill rota gaps to maximise nurse staffing capacity. Nevertheless, there were times when wards were not fully staffed,” said the CQC in its report on the trust.

But a number of improvements had been made since the previous year, particularly in urgent and emergency care, it said.

A nurse-led “REACT” (rapid enhanced assessment clinical team) service had been introduced to try and reduce handover times from the ambulance service.

“This time we saw a trust with a much improved approach to safety, training, and mortality rates”

Mike Richards

The CQC also found areas of outstanding practice, such as the emergency department’s practice development nurse providing “excellent” support and education to staff.

In addition, it praised the organisation for its support programme for pregnant women with alcohol consumption problems, as well as a system within end-of-life services that allowed staff to gain direct access to electronic information held by community services.

CQC chief inspector of hospitals Sir Mike Richards said: “Tameside and Glossop Integrated Care NHS Foundation Trust were placed into special measures in 2013, and it should be acknowledged how far they have come in three years.”

Sir Mike said that the trust had “worked hard to address the issues we raised” at the last inspection in 2015, which meant it had now been assessed as “good”.

“This rating amendment reflects the changes the trust has made. This time we saw a trust with a much improved approach to safety, training, and mortality rates, and one that was addressing staff shortages through initiatives including partnership working, in a proactive and sustainable way,” he said.

“We saw big improvements in urgent and emergency care. The department’s handling of a major incident which occurred during our inspection was very impressive and ensured patients were treated in the safest and most appropriate way possible,” he added.

“I am immensely proud of my staff and the contribution they have made to improve services”

Karen James

However, he said there was still some work required by the trust to sustain improvements.

Tameside and Glossop chief executive Karen James said: “In 2013, when I joined the trust, I promised to the local people, patients and staff that together we would improve the services at the organisation.

”Today we can look back at our journey so far and appreciate that we have come a long way,” she said. “I am immensely proud of my staff and the contribution they have made to improve services for local people.”

She added: “We will continue to improve the quality of services at the organisation. The latest inspection by the CQC puts the trust in an excellent position as we enter 2017 and look to progress our plans to improve the health and wellbeing of our local community.”

A trust statement said action plans had been put in place to address the areas where the CQC would like to see further improvements made.

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