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Pioneering integrated care trust rated 'requires improvement' by CQC

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Torbay and South Devon NHS Foundation Trust, one of the first integrated care organisations in the country, has been rated as “requires improvement” by the Care Quality Commission.

The trust was rated “requires improvement” for safety, effectiveness, responsiveness and well led, but judged “outstanding” for being caring.

“We have had longstanding pressure on our urgent care service”

Mairead McAlinden

Torbay as an area has long been held up as a pioneer for integrated care. The trust was formally created in October when South Devon Healthcare NHS Foundation Trust merged with Torbay and Southern Health and Care NHS Trust.

The trust provides acute services from Torbay Hospital, as well as community health services and adult social care services.

Torbay Hospital was rated “requires improvement” by the CQC, buts its urgent and emergency care services were found to be inadequate.

According to the regulator’s report, inspectors found there were not always enough senior clinicians in the emergency department and facilities were “not suitable or well maintained”.

Nurse staffing on medical wards was often too low, and medical understaffing in outpatients was preventing the trust from addressing a “significant backlog”.

Community services were rated “requires improvement” but mental health and adult social care services were both rated “good”.

Sir Mike Richards, the CQC’s chief inspector of hospitals, said that, while it was “sometimes hard to manage change in large organisations”, there was “a strong vision” for the trust’s future.

He said the changes over the last seven months had been “well managed” and most staff felt “upbeat about the new organisation and ethos”.

However, he said the inspection found “an apparent lack of urgency to assess or treat some patients promptly” at Torbay Hospital, and “poor patient flow” in the emergency department was risking “avoidable harm”.

Mairead McAlinden

Mairead McAlinden

Mairead McAlinden

Trust chief executive Mairead McAlinden said: “We set high standards for our services and the CQC’s rating reflects our own self-assessment as ’requires improvement’.”

She said the outstanding rating given for caring was “very well deserved recognition” of staff’s commitment, but acknowledged “there are other areas… we need to improve”.

“We have had longstanding pressure on our urgent care service and, at the time of our inspection, our urgent and emergency care service was at maximum escalation. We have already addressed many of the areas identified as needing improvement,” she said.

“Other improvements are more challenging to achieve, and will need significant investment, new ways of working to address our recruitment challenges, and changes to how and where we deliver care,” she added.

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