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Cambridge teaching trust recommended to exit special measures after 'wake up call'

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Cambridge University Hospitals NHS Foundation Trust has been recommended to leave the “special measures” regime by the Care Quality Commission, after it was rated as “good” in its last inspection.

The regulator highlighted improvements in permanent workforce numbers, a monitoring system for safe staffing levels, governance arrangements and trust culture among the reasons on which it had based its recommendation.

“The inspection found improvement in the quality and safety of services”

Mike Richards

The trust, which runs Addenbrooke’s and the Rosie hospitals, was originally rated as “inadequate” overall and placed in the support scheme for struggling healthcare providers following an inspection in April 2015.

A follow-up inspection in February 2016 found a number of improvements had been made and, when inspectors returned again in September 2016, they concluded that the trust had made further and significant improvements. 

As a result, the CQC has now rated the trust to be “good” overall and outstanding for the care it provided. It was also rated as “good” for being safe, effective and well led, but as “requires improvement” for its responsiveness, according to the regulator’s latest report, published today.

CQC chief inspector of hospitals Professor Sir Mike Richards said: “Senior staff at the trust described being placed in special measures as ‘a wake up call’. The inspection found improvement in the quality and safety of services.

“There had been an increase in permanent staffing levels, resulting in low levels of agency nurses being used across the trust, and a system of monitoring allowed senior managers and clinical staff to adjust staffing levels to meet patients’ needs,” he said. “Governance systems had been revised which ensured robust information was available for the senior team.”

“We focused very hard on empowering our staff and developing the culture of the organisation”

Roland Sinker

He added: “Staff were very caring, there was an open culture at the trust, staff reported incidents and there was increased evidence of learning from incidents. Staff spoke positively about local management and patients spoke highly of the care they received.”

Roland Sinker, who took over as chief executive from Keith McNeil in November 2015, said: “We cracked on with the recommendations from the CQC, which were very fair, and then we focused very hard on empowering our staff and developing the culture of the organisation.”

On Wednesday afternoon, NHS Improvement confirmed that the trust had been taken out of special measures.

Jeff Worrall, delivery and improvement director at NHS Improvement, said: “The trust has worked hard to improve the care it provides to its local community and has introduced innovative practice in order to meet the rising demand on its services.

“We will continue to support the trust as it seeks to build on the excellent progress it has made on behalf of its patients,” he added.

CQC inspectors highlighted examples of outstanding practice at the trust:

  • A ward which ran weekly ‘music and movement’ classes to help meet the holistic needs of patients during their recovery. Staff encouraged patients and their relatives to attend and this received excellent feedback
  • The teenage cancer unit provided outstanding facilities for young people receiving cancer treatment
  • The emergency department team had developed a mobile phone app called Choose Well which offered guidance on waiting times and hospital services across Cambridge, to improve patients’ experience
  • The emergency department secured £100,000 funding from the Small Business Research Initiative to support the development of a crowd prediction modelling tool, so the trust could understand and map patient flow through the department
  • An initiative for Family Facetime proposed the purchase of two tablets to enable mums, who are too unwell to visit their baby on the neonatal intensive care unit, to see their child on video through Facetime

However, there were areas where the trust must make improvements:

  • Medicines, including controlled medicines, must be securely stored at all times
  • End of life care must be properly audited (such as preferred place of death and DNACPR) and action must be taken in response to those audits
  • Complaints must be responded to in a timely way
  • Resuscitation decisions must be documented legibly and completed fully in accordance with the trust’s policy and the Mental Capacity Act 2005
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