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Acute trust out of special measures, but staffing issues continue

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Sherwood Forest Hospitals Foundation Trust in Nottinghamshire has been lifted out of special measures, although concerns about the number of nursing vacancies in some of its departments still remain.

A Care Quality Commission report published today said the trust had made progress, and would now be rated as “requires improvement” rather than “inadequate”.

“Staff said there were not enough nurses to meet demand”

CQC report on Sherwood Forest Hospitals FT

Following its latest inspection in July, the CQC recommended the trust should be removed from the special measures regime – which has seen the organisation receive leadership support over the past few years – and regulator NHS Improvement agreed to the request.

The trust was put in special measures following a review by NHS medical director Professor Sir Bruce Keogh in 2013, which raised concerns about high mortality rates.

Two years later, the trust was rated “inadequate” by the CQC amid continued fears over death rates and patient safety risks.

However, the inspection over this summer found a number of improvements and some outstanding practice.

CQC chief inspector of hospitals Professor Sir Mike Richards said: “During our inspection we found that wards and clinical areas were clean and there were systems to monitor and manage the risk of the spread of infection.

”During our inspection we found that wards and clinical areas were clean and there were systems to monitor and manage the risk of the spread of infection”

Mike Richards

“There were systems to ensure records, medicines management and maintenance of equipment was given priority.”

Improvements had taken place regarding the outpatient service and the number of overdue appointments, he added.

Outstanding practice was observed in several areas, including the way staff managed the deteriorating patient and treated sepsis.

Despite the improvements, in its report on the trust the CQC said that “concerns around staffing levels and high agency use were raised by most nursing and medical staff we spoke with”, although staff shortages were responded to quickly and adequately.

Nurse staffing levels were insufficient in the emergency department when all patient beds in the resuscitation area were full, the report said. The trust is considering whether to hire an extra full time equivalent nurse to address the problem.

Inspectors were also concerned about staffing levels in the ophthalmology clinic, where “staff said there were not enough nurses to meet demand”, according to the report.

”We cannot stand still and there is yet more to be done. We want this trust to be ‘outstanding’ ”

CQC report on Sherwood Forest Hospitals FT

“We saw staff were busy and they told us they had to work more than their contracted hours,” it added.

Chief nurse Suzanne Banks had personally visited any nursing staff who had resigned, in order to understand why they were leaving the trust, the report noted.

Nursing staff spoke “extremely highly of the support offered by the chief nurse”, who met with ward sisters weekly and had worked hard to empower the ward sisters, added inspectors.

Sir Mike Richards

Sir Mike Richards

Sir Mike Richards

Inspectors also said the trust needed to ensure that staff understand the requirements of the Mental Capacity Act and Deprivation of Liberty Safeguards laws, aimed at protecting vulnerable patients.

Alongside the overall “requires improvement” rating, the trust was rated “good” for being safe and “requires improvement” for being well-led. The CQC will continue to monitor the organisation.

Trust chief executive Peter Herring said he was “immensely proud” of staff achievements that had led to improvements in the quality of care.

“However, we cannot stand still and there is yet more to be done. We want this trust to be ‘outstanding’, and our board committed in this month’s public meeting to focusing on this over the next year,” he said.

He said among the trust’s top priorities was recruiting more nurses and other clinicians and establishing a stable leadership team.


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