The Nursing and Midwifery Council has decided to take no fitness to practice cases against nurses and midwives at Basildon and Thurrock University Hospital Foundation Trust following a special review at the trust.
However the extraordinary review, launched after the Care Quality Commission discovered serious problems at the trust, highlighted several areas where it still needs to improve.
The review report, published today, says there is “a perceived lack of confidence in the ability of the chief executive and director of nursing to foster a culture of strong leadership and team working amongst the nursing and midwifery staff”.
It says there was “no clear evidence that the board were checking the reality in the trust regarding actual patient experience and clinical standards”, rather than relying on regulation and surveys.
Its 22 recommendations include that the chief executive should be “fostering a culture where excellence in nursing and midwifery can flourish and support the director of nursing in achieving this”.
“It is critically important that the director of nursing and head of midwifery are supported to be champions of excellence in nursing and midwifery care and to ensure that students are afforded high quality educational opportunities,” it says.
The NMC said standards for education were being met, students are “generally sufficiently supported”, and there is “excellent partnership working between the trust and the [partner] universities”.
But it said the findings, “highlight the need for stronger leadership, improved communication channels between senior staff and those on the wards, and a robust reporting system for staff to effectively raise concerns about problems in the environment of care that may put people at risk”.
NMC chief executive and registrar Professor Dickon Weir-Hughes said in a statement: “While our findings are largely reassuring and they are making improvements, high quality patient care is a corporate responsibility and strong leadership and support from the very top are fundamental components of ensuring that all members of staff are fully able to deliver it in any healthcare environment.
“This is not the first time where issues around poor care have been linked to leadership and we have invited every director of nursing, head of midwifery and human resources director to the NMC over the next 12 months to discuss this and other issues related to their role in effectively safeguarding patients and the public.”
Professor Weir-Hughes pointed to the Prime Minister’s Commission report, which said nursing and midwifery leaders had “corporate responsibility” for patient safety, and the NMC code of conduct which, he said, “applies equally to the director of nursing on a trust board who designs services as it does to a Band 5 nurse delivering care on a ward”.
The CQC report, which was leaked to the media in November, said inspectors found blood stains on floors and curtains, blood splattered on trays used to carry equipment and badly soiled mattresses in accident and emergency.
They also found equipment being used repeatedly that should only be used once, and resuscitation room equipment that was past its use-by date.
Other items included blood-pressure cuffs stained with blood, suction machines contaminated with fluid inside and out, and apparent mould on equipment.