Nursing shortages were at the heart of three critical inspection reports on trust standards, which were published last week by the Care Quality Commission.
Most high profile was Cambridge University Hospitals Foundation Trust, which was placed in special measures after inspectors found problems including major shortages of nurses and midwives.
“Nurse numbers haven’t kept pace with demand, and nurse training places have been cut”
After inspecting the trust’s two main sites, Addenbrooke’s Hospital and the Rosie Hospital, the CQC rated its services as being “inadequate” overall.
Inspectors found a lack of staff in a number of areas, including critical care and maternity services. Staff were “frequently” moved to other wards to cover for the shortfall in nursing teams and due to capacity issues a number of wards were caring for patients with conditions for which their staff had little experience.
Inspectors also found a high number of nurse vacancies that was being tackled through the use of bank and agency workers. Despite this, some shifts were still not filled, added the CQC’s report.
“Substantial” shortages of midwives were noted and lack of workforce planning, which had contributed to the maternity unit being closed 37 times between July 2013 and April 2015.
Last week regulators also recommended that East Sussex Healthcare Trust be placed in special measures following a second inspection inside 12 months rated it as “inadequate”.
There was a high reliance on agency staff in surgical services. Staffing in the emergency department relied “heavily” on locums and nurse sickness levels were high.
In addition, staff were “afraid to speak out or to share their concerns openly”, with some telling the inspectors that relationships with management “had never been worse”.
- Addenbrooke’s trust placed in ‘special measures’ by regulators
- CQC warns of poor staff engagement at Sussex acute trust
- Community trust warned about use of unqualified staff
Meanwhile, Gloucestershire Care Services Trust was told to address safety concerns in its minor injuries units, after healthcare assistants were found to be assessing patients beyond their skillset.
“We were concerned that some patients waited too long to be assessed by a registered nurse on arrival and that unregistered practitioners were undertaking this task without adequate training or supervision,” said inspectors. Overall the trust was rated “requires improvement” by the CQC.
Despite the various staffing issues identified, all three trusts were rated highly for how caring their clinical staff were.
In one of her first comments since becoming shadow health secretary earlier this month, Labour MP Heidi Alexander emphasised the “serious warnings” made by the CQC reports on hospital short-staffing.
“Nurse numbers haven’t kept pace with demand, and nurse training places have been cut. This has left hospitals dangerously understaffed and has put patient safety at risk,” she said.
“Hospital bosses all over the country now face a stark choice between balancing the books and delivering safe care,” she added.