A shortage of paediatric staff, missing patient waiting time targets, lengthy handovers from ambulance crews and a failure to meet the needs of the town’s Eastern European population are some of the issues facing Grantham’s A&E department according to a report published by England’s Chief Inspector of Hospitals.
The findings are published in a report made by Professor Sir Mike Richards on the quality of care provided by the United Lincolnshire Hospitals NHS Trust – which he has recommended stays in special measures for a further six months.
The trust was placed into special measures by Sir Bruce Keogh last year, after concerns were raised about mortality rates and standards of care.
Under its new inspection model, the Care Quality Commission (CQC) has rated each core service, including A&E, medical care, surgery, critical care, maternity and family planning, services for children and young people, end of life care, and outpatients.
Both the A&E and medical care categories at Grantham Hospital ‘require improvement’, while surgery, critical care, end of life care and outpatients were rated as ‘good’.
However, maternity and family planning was a category described as offering ‘not sufficient evidence to rate’ as maternity care is no longer offered in Grantham. The report did state: “The majority of staff told us they felt isolated from the trust and felt decisions were made without consultation.”
Concerns raised following inspections at Grantham in April, and published this week, include:
* a shortage of consultants and paediatric staff in A&E
* poor completion of patient records in surgery
* poor dissemination of learning from incidents within maternity outpatients
* a lack of dedicated rescitiation emergency call number, paediatric team or paediatric bleep system
* handovers between ambulance crews and A&E staff was in excess of targets set
* the needs of the large Eastern European population in Grantham were not met
* insufficient equipment available in some areas, including A&E, critical care and the emergency assessment unit
Praise was also given in the report, mainly directed at the care, kindness and compassion provided by staff, something which is also evident by the many letters received and published in the Journal from grateful patients. Findings include:
* food and drink were made available to patients in most areas of the hospital
* the hospital was clean, and hand-washing and alcohol gel was available in all areas. Staff used gloves and aprons when providing care
* a robust system for reporting incidents in A&E was in place
In addition to Grantham Hospital, Lincoln County, Boston Pilgrim and Louth were also rated as requiring improvement overall.
Professor Sir Mike Richards said: “I recognise the leadership team at United Lincolnshire Hospitals NHS Trust has been working hard over the last year to make improvements. While we saw definite evidence of improvement, the trust still has some way to go before it reaches the required standard.
“In particular, medical staff need to be better engaged in improving service quality and better integration of clinical services between the hospital sites is needed. That is why I have recommended to the Trust Development Authority that the trust remains in special measures for a further six months.
“I hope that, in six month’s time, the trust will be able to demonstrate enough improvement to review this again.
“People deserve to be treated in services which are safe, caring, effective, well-led, and responsive to their needs. We will continue to monitor the trust closely and this will include further inspections.”
** More on the findings of Professor Sir Mike Richards will follow, with coverage also in tomorrow’s Journal.