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Requires Improvement for East Suffolk and North Essex
England’s Chief Inspector of Hospitals has found improvements are needed at East Suffolk and North Essex NHS Foundation Trust following an inspection by the Care Quality Commission.
Professor Ted Baker and his inspectorate team visited services across Colchester Hospital and Ipswich Hospital in June and July last year, and deemed the care provided by staff to be Requires Improvement overall. Additionally, the trust is rated as Requires Improvement for whether its services were safe and responsive, while rated as Good for whether its services are effective, well-led and caring.
The trust has been told it must make several improvements, including: staff not always supporting patients who lacked capacity to make their own decisions; systems and processes to maintain cleanliness and control infection not being implemented effectively; and staff not always completing nutrition and hydration risk assessments to ensure that patients had enough food and drink to meet their needs.
Areas of outstanding practice highlighted by the CQC include: staff in urology using new technology to carry out prostate urethral lifts, allowing staff to perform minimally invasive surgery, resulting in fewer complications; a recently introduced virtual fracture clinic; and consultants within urgent and emergency services dedicating their own time to provide training opportunities to medical and nursing staff on a regular basis. Staff described how valuable this training was.
Baker said: “Our visit to East Suffolk and North Essex NHS Foundation Trust found a number of improvements were needed. Some of the issues we found were understandably caused by complications following the formation of a new trust and one which is the biggest in the locality. For example, the trust was in the process of recording the provision of mandatory training in key skills to all staff. This had been challenging due to the different recording systems and mandatory training programmes from each former hospital.
“At the time of our inspection, the trust was still aligning systems and programmes. This meant that some of the information submitted prior to inspection and within this report did not reflect an accurate picture of training performance. Risks to patients were not always assessed, monitored and managed effectively. In the emergency departments staff did not always complete risk assessments for patients in a timely manner, particularly for patients with mental health needs.
“Despite these concerns, inspectors observed that the leadership across services was mostly effective despite the challenges of managing a newly merged trust. Leaders had the skills and abilities to run the trust effectively and they understood the priorities and issues they were faced with. They were visible and approachable in the service for patients and staff alike and supported colleagues to develop their skills and take on more senior roles.
“All staff were committed to continually learning and improving services. They had a good understanding of quality improvement methods and the skills to use them. The trust has told us they have listened to our inspectors’ findings and its board knows what it must do to ensure it makes the necessary improvements. We will return in due course to check on the progress that they have made.”
Nick Hulme, chief executive at the trust, said: “This is a survey at a point in time. We were inspected six months ago when we were merging systems and process across our hospital sites, and we have now completed most of this work. It is really pleasing to see our end of life care praised for outstanding practice and children and young people’s services given an overall outstanding rating.
“We know that there are some areas we clearly need to improve. We have invested £3million in nursing and have one of the lowest vacancy rates for nurses in the country at around 8%. We know that part of our challenge with our emergency department is with the constraints of the current building given the numbers of patients we now see. We have also recently changed our processes for caring for emergency patients at Colchester with the new urgent treatment centre, and we plan to do the same at Ipswich. It is good news that we have extra investment now to build a new emergency department at Ipswich with planning permission recently approved. These changes will really help us to improve our emergency department performance.”
East Suffolk and North Essex NHS Foundation Trust was formed on 1 July 2018 through the merger of Colchester Hospital University NHS Foundation Trust and The Ipswich Hospital NHS Trust.