‘We are now much better’ - Shropshire hospital chief executive invites inspectors back to see improvements
Government inspectors are being invited back into Shropshire’s two main hospitals to see the improvements made since their visits in December, a health boss has said.
In a report released by the independent regulator Care Quality Commission (CQC) today, the trust has been given a ‘requires improvement’ rating.
The findings, following inspections in December and January, rated a number of areas as ‘good’ but raised concerns about A&E, maternity and staffing.
But Simon Wright, chief executive of the Shrewsbury and Telford Hospital NHS trust, said while he was pleased the CQC inspectors had recognised the improvements made at the trust, further work had taken place in the last six months since their visit.
He said: “We are keen to invite the CQC back in. The new regime means they come in every couple of months so we see them quite regularly.
“This means we can flip some of the rating from required improvement to good quicker.
“There has been a huge improvement in a two-year period and I think the staff deserve all the credit for that. They have done a fantastic job under hard circumstances.
“I would have liked the inspectors to have recognised a little more the steps the organisation has taken. That hasn’t translated into the formal report.
“The formal report feels a bit dry. It feels like it doesn’t really capture some of the energy we have seen from our workforce in regards to their efforts to elevate the safety and care we are able to give.
“The changes we have made is significant but it has not quite tipped us into the good yet.
“In two years what we have seen is from us going from having inadequate in the scoring – particularly around end of life – and a number of areas need improvement.
“What we have now moved to is the majority of areas are now rated as good and we have seen some significant movements.
“As we start to make improvements and create an environment of excellence then having the CQC coming back in and telling us we are doing well will be powerful and restore any confidence that has been lost over the years.
“Yes we would have loved to have had good but what we can see is positive change and I am confident that we will soon see more of our services converted to good – we don’t have many to go.”
One of the areas the inspectors identified as needing improvement was the trust’s urgent and emergency services.
Mr Wright said: “What they are saying is what we have been saying for a long long time – which is that we can’t deliver the kind of service our population deserves without a strategic change.”
One of the areas that the CQC identified as ‘good’ across the board is medical care.
Mr Wright said: “If we look at medical care, which has converted into good, we are seeing movement in the right direction which is great.
“That is down to our hard working doctors.
“End of life care has also seen some great improvements. We have invested in a fantastic end of life team who are doing some great work like creating the Swan rooms and Swan boxes for bereaved families.
“The inspectors were also very complimentary about our partnership work with the Virginia Mason hospital in the USA. This has been recognised as one of the safest hospitals in the world. Inspectors very clearly saw all the work we have been doing with them is really starting to make an impact on our organisation.
“The level of enthusiasm hasn’t decreased for the programme and we still have people wanting to do more and more.
He added: “What hasn’t translated in the way we would have liked is maternity at Ludlow Midwife Led Unit and at Telford’s Princess Royal Hospital.
“It is no surprise to me at all that there were some concerns from the inspectors when they were reviewing those areas- not least because Ludlow had only just moved into a new area because we had problems with the building – so it wasn’t in as a finished state as we wanted it to be.
“And also we were experiencing the challenges with our workforce which later required us to suspend the birthing units for six months.
“The combination of those things has translated into the scoring.
“We have also seen a new leadership team in women and children’s and they had not been there long enough. They hadn’t had the time to make the impacts which we are now seeing coming through. We are also now recruiting midwives again – at that particular moment in time those pointers were not been in place. We accept and recognised that.
“There is a lot for us to be proud of and the staff are continuing to do a remarkable job.
“The decisions around Future Fit are a clear marker in the journey from good and into outstanding. So clearly there is a limit to what our wonderful staff can achieve whilst we have got these restrictions.
“The inspectors say we can’t create the environment we want without making the changes. So to have it backed up by the CQC is a powerful thing – another independent body saying this is what we need.
“Even in difficult circumstances the care our staff have been given has been good.
“We are not going to go from requires improvement to outstanding overnight. But the journey we have taken is robust and what we are building on is very solid foundations now.”
The CQC has commended the trust for its efforts, but says it still has “some way to go”.
Professor Ted Baker, CQC’s chief inspector of hospitals, said: “Our inspectors found a number of improvements had been made at Shrewsbury and Telford Hospital NHS Trust since our last inspection, and staff are to be commended for this.
“End of life care services had made significant progress and we noted a positive change in culture among staff and leaders at the trust. The change in ratings in a number of areas acknowledges what has been achieved by the trust’s staff and leadership team and we found several examples of outstanding practice.
“However, the overall rating reflects the fact that the trust still has some way to go on its improvement journey. There were a number of areas where action was needed, particularly with regard to maintaining appropriate staffing levels in the emergency department and ensuring a strong safety and learning culture within maternity services.
“At the time of our inspection, new senior leaders had started to make positive changes in the trust’s maternity service, but more action is needed to ensure these changes are fully embedded and sustained.
“We have made it clear where we expect to see further improvement and the trust knows what it must do.
“We will continue to monitor Shrewsbury and Telford Hospital NHS Trust and return to check on its progress.”
