'Significant work' still needed to address urgent concerns over Shropshire's A&Es
Hospital bosses will hear today that there have been consistent improvements in Shropshire maternity services but there is still "significant work" to do to address concerns with its A&Es.
The Care Quality Commission (CQC) re-inspected The Shrewsbury and Telford Hospital NHS Trust (SaTH) in November – two years after it was placed in special measures.
It previously said urgent action was needed to protect patients at the emergency departments at both Princess Royal Hospital in Telford and Royal Shrewsbury Hospital.
Conditions in place regarding the A&E departments were extended in relation to managing patients with possible sepsis, under 18s and those needing mental health risk assessments.
A new report, which is due to be discussed by SaTH's board at a meeting today, has revealed the recent steps taken by the CQC and how the trust has responded.
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Hospital bosses were told there must be an "effective system" in place to manage these types of patients, and are required to report weekly on the actions taken.
Staff were told they had to record the number of patients under the age of 18 who are not triaged within 15 minutes of arriving at A&E, or seen by the paediatric medical team within the hour, and whether they came to any harm.
However, the report reveals this has not always happened in the past month.
It says the majority of paediatric patients did not have a time recorded for when they were triaged, and where it was recorded, only a "small percentage" were triaged within 15 minutes.
A number of actions are now being taken, according to the report.
Specialist
It says teams are considering whether to have a dedicated paediatric triage nurse in place, as well as a specific area at PRH where all paediatric patients would be treated by a separate team.
A specialist sepsis nurse is also working closely with the two A&Es.
The mental health liaison team has been supporting the emergency departments and there is further training planned.
No new conditions were imposed by the CQC on maternity services following the inspection in November.
In the report, deputy director of nursing Kara Blackwell says: "The maternity unit has consistently demonstrated improvements in relation to the weekly reporting against these conditions.
"For the emergency departments, inpatient wards and conditions applied to all clinical areas the data analysis in this report outlines that although systems, processes, monitoring and actions are in place in relation to the improvements required there is significant work to be done to ensure these actions are embedded and consistently applied."
She continues: "Improvement work needs to be embedded at some pace given the significant concerns relating to the quality and safety of care."
In her report to the board, interim chief executive Paula Clark says the trust has also received initial feedback following a recent CQC inspection focussing on leadership.
The feedback has been mixed, with inspectors noting that the trust is not always taking action when concerns are raised.
They said there is "inconsistent completion of serious incidents investigation forms" and "some middle managers lack the skills and knowledge in how to lead and manage effectively".
