Inadequate: Safety failings highlighted as Shropshire hospitals trust is rated at lowest level
Safety failings at the trust running Shropshire's two main hospitals were today highlighted in a new report by a health watchdog, which has rated services 'inadequate'.
Shrewsbury and Telford Hospital NHS Trust (Sath), which runs Royal Shrewsbury Hospital and Telford's Princess Royal Hospital, was previously rated as 'requires improvement' by the Care Quality Commission (CQC), but its overall rating has now dropped to the lowest level.
The CQC said staff were caring and dedicated, but stressed there is much work needed to ensure patients are kept safe.
The watchdog's chief inspector of hospitals, Professor Ted Baker, says concerns remain around A&E and maternity services at the trust, which was placed in special measures earlier this month followed repeated warnings from the watchdog.
Leadership and the safety of services were both rated 'inadequate', while the CQC said the trust needs to make improvements in how effective and responsive its services are.
It was rated 'good' for whether services were caring.
Inspectors said that at times of high operational pressures, patients at PRH were not always assessed and treated in a safe and suitable environment.
Medical and nurse staffing was not adequate to keep patients using the hospital's urgent and emergency service safe, the report said.
In maternity services, issues were highlighted around staff training, equipment and inspectors noted that 'high risk' women in labour were not always reviewed regularly and by the appropriate member of staff.
Inspectors said services at both PRH and RSH did not always manage patient safety incidents well.
The report continued: "The deteriorating patient was not always recognised within urgent and emergency care services to ensure appropriate and timely care was provided.
"Not all services had sufficient numbers of permanent staff with the right qualifications, training and experience to keep people safe from avoidable harm and abuse."
Shortages of midwives
Inspectors said there were shortages of midwives and during the inspection the environment of Shrewsbury's midwife-led-unit was 'unfit for purpose'.
The report said the temporary environment was cramped and posed a fire risk and infection control issues.
It also said staff reported a culture of bullying and harassment and were sometimes fearful to raise concerns or issues.
According to inspectors, not all leaders had the right skills and abilities to run a service providing high-quality sustainable care.
Other areas inspected included critical care, surgery, end of life care, outpatients, medical care and services for children and young people.
Inspectors said they had found examples of outstanding practice in end of life care services at both sites, maternity at PRH and critical care at RSH.
The CQC has told the trust it must take action in a number of areas, including ensuring that sufficient and suitably qualified and trained staff are available to care for and protect people from the risk of harm.
The trust has been told to review and improve midwifery staffing levels, review its policy on reduced foetal movements and improve the rates of administering antibiotics within an hour of identifying patients with suspected sepsis.
Mr Baker today said the trust was being closely monitored by the CQC.
He said: “While we found staff to be caring and dedicated, there is clearly much work needed at the trust to ensure care is delivered in a way that ensures people are safe.
“We remain particularly concerned about the emergency department and maternity services at Sath.
"We have already taken urgent action to protect people and we are monitoring the trust extremely closely.
“We will continue to work with NHS Improvement with regard to the trust. This trust must take action to ensure it makes all improvements necessary to give patients the standard of safe care they should be able to expect. We will return to check on progress with those improvements.”
Dr Kathy McLean, executive medical director and chief operating officer of NHS Improvement, said the trust faces 'significant challenges' but is receiving support to improve its services.
The inspection was carried out in August and September.