Poor care at Shropshire's hospitals 'normalised' and fuelled by 'failing leadership', report finds
Poor care at Shropshire's major hospitals has been "normalised" and fuelled by "failing leadership", England’s chief inspector of hospitals said today.
Further serious concerns have been outlined in reports published by the Care Quality Commission (CQC) today following inspections of medical and end of life care at Shrewsbury and Telford Hospital NHS Trust in June.
It comes almost two years after the trust was placed in special measures after a highly critical CQC report in 2018, when former chief executive Simon Wright was at the helm. He stepped down as CEO of SaTH in June last year.
Royal Shrewsbury Hospital's overall rating has now fallen from requires improvement to inadequate, matching that of Princess Royal Hospital in Telford.
The CQC said the trust’s issues have been "perpetuated by its leaders’ collective failure to demonstrate they had the skills and abilities to meet the challenges the trust has faced".
The health watchdog says they were "not always visible or successful in embedding their priorities" and "fed a culture that did not identify or respond to problems".
It comes as senior staff from the Midlands' largest NHS trust are being brought in to improve struggling services, and SaTH's chairman Ben Reid has stepped down.
The new alliance with University Hospitals Birmingham NHS Foundation Trust (UHB) has been welcomed by the CQC's chief inspector of hospitals, Professor Ted Baker.
He said: "We have repeatedly called for intervention to support improvement at SaTH.
'Long-standing known issues'
"Despite this, the trust has not resolved long-standing known issues, and poor patient care has been normalised. This situation must not continue.
“The trust has not responded satisfactorily to previous enforcement action.
"So I welcome their improvement alliance with UHB, which has been prompted following further intervention and enforcement action from CQC. This is the first step towards implementing the urgent changes that are required.
"We will continue to carefully monitor the trust to determine whether this drives the required change and will take further action if there is no progress.
“The trust’s board is fully aware of the essential improvements it must deliver. We continue to monitor the trust, including through further inspections.”
Following the inspection in June, both hospitals were rated inadequate at being safe, effective, responsive and well-led.
Caring was not rated as the inspection team were unable to speak with patients due to the coronavirus pandemic.
Risks were not well-managed, patient records did not consistently reflect people’s needs and some staff did not have the right competencies for their roles, it was found.
Needs and experience
Inspectors also found issues the watchdog previously identified had not been addressed, as well as new areas for concern where services had been meeting standards previously.
The report said the end of life care service "did not ensure that all staff were competent for their roles, placing patients at risk of receiving unsafe and inconsistent care".
It said the culture of the services was not centred on the needs and experience of patients and the trust’s policies and procedures were not always based on the most recent national guidance.
Following the inspection, the CQC issued a warning notice identifying the specific areas where improvements must be made by the end of September.
They include implementing effective risk assessments and using processes to learn from incidents, maintaining accurate patient records, ensuring its staff are competent for their roles and fully complying with the Mental Health Act.
The trust has been the subject of a number of warnings after follow up inspections since the initial findings in 2018.
The overall rating for the trust remains inadequate.
SaTH's current chief executive, Louise Barnett, has been in the post since February.
She said: “We welcome the CQC's report and accept all the findings following their inspection in June. I am determined we take immediate action to ensure a significant improvement in performance and delivery of care at SaTH.
“We have already begun this process. Last week it was announced that SaTH will form an ‘improvement alliance’ with UHB. This new alliance will enable us to prioritise the development and delivery of a rapid improvement plan that will support clinically safe and sustainable patient services at SaTH.
“Over the coming months, we will be working closely with colleagues at UHB to address the issues raised by the CQC in their report.”