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The report follows the Chief Inspector of Hospitals visit to the Cumberland Infirmary in Carlisle and West Cumberland Hospital in Whitehaven which took place from 31 March to 2 April 2015.
Overall, North Cumbria University Hospitals NHS Trust has been rated by the CQC as ‘requires improvement’. However, this year’s inspection saw many more services being rated as ‘good’.
As with last year’s inspection, every single service across both hospitals was rated as ‘good’ for providing a caring service to patients. The CQC saw ‘services being delivered by caring and compassionate staff. They witnessed staff treating patients with dignity and respect, with care planned and delivered in a way that took into account the wishes of patients.
Following the Trust’s 2014 inspection, critical care was rated overall as ‘good’ across both hospital sites. The service has maintained that rating this year with further improvements noted and has been joined by surgery and services for children and young people which have all been rated as ‘good’ across both the Cumberland Infirmary and West Cumberland Hospital.
Last year, the CQC found that outpatient services at both hospital sites were rated as ‘inadequate’ under the safe domain, largely due to issues around the timely supply of up-to-date medical records to outpatient clinics. Over the past 12 months, the Trust has carried out a significant amount of work in order to improve outpatient services including the opening of a new Contact Centre, which along with other improvements, has resulted in more ‘good’ ratings for the service. The inspection team noted that performance had improved by over 20% with 95% of patient records now available for appointments. It was also noted that with a clearer plan and vision for the service, staff were very positive and feel supported.
In surgery, the inspection team found ‘a number of improvements to the service’ which is now rated as ‘good’ overall. Good patient outcomes were demonstrated through patient reported outcomes measures (PROMs) data which showed the percentage of patients with improved outcomes following groin hernia, hip replacement, knee replacement and varicose vein procedures was either similar to or better than the England average. It was also found that the average length of stay for planned and emergency surgical admissions was better than the England average across all specialities.
In services for children and young people, it was noted that the service has improved since the last inspection in both hospitals with a ‘visible children centred culture within the service.’ The team found ‘staff were motivated and offered care that was kind, sensitive and supportive.’
The report acknowledges that the Trust has sustained the improvement in its mortality rates and says it is ‘evident the leadership team were committed to service improvement for the benefit of patients and were keen to include staff in the improvement journey.’
The Trust received one rating of ‘inadequate’ for the safety and responsiveness of medical care at West Cumberland Hospital as a result of the ongoing issues with regard to recruitment of medical staff and the high number of vacant consultant posts.
The CQC has outlined a series of recommendations which must be made to further improve services and the urgent actions required by the health system in order to agree and implement a clear clinical strategy which will help the Trust address the longstanding challenges which it has been unable to solve alone. The Trust will remain in special measures with the NHS Trust Development Authority and will continue to work closely with buddy trust Northumbria Healthcare NHS Foundation Trust and as part of the newly formed Success Regime which aims to accelerate the scale and pace of improvements needed across the entire health economy.