Inspectors from a health watchdog are demanding urgent action by NHS bosses after it found Boston’s Pilgrim Hospital to be meeting none of its required standards at a recent inspection.
The Care Quality Commission has told United Lincolnshire Hospitals NHS Trust it must take responsibility and make sure standards are improved, met and maintained following visits to the Pilgrim and Lincoln County Hospital.
The inspections took place in June and July – the time the trust was placed in ‘special measures’ by health minister Jeremy Hunt after the review by Sir Bruce Keogh into high mortality rates.
The trust says it accepts the findings of the CQC and the Keogh Review and says it has ‘strong evidence’ of an improvement since then. It says it has met 100 of the 261 milestones set out by the Keogh team.
The CQC inspection was prompted by concerns raised by Keogh.
It says its report highlights further concerns that must be addressed at both the Pilgrim and Lincoln County.
Andrea Gordon, CQC regional director, said: “This is not acceptable and it is disappointing that we are again talking about this hospital trust in these terms.
“Our inspectors found caring and dedicated people working at the hospitals but they were being let down by low staff numbers, a lack of training and systems in place to ensure they could carry out their work effectively. Far worse is the fact this resulted in patients being let down.
“The trust and performance managers, such as the Trust Development Authority (TDA), must make sure long lasting improvements happen so people entering these hospitals receive the standards of care they should be able to expect.”
The inspection team assessed the national standards relating to respecting and involving people who use services, the care welfare of people who use services, management of medicines, staffing, supporting workers, assessing and monitoring the quality of service provision and records.
At both Pilgrim Hospital and Lincoln County Hospital none of these standards being met.
Inspectors found low staffing levels had an impact across the hospital including in the care and treatment of patients, communication between clinical staff, the maintenance of patient records and access to staff training and appraisals.
Staff could not always respond to the needs of patients, not all care needs were assessed or planned on a timely way and there were concerns surrounding the documentation and decision making about whether to resuscitate patients.
It said improvement made after previous inspections had ‘not been properly embedded’ into the trust’s culture.
“CQC has a range of enforcement powers but after careful consideration, we concluded further action would not lead to improvement in this case. We think it is important for the trust to focus on delivering its action plan in response to Sir Bruce Keogh’s review, which is published today, and will monitored by the Trust Development Authority”, Andrea Gordon added.
“We are publishing our report on the day that the Secretary of State for Health is publishing progress reports on the 14 trusts, including United Lincolnshire. We will be looking carefully at the trust’s progress in delivering the improvements sought by Sir Bruce Keogh.”
Inspectors will make an unannounced return to the Pilgrim to see what progress is being made.
ULHT said the CQC report ‘confirms’ the issues that came from the Keogh Review.
A spokesman said: “We take our responsibilities to provide excellent patient care extremely seriously and are focused on meeting constantly rising expectations around our quality of care.
“ULHT is already implementing a comprehensive action plan in response to the Keogh Review. More than 100 of the 261 milestones in that plan have already been achieved (see Notes to Editors for more details).
“The Trust is now being closely managed and scrutinised by the NHS Trust Development Authority under special measures and this process will continue with a follow-up inspection by the new Chief Inspector of Hospitals, Professor Sir Mike Richards, in 2014.
“There is strong evidence to show that ULHT is improving. This includes a significant improvement in mortality rates, which were the basis for the Keogh Review.”
The spokesman said mortality rates are at the lowest for five years.
The trust added that it is spending millions of pound on recruiting more nurses and says it has improved care on wards.
It also pinpointed how The National Hip Fracture Database published yesterday shows that Pilgrim Hospital is best in the country for getting patients to surgery promptly.
It features Pilgrim as a best practice case study for reducing length of stay and mortality.
The trust also says it welcomes the fact that the CQC praises staff and flags up many examples of good practice in Lincolnshire.
The Trust’s Chief Executive Jane Lewington said: “It is our top priority to ensure that we provide patients with the best possible care. We are improving, but we know we have more to do. That is why we have completely acknowledged the important findings of the Keogh Review and are responding to them.
“ULHT will continue to focus on maintaining our journey of improvement. We will work with the CQC, Trust Development Authority and other agencies to confirm that the Trust is moving forward.”