Royal Preston and Chorley hospitals aren’t making the grade

MP Lindsay Hoyle with protestors outside Chorley A&E. Picture by Mick Ellison
MP Lindsay Hoyle with protestors outside Chorley A&E. Picture by Mick Ellison
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Inspectors have highlighted the serious strain two NHS hospitals are under in new reports ordering improvements.

Care Quality Commission (CQC) officials have flagged up that four out of five key areas at Royal Preston and Chorley hospitals which aren’t making the grade.

Royal Preston Hospital

Royal Preston Hospital

Inspectors visited both hospitals - run by Lancashire Teaching Hospitals NHS Foundation Trust - in September last year, at a time when Chorley’s A&E was subject to a nine-month closure amid staff shortages.

Read the reaction to this latest report here

PRESTON:

CQC service ratings:

It’s good to see the one thing both hospitals were rated ‘good’ in was ‘caring’ because that shows the people on the front line are the right people.

• Medical Care (Including older people’s care) - requires improvement

• Urgent and emergency services (A&E) - requires improvement

• Surgery - requires improvement

• Intensive/critical care - requires improvement

Royal Preston Hospital Accident and Emergency

Royal Preston Hospital Accident and Emergency

• Maternity and gynaecology - requires improvement

• Services for children and young people - requires improvement

• Outpatients - requires improvements

• End of life care - good

Improvements needed included:

• In surgery - Take appropriate actions to improve staff training compliance in areas such as safeguarding training and life support training.

• In maternity and gynaecology - Develop a baby abduction policy and take action to ensure that there is a safe system for protecting babies from abduction.

• In children and young people’s services - Ensure that staffing levels in neo-natal and children’s services are maintained in accordance with national guidelines.

Positive highlighted included:

•‘To minimise disruption to patients during the night, they offered eye masks and earplugs, dimmed lights, anticipated empty infusion alarms, turned down the volume on medical equipment and phones and encouraged staff to talk away from the bedside. Staff were also reminded to check regularly for signs of delirium’.

•In End of Life care, There was good use of the individualised plan of care document throughout the hospital.

•In End of Life care, There was evidence of changes and improvements made as a result of feedback from patients and other staff.

CHORLEY:

CQC service ratings -

• Medical Care (Including older people’s care) - requires improvement

• Urgent and emergency services (A&E) - requires improvement

• Maternity and gynaecology - requires improvement

• Services for children and young people - requires improvement

• Outpatients - requires improvements

• Surgery - good

• Intensive/critical care - good

• End of life care - good

Improvements needed included:

• In maternity and gynaecology - The hospital must ensure all necessary staff completes mandatory training, including Level 3 safeguarding training and annual appraisals.

• In urgent care services - Ensure major incident plans are updated to reflect the current use of the department.

• In medical care - The trust should ensure that patients are discharged as soon as they are fit to do so.

Positive highlighted included

• ‘In the urgent care centre the housekeeper helped make sure elderly patients being discharged home had basic groceries provided such as bread or milk’.

• In Surgery, there were systems in place to support vulnerable patients. Most complaints about the services were resolved in a timely manner and information about complaints was shared with staff to aid learning.

• In Intensive Care, the critical care services were well led and staff were aware of the trusts vision and values.

In a report published this week, the CQC rated both hospitals as ‘requires improvement’ in the categories of ‘safe’, ‘responsive’, ‘effective’ and ‘well-led’.

Some of the key issues the CQC inspectors found were problems with capacity and flow of patients, waiting in accident and emergency wards and staff shortages.

Out of the five key areas, only ‘caring’ scored a rating of ‘good’, reflecting the 
hard work put in by medical staff.

The report shows a downturn in ratings for both hospitals since previous CQC inspections in July 2014. It follows a turbulent period for the trust which saw Chorley’s A&E close last April and reopen part-time in January.

Andrew Birchall, lead campaigner for Protect Chorley Hospital From Cuts and Privatisation, said: “It’s good to see the one thing both hospitals were rated ‘good’ in was ‘caring’ because that shows the people on the front line are the right people.

“They are still trying to care for us but it’s the leadership that leaves a lot to be desired.”

At Royal Preston, the areas of Urgent and Emergency Services, Critical Care, Maternity and Gynaecology and Services for Young People have all dropped from being rated ‘good’ to being rated as ‘requires improvement’ in two years.

At Chorley and South Ribble, the areas of Urgent and Emergency Services and Maternity and Gynaecology have also fallen from being rated ‘good’ to ‘requires improvement’.

But the areas of surgery and intensive care have improved from ‘requires improvement’ to ‘good’.

Professor Sir Mike Richards, chief inspector of hospitals said: “We inspected the hospital as a follow up to the inspection in July 2014 where the hospital was found to require improvement in the safe, responsive and well led domains and good in the effective and caring 
domains. We visited Royal Preston Hospital between and September 27-30, 2016.

“Following this inspection we have rated the hospital as requires improvement overall and the trust needs to make improvements.

“Staff were noted to be caring and patient focused and the caring domain was rated as good in all service areas.”

The Department of Health yesterday announced £1m for A&E capital funding for the trust, designed to help them meet four-hour patient discharge targets.