Oldham hospital trust told to improve

THE TRUST that runs the Royal Oldham Hospital has been told to improve by inspectors.

The Care Quality Commission performed an unannounced visit to the Northern Care Alliance NHS Foundation Trust in August and September.

And it found a number of failings at the trust that runs the borough’s main hospital.

It deemed it requires improvement overall, and for being safe, effective, responsive and well-led. It has been rated good for being caring.

Inspectors found some leaders expressed different levels of understanding of the drivers for change and the priorities expressed by their executive colleagues.

Some staff expressed reservations about raising concerns, and others did not always feel listened to.

Leaders did not operate consistent, effective governance processes throughout the service. There were differences in policies and clinical practice which did not reflect best-practice guidelines. However, most were clear about the need to review these functions to ensure they were fit for purpose.

The service collected data and analysed it. However, not all staff were assured the data was always accurate.

Staff could not always find the data they needed, in accessible formats to understand performance and make decisions and improvements.

Northern Care Alliance NHS Foundation Trust was formed on October 1 last year when Salford Royal NHS Foundation Trust legally acquired Pennine Acute Hospitals NHS Foundation Trust.

It controls four hospitals – Royal Oldham, Salford Royal, Fairfield General and Rochdale Infirmary and this was its first inspection.

CQC carried it out as part of its continual checks on the safety and quality of healthcare services, and as the trust is a new provider running services formerly run by different trusts.

It only included services where CQC were aware of risks.

Inspectors looked at how well-led the trust is overall, as well as some services – which provide a range of acute services, including acute medicine, urgent and emergency care, acute frailty units, rehabilitation services, dental services and surgical services.

Inspectors found plus points like its vision and strategy being focused on sustainability of services and aligned to local plans within the wider health economy.

All staff are committed to continually learning and improving services and improvement projects were at various stages of development and completion across the trust.

The service also has a culture where patients and their families could raise concerns without fear.

But Karen Knapton, CQC head of hospital inspection, said: “When we visited Northern Care Alliance, we found staff working incredibly hard under pressure to deliver the best possible care to patients.

“During our inspection, we found there had been positive changes in the leadership team since the acquisition, and new leaders, led by the chief executive, had already identified issues and started to make improvements.

“Their initial focus was on maternity services, patient safety, waiting times and addressing health inequalities. These improvements weren’t fully embedded at the time of our inspection.

“It was clear that leaders didn’t always actively and openly engage with patients and staff to plan and manage services, although plans were in place to improve this.

“However, it was reassuring that the trust engaged well with external stakeholders and local partners to help improve services for patients.

“Additionally, the trust reported and investigated complaints and incidents. However, these weren’t always completed in a timely manner, and learning wasn’t always shared with relevant departments across the trust.

“Our inspectors found staff didn’t always feel respected, supported and valued. However, they remained focused on the needs of patients receiving care.

“Leaders have started to make changes to improve patient care and know what further improvements are needed.

“We will return to check on progress to ensure these are embedded and sustained across the trust.”

Dr Owen Williams, NCA’s chief executive, accepted the inspectors’ findings and promised to do more to tackle shortcomings.

He said: “The care and safety of patients and the wellbeing of our colleagues remain central to what we are about and we are determined to work together to get better results for the people we serve.

“We fully accept the CQC’s judgement and their recommended areas for improvement and as the CQC have acknowledged, some improvements are already being made but they do not go far enough at this moment in time.”

Dr Williams thanked colleagues working across the organisation for their ongoing care and commitment during a time of unprecedented demand and added: “I am pleased that the inspectors recognised what I have found out to be true in my first year as CEO, which is that many colleagues are totally caring and are working incredibly hard under a level of pressure the likes of which many of us have not experienced before.

“There is a lot of work to do but our patients can be assured that their safe care and treatment is of utmost importance to us and, on behalf of all my colleagues at the NCA, I would like to thank them for their understanding and support as we work very hard to turn this around.”