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Cornwall hospitals trust to remain in special measures

Health and Wellbeing Show

Published by Emma Carton at 6:45am 14th December 2018. (Updated at 7:20am 14th December 2018)

The trust that runs Cornwall's main hospitals has gone from being rated 'Inadequate' to 'Requires Improvement' but remains in special measures.

Another inspection has looked at Treliske, the West Cornwall in Penzance and St Michael's in Hayle.

A&E remains one of the big concerns flagged up in the latest report from the watchdog.

It found casualty is often crowded and patients were not always seen within 15 minutes.

treliske 1
The trust that runs Cornwall's main hospitals is to remain in special measures after another inspection by the watchdog

Chief Executive Kate Shields insists changes are happening but knows safety is a major concern.

"We have acute GPs working at the front door now. We've re-streamed the way in which patients come into ED so that if we can manage you on the same day rather than admitting you, we are.

"By doing that we're protecting the resources within the emergency department for those sickest patients so that we are generally seeing those patients very quickly.

"Over the coming weeks and months we'll be talking with our doctors, our nurses and our therapists about how we build in to every day practise the things that we need to do to move safety from requires improvement to good.

"I'm hoping that by the this time next year, we'll be able to say that we are a good, safe hospital".

RCHT Chief Executive, Kate Shields

What did the inspection find?

Royal Cornwall Hospitals' Trust:

Our rating of the trust improved. We rated it as requires improvement because:

We rated safe, effective and responsive as requires improvement. Well-led was rated inadequate and caring was rated good.

Royal Cornwall Hospital was rated requires improvement. West Cornwall Hospital and St Michael's Hospital were rated good.

Royal Cornwall Hospital:

Treliske health hospital
The Royal Cornwall Hospitals' Trust has gone from being rated as 'Inadequate' to 'Requires Improvement'

Our rating of services improved. We rated them as requires improvement because:

We rated safe, effective, responsive and well-led as requires improvement. Caring was rated good.

Urgent and emergency care remained the same and was rated as requires improvement. Safe and responsive remained the same and were rated requires improvement. Effective and caring stayed the same and were rated good.

Well-led improved and was rated good. Medicine improved since our last inspection and was rated requires improvement. Safe and well-led improved and were rated requires improvement. Effective improved and was rated good. Caring remained the same and was rated good. Responsive stayed the same and was rated inadequate.

Surgery had improved since our last inspection and was rated as requires improvement. Safe and responsive had improved since our last inspection and were rated requires improvement. Effective and well-led remained the same and were rated as requires improvement. Caring stayed the same and was rated good.

Critical care services remained as good overall. Safe went down one rating since our last inspection and was rated as requires improvement. Effective, caring and well-led remained the same as our last inspection and both were rated good. Responsive went up one rating and was rated good.

Maternity services were rated as requires improvement. Safe and well-led were rated requires improvement. Effective, caring and responsive were rated good.

End of life services had gone up one rating since our last inspection and were rated requires improvement. Safe had stayed the same and was rated requires improvement. Effective, responsive and well-led had improved and were rated requires improvement. Caring remained the same and was rated good.

Outpatient services were rated as requires improvement. Safe, responsive and well-led were rated requires improvement. Caring was rated good. Effective was not rated.

Diagnostic imaging was rated outstanding. Responsive and well-led were rated outstanding. Safe and caring were rated good. Effective was not rated.

Children and young people's services remained the same and were rated good. Safe remained the same and was rated as requires improvement. Effective, caring, responsive and well-led remained the same and were rated good.

hospital bed
Despite improvements, inspectors found concerns remained around patient safety and the emergency department at Treliske

Why is the hospitals' trust still in special measures?

“The Royal Cornwall Hospitals has had a challenging recent history – so I am pleased to report that the trust is making progress in improving the quality of its services, albeit with further work to be done.  

“At our earlier inspection in June 2018 we found real improvements in specific areas, and this wider inspection has now found further significant progress, including diagnostic imaging services which we rated Outstanding. 

“However, many of the executive team are newly in place, and some of their changes will take time to take effect.

“We did find some remaining concerns during the inspection and while we are aware the trust is addressing these I am recommending the trust should remain in special measures for a further period. We will continue to monitor the service closely and return in the future to check on progress".

Chief Inspector of Hospitals, Professor Ted Baker

doctor
The RCHT insists improvements are being made, such as acute GPs at the front door of the emergency department at Treliske

What is the trust's response?

“This is a positive report for us and shows that the work we have been doing to improve care and safety is starting to show through. It’s fantastic to see Care has been rated as ‘Good’ across all of our hospitals.

“Overall we have more areas that are good than last year and just about every part of the Trust has improved. It is a significant shift and there’s a real sense of belief that we can do what is needed to become the brilliant Trust our staff and local population deserve.”

The report gives a balanced view of progress and as well as highlighting areas of where progress has been made.  It also recognises where there is more to do and where, such as in the assessment of how well-led the Trust is, more time is needed with such a new leadership team and organisational structure being put in place. 

“The improvement we have seen is down to our great staff,” added Kate, “they are the people who really hold the quality of care for the people of Cornwall in their hands. We are looking at what we can do to support them in every way so they feel empowered to make changes where they need to be made".

RCHT Chief Executive Kate Shields

You can find full reports and ratings for the Royal Cornwall Hospitals' Trust here.

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