December 11 2013 Latest news:
Thursday, August 22, 2013
The leaders of a hospital which received a damning inspection have apologised to patients and families experiencing poor care – but have pledged to improve it as a matter of urgency.
As a 99-year-old woman revealed how she spent 12 hours on a trolley at King’s Lynn’s Queen Elizabeth Hospital, the chairman of the hospital’s trust accepted the contents of the Care Quality Commission report.
Kate Gordon, chairman of the hospital’s trust, said she and other board members took full responsibility for the criticisms, which include low staffing, poor record-keeping and failure to store medicines properly.
During a visit to the hospital over three days in May, inspectors said action was needed in nine areas, including its complaints procedure, obtaining people’s consent to care and patients’ privacy, dignity and independence, which the CQC said was “not always respected”. But asked whether she or any of the senior management team should resign over the report, Mrs Gordon replied: “The role of the board in this situation is to put things right for our patients. That’s what we’re going to do and you don’t walk away from it.”
Dr Bev Watson, joint medical director, added: “We’ve got a good management team in the trust and the last thing we need is more instability by losing people. I support the board staying as it is.”
Mrs Gordon revealed that her own board’s monitoring of the Gayton Road hospital’s performance revealed that cracks first started to appear in the autumn last year, when regular tracking showed the number of nurses was falling. The low staffing numbers, she said, was one of the underlying problems at the QEH – but said that did not mean there were other areas of concern.
“What the CQC is telling us is that at times of pressure, other things show up,” she said.
One of those was the maintenance of patient records, which the CQC said in some cases “were not completed in suitable detail, were inaccessible or were contradictory”.
As a result a comprehensive review is taking place into the QEH’s systems and procedures, but Dr Watson said many of the problems would be solved when the trust moved to electronic record keeping in the future. “At the moment we’ve got a hybrid system of paper and electronic records that leads to some difficulty.”
The hospital also said it would be implementing a recruitment plan throughout the rest of the year to deal with staff shortages, which would include going to Portugal to see if any more nurses could be recruited, as well as careers fairs in Glasgow and Manchester.
The CQC acknowledged that “some actions had been taken by the trust to address the issue” but added: “They had not had sufficient impact.”
“We have been a hospital under pressure,” said Mrs Gordon. “The review took place in May at a time when nurse numbers were not where we wanted them to be. Clearly, wards are much more efficient when you have got the right skill mix.”
Some concerns that are quick and easy to fix, such as the storage of medicines, have already been dealt with, the hospital said.
The CQC report highlighted that medication was not always stored safely and securely and that it could be accessed by unauthorised people. However, Dr Watson said that had now been put right.
It has also started to transfer people more quickly from the accident and emergency department to the medical assessment unit, so people can get a quicker assessment by senior doctors.
However, Dr Watson said other improvements would take a longer period of time, such as increasing the amount of space in A&E for more assessment and treatment facilities, which will require applying for additional investment.
Mrs Gordon admitted that money for NHS services across the country at present was tight, but said: “It’s not easy but the fact is we have got to balance that to achieve the right outcomes for patients.”
In its summary, the CQC said: “We found that care was not always effective.
“This was because the trust did not adequately promote the welfare of patients who lacked capacity and it was not clear how ‘best interest’ decisions were being made about their care and treatment.
“We found examples where some parts of the service had not been well led. For example the trust did not always work effectively with other providers to manage the flow of patients in and out of the hospital. This often resulted in a poor experience for the patient.”
Mrs Gordon added: “We are obviously very concerned by the findings. Our aim is always to provide safe, high-quality care and we are very sorry that, in some cases, patients, carers and families have experienced poor care.
“We want to reassure the public that we have, and continuing to, take action to address the concerns the CQC have raised.”