How do you turn around a failing hospital? The 60 points inspectors demand the Norfolk and Norwich Hospital takes action on
PUBLISHED: 17:50 20 June 2018 | UPDATED: 11:43 21 June 2018
The county's busiest hospital could take notes from another of Norfolk's healthcare centres as it looks to turnaround a report which found it was unsafe and poorly led.
On Tuesday the Norfolk and Norwich University Hospital (NNUH) was plunged into special measures after a damning inspection report from the Care Quality Commission (CQC).
And inspectors highlighted 60 areas the hospital must improve on to comply with the law, plus a further 23 things they should fix.
The obligatory changes included practical changes like making sure emergency equipment such as ligature cutters and children’s resuscitation devices were readily available, and making sure do not resuscitate forms were filled in correctly.
But also focussed on more long term issues including improving the culture and transparency at the hospital.
Just five years ago the Queen Elizabeth Hospital, in King’s Lynn, found itself in the same boat when it was criticised for areas including A&E services, surgery and leadership - all topics also seen in the NNUH report.
But while NNUH chief executive Mark Davies said he was “in it for the long haul” on Tuesday, a new leadership team at the QEH was the key to turning things around.
Troubleshooter Dorothy Hosein was brought in and it was her who was celebrated as the driving force behind pulling the QEH out of special measures in 2015.
In a presentation on how she turned the QEH around she said it was about strengthening leadership.
Mrs Hosein said the QEH previously had a “delusional organisational culture” and a “blaming of ‘others’”.
But her vision was “a true meritocracy (not clubs) with a hospital filled with excited people with good values, high integrity, and the ability to use data for improvements to patient care”.
At NNUH recent changes at the top included John Hennessey as chief finance officer, and Professor Nancy Fontaine has recently been appointed as the new chief nurse.
But Mr Davies said he did not expect any more departures. He said: “When I moved here with my family I did so with my eyes open and I’m in this for the long haul.”
However NHS Improvement, the body which oversees foundation trusts, will parachute in an improvement director to help turn things around.
It is understood the improvement director was previously a chief executive of a failing hospital where Mr Davies was put in as the improvement director.
Mr Davies said on Tuesday: “We thank the CQC for their report and have accepted its findings. Lack of capacity and sustained high levels of demand over winter put our services under extreme pressure and I would like to apologise to our patients that we were not always able to provide the level of service that we would have wanted.
“The NHS has been through one of the longest, toughest winters on record and I would like to thank staff across all professions and support services at the trust for everything they have done, and continue to do, for our patients and colleagues. The CQC team also recognised the consistently caring approach by our staff.
“In the nine months or so since the start of the inspection process we have continued to work on many improvements, which, in line with CQC recommendations, have included the significant increase in the capacity of the Emergency Department (ED) and trebling the size of the children’s ED. In addition we have over two years increased ED staffing by 38pc and introduced the UK’s first Older People’s Emergency Department (OPED). We are also improving facilities and increasing staffing (alongside Norfolk and Suffolk Foundation Trust) for patients with mental health needs in crisis.
“We are starting to see the positive impact of these and other changes (such as an increase in staffing of 540 – 8pc, including an additional 70 consultants – 18pc – in the last two years).
“Across all services the CQC has rated us as good for caring, this year the trust has the fifth most improved staff survey in the country, and NNUH has one of the lowest mortality rates in the East of England (a key indicator for quality in hospitals).
“However, we absolutely recognise there is still much to do and that we have some significant challenges to deal with, particularly in relation to staff feeling able to speak up and raise concerns, and we must improve next winter’s escalation plans and improve our systems and processes overall.
“We are working on our improvement plan with the help and support from NHS Improvement and also the King’s Fund (the independent charity and expert think tank on health and care).
“We are pleased that the CQC identified some of our outstanding areas of practice including stroke and fractured neck of femur pathways which “were impressive”, the appointment of 15 Advanced Clinical Practitioners in ED, and a forum for outpatient staff which “provided an opportunity for staff to network and communicate across divisions, grades and specialties” and gold standard “Mohs” surgery for certain skin cancers.
“Nothing is more important to us than providing the best possible care for our patients and the right culture and environment for our staff.”
• For the full list of action the hospital must take, see the embedded CQC report.
Tell us about your healthcare hero
While the CQC report paints a bleak picture for the hospital it heaped praise on frontline staff for their caring attitude.
This newspaper will always ask tough questions of the hospital, but it is also right to recognise the hard work which goes on on the ground.
Which is why today we are asking readers to share with us their hospital heroes. It could be one person’s acto of heroism at any of our hospitals or maybe a whole teams.
In today’s letters page there is recognition from Alan Richards, of Norwich.
Mr Richards, whose head went through a pane of glass when he was in his greenhouse, said thank you to paramedics Rob and Sean for their “first class treatment” and also appreciated the “wonderful care and attention from nursing staff and doctors”.
He said: “Thank you for a marvellous service from the NHS.”
And we know he is not the only one who appreciates their care.
• To highlight the care you’ve received from healthcare heroes, email firstname.lastname@example.org