Norfolk & Norwich University Hospital ordered to improve

The Norfolk and Norwich University Hospital CEO Mark Davies, speaking at the hospital AGM. Picture:

The Norfolk and Norwich University Hospital CEO Mark Davies, speaking at the hospital AGM. Picture: DENISE BRADLEY - Credit: Copyright: Archant 2015

A five-point plan has been drawn up at Norfolk's biggest health provider in a bid to address issues raised by a health watchdog.

Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUH) has been rated as 'requires improvement' by the Care Quality Commission (CQC) after a wide-ranging inspection last November.

The CQC's 205-page report, published today, found many areas where improvements were required, but inspectors described staff as caring and praised several 'outstanding areas of practice'.

Among the watchdog's findings were:

- A lack of nursing staff which impacted on the safety of care, most notably in children's, palliative, and critical care services.

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- Security and safety risks on the children's day ward.

- An 'under-utilisation' of Cromer Hospital, where staff felt disconnected to the trust.

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- Outstanding pratice at the N&N's A&E department.

Mark Davies, who became chief executive of NNUH last autumn, said he accepted the report's findings as accurate but added it was a 'big pat on the back for the staff'.

He said the comments by the CQC effectively signalled that the trust needed to relieve pressure on its staff and facilities.

'At the moment we're struggling to keep pace with demand,' he said.

'Two days ago we had 156 ambulances outside A&E, when you would normally expect 120 to 130 per day. The nearest big hospital in the eastern region (Addenbrooke's) gets around 90.'

In addition the trust is not hitting treatment targets for non-emergency healthcare.

To take pressure off the trust's facilities, which Mr Davies accepts are too small to cope with demand, a five-point plan has been drawn up.

The plans are:

- Developing a day case surgery unit which is open longer for patients.

- Increase the size of the children's emergency department.

- Develop services for interventional radiology and cardiac catheter labs to increase patient access.

- Increase capacity for critical care patients, such as those who require intensive support after operations

- Develop endoscopy services at the planned food and health research centre next to the Bob Champion Research and Education Building.

'We think it's a very clear plan,' Mr Davies said.

The CQC made unannounced visits after completing their original inspection and has monitored the trust while compiling its report.

Norman Lamb, MP for North Norfolk and former health minister, said: 'The difficulties at the trust have been known so the rating is not surprising.

'It is paramount that we treat the concerns about safety with the utmost seriousness.

'The national picture is challenging in the NHS, but there can be no excuse for failing to provide enough medical staff to ensure the care and safety of patients.'

Professor Sir Mike Richards, the CQC's chief inspector of hospitals, said: 'Our inspectors found that some improvements were needed at NNUH.

'The trust was not meeting referral to treatment times in a number of specialties. Inspectors regularly saw people waiting and queuing for a bed in the acute medical unit and three ambulance trolleys queued during our inspection.

'These patients had to wait in armchairs or trolleys by the nurse's station at the entrance of the ward which offered no privacy or comfort.

'Patients spoken to on Gately, Gissing and Denton wards told inspectors that there were delays in staff answering call bells as they were busy. This was worse at night time when patients noted that there was a shortage of staff.

'Staff in the critical care complex and specialist palliative care teams felt that there was a disconnect between their teams and the senior management team. Gately ward was identified as an area where staff turnover was higher than usual and a number of investigations had been undertaken following concerns from staff.

'We have seen, however, that some progress has already been made across some areas and we found many areas of good practice that staff should be proud of.

'We were particularly impressed by the professionalism and efficiency of the urgent and emergency services and critical care services which we rated as good overall. Patients we spoke with told us they had been well cared for, were shown respect, treated with dignity and their privacy was protected.

'In particular, the nursing team within the emergency department demonstrated outstanding care, leadership and treatment of patients.

'The trust leadership knows what it needs to do to bring about improvement and our inspectors will return at a later date to check on what progress has been made.'

To read the CQC report visit

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