Latest inspection says urgent action needed at Shropshire's two acute hospitals

The Care Quality Commission says that urgent action is needed at Shropshire's two acute hospitals following an unannounced inspection of emergency departments.

The CQC carried out visits to the emergency departments at the Princess Royal Hospital and Royal Shrewsbury Hospital on 15 and 16 April this year.

It follows an inspection in August last year in which the CQC asked the Trust to report to it weekly following concerns.

A report following the latest inspection says that on a single day, 11 children at the Princess Royal Hospital were left without being seen due to lengthy waits.

Some children are reported to have shown possible symptoms of sepsis. Case notes were also not completed for the young patients.

Inadequate levels of staff also meant six children left the Royal Shrewsbury Hospital without being seen due to long waiting times.

The report also said too many people were waiting too long to be seen by staff, and there was insufficient protection for patients with mental health issues.

The CQC has said the Trust which is rated 'Inadequate' must implement an effective system to assess all children presenting at its emergency departments within 15 minutes of arrival, as well as ensuring it has the right numbers and mix of staff on duty to undertake triage and escalate clinical risks in a timely way.

Trust says improvements have been made

The Shrewsbury and Telford Hospital NHS Trust which runs both hospitals says improvements have been made following the inspection in April.

Barbara Beal, Director of Nursing, Midwifery and Quality at SaTH, said: “Following the focussed inspection of our Emergency Departments by the CQC in April our teams, working with our healthcare partners, have made a series of significant improvements for both our patients and our staff.

“We recognise the areas of concern highlighted by the CQC and are sorry we were not able to make improvements more quickly. We are working with our staff, clinicians, and regulators, including CQC, to increase the pace of our improvements to provide a greater level of confidence and assurance.

“Some of the work we are doing is ongoing and we expect to see further improvements over the coming months.”

The Trust has approved spending of over £1 million on additional staffing for its emergency departments with a clear recruitment drive for additional nursing staff.

It has recruited additional nurses to ensure children are seen in its emergency departments within 15 minutes of arrival.

Four new paediatric nurses have been employed with two more due to start in September and 13 registered nurses have been appointed with an additional 13 newly qualified nurses due to start in September.

It is also undertaking a Value Stream as part of a Transforming Care programme to improve patient flow for minor injuries.

Barbara added: “We are continuing to work hard to not only implement improvements, but to ensure they become embedded. There have been some significant changes to strengthen the Executive and Senior Leadership teams since this inspection was carried out and we are focussed on making SaTH the best it can be for patients, visitors and staff.

“Our workforce remains a major issue for us, but we are making some progress in this area. We have recently secured an additional 50 nurses across all departments in our hospitals and interviewed a further 90 last week.

“Although we have also improved recruitment in our Emergency Departments, this is an area that remains fragile, particularly in respect of Middle-tier doctors and is an area which we will continue to focus on.”

Areas of improvement highlighted

The report highlighted a number of improvements made at the Trust.

It says that Junior doctors spoke positively about working in the emergency departments and said Consultants were supportive and always accessible.

An increase of Band 6 nursing staff and the appointment of four substantive Consultants were considered as positive by staff.

Staff reported morale improving and described an “appetite for change” with staff feeling supported and encouraged to be open and transparent. Staff from all disciplines said they could raise concerns without fear.

Staff had access to a Sepsis trolley which had step-by-step guidance and equipment needed for dealing with suspected Sepsis patients, with a doctor identified daily to carry a dedicated Sepsis bleep to respond quickly to suspected cases.

Council leader says Government must act urgently

The leader of Telford & Wrekin Council today said the Government must take urgent and even closer interest in the way that the Trust is managed.

Council leader Shaun Davies said: “The Council has been raising concerns with the Government and NHS about how SaTH is run now for a number of years.

“We welcome recent changes in senior management at the Trust but these will take time to have an effect and that is why urgent action, support and resources are needed now.

“Government ministers must take a personal and very close interest in what’s happening at SaTH because we have been warning them and NHS senior managers about it for years.

“We want best healthcare for our area as possible. In so many ways we are supporting our hospital and the hard working staff there who face very difficult challenges.

“We continue to stand by ready to support them and help turn this situation around.”