Trust says it remains committed to improvements following latest ‘inadequate’ rating

The Shrewsbury and Telford Hospital NHS Trust, which runs the Royal Shrewsbury Hospital and Princess Royal Hospital, serves nearly half a million people in Shropshire, Telford and Wrekin and mid Wales.

The Trust was inspected between November 2019 and January 2020.

The CQC report says the rating of the trust stayed the same because the safe, effective, responsive and well-led key questions were all rated as inadequate.

The report found 92 breaches of legal requirements that the trust must put right. Inspectors also found 75 things that the trust should improve to comply with a minor breach that did not justify regulatory action, to prevent breaching a legal requirement, or to improve service quality.

Chief Executive Louise Barnett, who joined SaTH in February 2020, has described the determination of the Trust’s leadership team to make the necessary changes to improve.

Louise said: “The Trust was already well-sighted on the issues raised and we know the improvements we need to make. We welcome the feedback from the CQC and we will build on this to make the sustainable changes needed to ensure the consistent delivery of safe, high-quality care that the people of Shropshire, Telford & Wrekin and mid Wales deserve.

“The Trust faces significant challenges, however since joining SaTH I have met some really inspiring people and have seen first-hand examples of excellent work from individuals and teams who are passionate about what they do and the care they provide. It is going to take time but we are absolutely determined to get this right for our patients, their families and our staff.”

Areas of ‘Outstanding Practice’ were, however, recognised in Outpatients at PRH, where a nurse-led wound clinic to provide continuity of care for patients has freed-up space in other clinics, and in surgery at RSH where the inspection team saw examples of “excellent support for patients living with dementia on most wards”.

Improvements have been recognised in maternity services, including staff treating women with compassion and kindness, respecting their privacy and dignity, and taking account of their individual needs.

The improvements made in maternity have been recognised, with the service now graded as being ‘Good’ for Caring, Effectiveness and Responsiveness. This is an improvement in the ratings for Safe and Effective compared with the previous inspection.

Louise said: “We are pleased the CQC has recognised improvements in our maternity services. A huge amount of work has been done to get to where we are now, however we recognise there is more to do and we are working hard to address the outstanding areas of concern to ensure all of our women and their families receive the very best possible care. These learnings will help us to drive further changes across the organisation.”

The full report can be read here:
https://www.cqc.org.uk/sites/default/files/new_reports/AAAJ7638.pdf

Focussed Inspection

Today the CQC also published their focussed inspection on SaTH’s urgent and emergency services for RSH and PRH, which took place on 17 and 18 February 2020, both of which were rated as inadequate.

Urgent and emergency services at Shrewsbury were rated inadequate in all areas including Safety, Caring, Responsiveness and leadership while Telford received the same ratings although caring was rated as Requires Improvement.

At the PRH inspectors found the design, maintenance and use of facilities, premises and equipment did not keep people safe. Staff did not always promptly identify and quickly act upon patients at risk of deterioration. The department was also understaffed with the report stating the service did not have enough permanent nursing staff with the right qualifications, skills, training and experience to consistently keep patients safe from avoidable harm and to provide the right care and treatment.

The RSH had similar findings within the urgent and emergency care department. As at the PRH the design, maintenance and use of facilities, premises and equipment did not keep people safe.

Staff did not always act to remove or minimise risks or update the assessments when risks changed. 

The service did not have enough permanent medical staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment.

Leaders did not have the skills and abilities to run the service in a safe and effective manner. Staff did not always feel respected, supported and valued by the senior executive team.

At both hospitals, people could not always access the service when they needed to, and they did not always receive the right care promptly with waiting times from arrival to treatment and arrangements to admit, treat and discharge patients again well below national standards. 

Louise said: “We take the feedback from the CQC extremely seriously. We will continue to work closely with our staff, patients and our regulators to improve the quality of care for all of our patients.

“Our staff work extremely hard in the face of increasing demand and we are supporting them through strengthened leadership, training and development, and further recruitment so that together we can provide the high standards of care to which we aspire every day.”

Louise added: “Clearly we need to improve. However, it is important that we do not lose sight of the things we do well. We are currently dealing with a global pandemic and a national emergency. The challenges being faced across the country, and here in Shropshire, are significant. None of us have ever faced anything like this.

“Teams right across our Trust are working incredibly hard to ensure we are prepared and that our patients are well cared for. This is only possible because of the incredible commitment and professionalism being shown by our 6,000 members of staff and our volunteers who support them every day. I would like to personally recognise and thank our staff for their amazing commitment and the way in which they are pulling together, and I am sure by continuing to work together we can make the improvements required for all our patients and families.”

The full reports from the Care Quality Commission can be viewed here:
Royal Shrewsbury Hospital:
https://www.cqc.org.uk/sites/default/files/new_reports/AAAK0527.pdf

The Princess Royal Hospital:
https://www.cqc.org.uk/sites/default/files/new_reports/AAAK0528.pdf