East Kent Hospitals University NHS Foundation Trust (EKHUFT) has made widespread improvements to the quality of care patients receive following the CQC’s reinspection of the Trust’s hospitals in Ashford, Canterbury and Margate in September.
There are no “red” inadequate scores and Sir Mike Richards, England’s Chief Inspector of Hospitals, has recommended that the Trust be taken out of special measures as a result of “further significant improvements” for local patients, recognised by the Care Quality Commission (CQC) in a report publishedon 21 December 2016.
Sir Mike Richards, CQC, says: “Staff at all levels are contributing to the improvement programme and as a result a momentum of improvement is apparent within the organisation.”
This is the third inspection for the Trust since 2014 and looked in detail at four areas at three of the Trust’s five hospitals - emergency care, medical services, maternity and gynaecology and end of life care.
The Trust was placed in special measures by Monitor (now NHS Improvement) in 2014 when the CQC rated the Trust ‘inadequate’. A year later the Trust was upgraded to ‘requires improvement’ as a result of “big steps forward” witnessed by the CQC. The Trust remained in special measures to allow more time to fully embed the improvements.
While the overall Trust rating remains ‘requires improvement’, the CQC report “indicates a number of areas in which further significant improvements have been obtained, notably that there are no longer any elements that are rated inadequate.”
NHS Improvement will make the final decision about whether the Trust will come out of special measures in early 2017.
Key findings include:
- Safer emergency services at all hospitals, with the Urgent Care Centre at The Kent and Canterbury Hospital (K&C) upgraded to ‘good’ overall; safer services at Queen Elizabeth The Queen Mother Hospital’s (QEQM) A&E department; and safer, more effective and better-led services at William Harvey Hospital’s (WHH) A&E department;
- Improved medical care at all hospitals, with services at QEQM upgraded to ‘good’ overall, more effective at WHH and more responsive at K&C;
- All hospitals rated ‘good’ for ‘caring’, with a continued “culture of compassionate care”, staff who put patients first, and patients and carers confident in how involved they are in their or their relatives’ care;
- Outstanding practise was found in the Trust’s Improvement and Innovation Hubs, highlighted as “an established forum to give staff the opportunity to learn about and contribute to the Trust’s improvement journey”;
- Improved leadership, with a fully established Executive Team and Trust Board, described as a “highly engaged team with a clear and common view on Trust strategy, risk and operational priorities”, who have provided “greater clarity” about the direction of the Trust, with staff “appreciative of the increased visibility and accessibility” of the Executive Team;
- Improved staffing, recognising that “significant investment has been made by the Trust to increasing staffing establishment”, with “key appointments made in emergency care, end of life care and maternity” addressing previous gaps;
- Better culture within the Trust, which had “improved significantly since 2014” and continues on “a trajectory of improvement with a continued reduction in bullying and harassment”;
- Improved end of life care, with better training and resources to support staff caring for patients at the end of their life and their relatives;
- Improved maternity services, with more staff, better equipment and new leadership.
Trust Chief Executive, Matthew Kershaw, said:
“The tangible improvements recognised by the CQC are the result of our thousands of dedicated and hardworking staff who have together driven improvements for patients in their wards, clinics, theatres, laboratories, workshops and offices over the last two years.”
“This is a major step forward in our ongoing journey to improve how we care for our patients, their relatives and our staff. We have made significant progress which means that hospitals provide better care for our patients and are better places for our staff to work.”
The CQC reports also highlights further areas for improvement, such as recruiting and retaining more staff, enabling more patients to access treatment sooner, improving the flow of patients through our hospitals, fully embedding early signs of improvement in maternity and end of life care, and making financial savings.
Matthew Kershaw added:
“The CQC rightly highlight the on-going challenges we face and further improvements we still need to make, such as recruiting and retaining more staff, enabling more patients to access treatment sooner, improving the flow of patients through our hospitals, and making financial savings.
“Encouragingly, these are things we know about and are already working hard to improve, through our on-going improvement plan and as part of efforts to transform how patients are cared for, both in and out of hospital, with our partners in Kent and Medway.
“We will not take the foot off the gas now that we are recommended as being out of special measures but instead continue the momentum of improvement at pace to deliver services that better meet the needs of patients both now and in the future.”
As well as the overall Trust rating the CQC gives an individual rating to each of the Trust’s three hospitals inspected this year.
- William Harvey Hospital, Ashford - rated ‘requires improvement’ overall, ‘good’ ratings for critical care and outpatient and diagnostic imaging.
- Queen Elizabeth The Queen Mother (QEQM) Hospital, Margate - rated ‘requires improvement’ overall, with medical care, critical care, services for children and young people, and outpatient and diagnostic imaging all ‘good’.
- Kent and Canterbury Hospital (K&C), Canterbury – rated ‘requires improvement’ overall, with the urgent care, critical care, services for children and young people, and outpatient and diagnostic imaging all ‘good’.
- The ratings for the Trust’s two hospitals in Dover, Buckland Hospital, and Folkestone, Royal Victoria Hospital, were rated ‘good’ in 2015 and not re-inspected in September.
Trust Board Chair, Nikki Cole, said:
“I am delighted that the CQC has recognised the widespread and sustained improvements made by the Trust’s hardworking staff. I am particularly pleased by the CQC finding that staff at all levels are contributing to the improvement programme. This is something that I have seen myself when shadowing and talking to our staff.”
The CQC gives each hospital up to 55 individual ratings for different services including whether they are safe, effective, caring, responsive and well-led, and six ratings for the Trust. The CQC gave EKHUFT a total of 162 ratings of which 80 were ‘good’ and none were ‘inadequate’ in 2016, compared to 66 ‘good’ and 9 ‘inadequate’ in 2015, and 51 ‘good’ and 34 ‘inadequate’ in 2014.
How are we improving?
We are committed to working together to make positive changes for our patients.
Each month we publish a report which outlines what improvements we are making and how we are progressing on implementing our changes.