East Kent’s hospitals are providing outstanding practice in some areas, but there is more work to do to embed improvements and manage pressure on the Trust’s services, according to the latest report on East Kent Hospitals University NHS Foundation Trust’s services published by the Care Quality Commission (CQC).
The CQC inspected the Trust’s hospitals in Ashford, Canterbury and Margate in May and June this year.
The Trust’s rating remains at Requires Improvement after the CQC looked in detail at four areas at three of the Trust’s five hospitals – urgent and emergency services, surgery, maternity and end of life care – as well as the ‘well-led’ aspect of the Trust.
This is the fourth inspection for the Trust since 2014 and the first since it was taken out of quality special measures in February 2017.
In its report, the CQC recognises that the Trust is on a journey of improvement, aiming to build on the progress which raised the Trust out of special measures in 2017.
It found areas of outstanding practice, including:
- How the Trust uses technology to improve the patient experience. For instance, patients can use mobile phone applications to access information about pregnancy and the maternity department, and to get additional support and guidance about surgery before and after their operation.
- An specialist intravenous access team takes blood samples and inserts cannulas under ultrasound guidance – this gives patients a better patient experience as it minimises the number of attempts that need to be made to ‘find a vein’. The Trust is the first in the country to implement this innovative service in emergency departments.
- Also within the emergency departments, equipment in the resuscitation area is very well organised with colour coded drawers and clearly labelled equipment in glass-fronted cabinets, which means staff can quickly find the correct equipment they need.
- The maternity service has ‘a unique and ambitious approach to education’ and the faculty of multi-professional learning provides training that ‘exceeded that of other maternity units’. The service has top of the range simulators for staff training and is the only maternity unit in England to have undertaken quality assurance in clinicians’ essential life support skills.
Ongoing improvement journey
The CQC report also highlights further areas for improvement, including improving safeguarding training of staff caring for children and young people and vulnerable adults; the levels of nurse staffing on surgical wards; referral to treatment times for surgical patients; and capacity within our emergency departments and receiving wards.
These are things we are already addressing as priorities. For example, by investing in extra operating theatres, hundreds of patients who would not normally be able to have their planned orthopaedic operation over the winter will see their operations go ahead this year.
We are pressing ahead with much-needed investment in our hospital sites to make sure east Kent patients are served well in the period before long-term decisions about the future organisation of health services in the county are made and implemented.
We have been approved for national funding to extend the emergency departments at Margate and Ashford in the New Year by building new observation areas.
We are recruiting additional nurses, doctors and consultants in our emergency departments, as well as paediatric nurses to provide 24/7 cover to care for children in the emergency department.
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 – remains rated ‘requires improvement’ overall, with surgical services at William Harvey Hospital upgraded to ‘good’ overall and critical care and outpatients diagnostic imaging rated ‘good’ overall.
- Queen Elizabeth The Queen Mother (QEQM) Hospital, Margate - rated ‘requires improvement’ overall, with medical care, critical care and outpatient and diagnostic imaging all ‘good’.
- Kent and Canterbury Hospital (K&C), Canterbury – remains rated ‘requires improvement’ overall, with services for children and young people, critical care and end of life care rated ‘good’ overall.
- 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 this year.
Children's services inspection
The CQC inspected services for children and young people provided at the William Harvey Hospital, Ashford, and Queen Elizabeth The Queen Mother Hospital, Margate, on 23, 24 and 25 October 2018. These services include the children’s ward at each hospital, the emergency departments and operating theatres. In its report, the CQC rated children’s services ‘good’ for caring, but the overall rating for children’s services in the two hospitals is ‘inadequate’.
Find out more about the significant changes the Trust has made to hospital care following the CQC inspection.