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Actions we are taking following the CQC report

Following the publication of the Care Quality Commission's (CQC) report, we have begun to work on a detailed action plan to address their concerns.

The finer details of the plan are being worked out with our staff and a summary of the actions we plan to take can be found in the tabs below.

The CQC has told the Trust we must ensure that:

There is always enough suitably-skilled staff on duty to meet people’s care needs in a timely way, including appropriately trained paediatric staff in all areas of the hospital where children are treated. 

  • Earlier this year the Trust set aside £2.9 million to create 69 extra jobs for nurses across the Trust. Of those, we have already employed 55. In addition, we have 55 newly qualified nurses starting this September as part of our normal recruitment process. The Trust’s Children Services Action Group has also identified areas where we need to recruit or train existing staff to care for children and young people.

The buildings are clean, well-maintained and fit for purpose and equipment is well-maintained and available when needed.

  • Clean: The CQC report describes our hospitals as ‘visibly clean’ - especially when referring to wards and patient areas. However, some very busy areas were identified as not reaching this standard. We have made plans to significantly improve them.
  • Well maintained/fit for purpose: We invest £2 million every year maintaining our buildings. The clinical and patient areas are our main concern. We have also invested in new theatres, procedure rooms, infrastructure and clinics over the past five years. Long-term, we will see where further improvements can be made. Our new purpose-designed hospital in Dover is planned to open early next year (2015). 

Members of staff are better informed of end-of-life care arrangements and end-of-life care is reviewed to ensure a consistent approach. 

  • Our end-of-life care steering group is developing a communication plan to improve staff awareness of our current policy. Tools are available to support end-of-life care.

The CQC has told the Trust we must ensure that:

There is an identified lead at board level who takes responsibility for services for children and young people. 

  • We have set up a Trust-wide Children Services Action Group. Julie Pearce, the Trust’s Chief Nurse and Deputy Chief Executive, is the lead for children and young people on the Board.

Outpatient services are given adequate administrative support so delays and cancellations to appointments can be properly assessed and kept to a minimum. 

  • We have started to introduce significant changes to our outpatient departments which will deliver substantial improvements. These include: better use of outpatient facilities; quicker follow-up appointments; introduction of  ‘one-stop’ clinics where patients are seen, diagnosed and treated on the same day; working more closely with our clinical commissioning groups to set minimum staffing levels and improving information given to patients about booking, cancelling and follow-up appointments.

Arrangements for end-of-life care are clarified to staff to ensure the patient is protected against the risk of receiving inappropriate care. 

  • Our end-of-life care steering group is developing a communications plan to improve staff awareness of our current policy. Tools are available to them to support end-of-life care for patients.

The CQC has told the Trust we must ensure that:

Safety is a priority in Accident and Emergency. 

  • Our A&E recovery plan is committed to achieving the four-hour waiting time standard. We have recently recruited two new A&E consultants and the quality of the service is being reviewed every month.

Patients are discharged or moved through the hospital according to their needs. 

  • We are working with our clinical commissioning groups to help control the number and type of patients who present at A&E and to help arrange better facilities for patients to be discharged back home or into the community as quickly as possible and with suitable support.

Patients are not subjected to unnecessary delays for outpatient appointments, either to get an appointment or when waiting in the department. 

  • We have started to introduce significant changes to our outpatient departments which will deliver substantial improvements. These include: better use of outpatient facilities; quicker follow-up appointments; introduction of  ‘one-stop’ clinics where patients are seen, diagnosed and treated on the same day; working more closely with our clinical commissioning groups to set minimum staffing levels and improving information given to patients about booking, cancelling and follow-up appointments.