Dudley's hospital trust ordered by inspectors to make improvements

The trust which runs Russells Hall Hospital has been rated as 'requires improvement' by the Care Quality Commission.

CQC found significant improvements were needed at The Dudley Group NHS Foundation Trust, particularly around the safety and leadership of diagnostic imaging and the safety of urgent and emergency care.

The trust’s previous overall rating was also Requires Improvement, following an inspection in 2017.

The trust runs Russells Hall Hospital alongside the Guest Outpatient Centre, in Dudley, and Stourbridge's Corbett Outpatient Centre.

• READ the CQC report here

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The trust is also rated 'inadequate' for whether its services are safe and rated 'good' for whether its services are effective and caring.

Professor Ted Baker, CQC Chief Inspector of Hospitals, said: “Inspectors found good practice at The Dudley Group NHS Foundation Trust, but they also identified areas where significant improvement was needed.

“The safety of urgent and emergency care fell short of our expectations. Inconsistent and poor practice meant that not all patients received sepsis treatment in a timely manner."

"There were also issues with the trust’s diagnostic imaging – a service which includes provision of X-rays, ultrasound and MRI scans.

“However, staff treated people with kindness and respect," he said.

The CQC carried out its latest inspection in January and February 2019.

Last July it emerged more Russells Hall Hospital patients died than were expected to last year.

Officials estimated there should have been 2,331 deaths at the trust or within 30 days of discharge in 2017.

However, 2,433 people died – four per cent more than had been estimated.

But the latest report does not refer to concerns over the rates.

'Disappointed'

A statement from the hospital trust said it was disappointed in some findings made by inspectors.

It said: "We welcome the publication of the report of our latest inspection by the CQC which took place between 15 January and 31 January 2019.

"Our overall rating remains the same at requires improvement and we are pleased that the hard work of our teams is paying off in our urgent and emergency services whose overall rating has improved to requires improvement.

"We are pleased the CQC recognised the outstanding aspects of our community end of life service which was rated good overall and received outstanding for caring.

"Community health services for adults received a good overall rating.

"This is great recognition of the dedication and commitment to excellent patient care these team deliver to their patients.

"We are thrilled that our surgical services received an outstanding rating for being a caring service and are rated good overall.

"Our critical care service improved to a good rating, in recognition of the improvements made by the teams in delivering safe patient care.

"One of our key areas of focus over the last two years has been the care of the deteriorating patient across the Trust with many improvements made in our Emergency Department (ED). This work means our patients are seen more quickly and effectively to ensure their safety.

"The CQC said “we saw that the Trust, emergency department leaders and staff had worked hard on their sepsis recognition and treatment throughout the year.”

"This is backed up by the Trust in hospital Summary Hospital-level Mortality Indicator (SHMI) figure which shows that sepsis mortality is now below the national average and below what was expected for the Trust. We have seen a steady improvement in this figure since 2016/17.

"From a sample audit reported on 5th July 2019, 92.8 per cent of patients in our ED who had suspected sepsis received IV antibiotics within an hour. Meantime to administer IV antibiotics is now 38 minutes in our ED.

"We are confident emergency patients are seen in timely manner with 83.7 of patients being seen within 15 minutes (4th – 10th July 2019).

"We are making steady progress across all of our services but we are, of course, disappointed that our diagnostic imaging services has been rated inadequate overall, and overall the Trust was inadequate for safe domain.

"Our diagnostic team responded immediately to the concerns and put actions in place at the time of the inspection and are confident of our improvements. We introduced a matron to oversee quality and safety and have increased monitoring 24/7 of our inpatients waiting for imaging.

"We have also conducted a comprehensive staffing review to ensure any additional posts are in the right places to support patient care and safety. We have had an external expert’s view on our staffing review and skill mix within the department. We have been successful in recruiting specialist MI and CT radiographers who are now in post and additional radiographers will be in post by September.. We are continuing to invest in radiology staffing."