The Care Quality Commission (CQC) has published a report following an unannounced inspection last June, of surgery services at Good Hope Hospital, run by University Hospitals Birmingham NHS Foundation Trust.
The hospital provides a range of emergency and elective surgery, including trauma and orthopaedics, general surgery and gynaecology.
This inspection was carried out following CQC receiving information of concern about the standard of care being provided.
The overall rating, as well as safe and responsive remain rated as requires improvement from the last inspection. Effective and caring remain rated as good from the previous inspection, and well-led has dropped from good to requires improvement.
Following this inspection, CQC issued a warning notice to focus the trust’s attention on making significant improvements around effective governance.
The trust rating remains rated as requires improvement overall.
Charlotte Rudge, CQC interim deputy director of operations in the midlands, said:
When we inspected surgery services at Good Hope Hospital, we were concerned about the significant improvements which were needed around how they were managing the service’s processes to consistently ensure people’s safety. These concerns resulted in us issuing a warning notice to the trust, to focus its attention on making improvements in this area.
We also found the service didn’t always manage safety incidents well, and didn’t always learn lessons from them to stop them from happening again to keep people safe in future.
Leaders weren’t managing flow through the service, or bed usage well. They were using beds designated for people already in surgery or who had upcoming planned surgery, for transfers into the department from other wards. This led to delays for people returning from theatres or at times, cancelling people’s operations due to no surgery beds being available. They must address this urgently.
Despite these issues with how leaders were managing the service, we heard from people who told us staff cared for them in a kind and considerate way. They also felt listened to and weren’t afraid to ask questions.
We have told leaders where we expect to see rapid improvements around its processes, and we are continuing to monitor the service closely to keep people safe during this time. We will return to check on their progress and won’t hesitate to use our regulatory powers further if people aren’t receiving the care they have a right to expect.
Inspectors found:
- The service did not always demonstrate effective governance processes.
- Not all staff had received training on all items of equipment they used, especially new items.
- The service did not have enough staff to care for people and keep them safe.
However:
- There were processes in place for staff to follow to ensure people were safeguarded from the risk of harm and abuse.
- People had their medicines administered in line with policy and legislation.
Due to a large-scale transformation programme at CQC, this report has not published as soon after the inspection as it should have done. The programme involved changes to the technology CQC uses but resulted in problems with the systems and processes rather than the intended benefits. The amount of time taken to publish the reports falls far short of what people using services and the trust should be able to expect and CQC apologises for this.
While publication of some reports has been delayed, any immediate action that CQC needed to take to protect people using services was not affected and was carried out in a timely way. CQC is taking urgent steps to ensure that inspection reports are published in a timelier way.
The report will be published on CQC’s website in the next few days.