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‘Positive culture shift’ pulls trust out of special measures after nearly 3 years

West Hertfordshire Hospitals NHS Trust will be removed from special measures for the first time since 2015 following a review by the CQC.

While the regulator said there was still work to be done, it congratulated the trust on key improvements in outpatient care, diagnostic images, and services for children and young people, which had previously been struggling.

Inspections took place between 30 August and 1 September 2017, with CQC examiners visiting Watford Hospital, St Albans Hospital and Hemel Hempstead Hospital.

Overall, the trust has been moved from its ‘inadequate’ rating to ‘requires improvement’ and inspectors found evidence of strong multidisciplinary teams working on all wards and departments.

Steve Barnett, chair at West Hertfordshire, said the results showed the trust had come a “long, long way” since being put in special measures more than two years ago.

“I am immensely proud of our staff,” he commented. “They never stop wanting to improve, to learn and to deliver the very best care for every patient, every day.

“Our leadership teams, from the board to the wards, have been growing in strength over the last few years and this has played a big part in our move out of special measures.

“I would also like to pay tribute to our wonderful volunteers. I was thrilled to see that the volunteer-run Carer Support Team was praised by the CQC for the support they give to the parents and friends of unwell babies and children.”

As well as the overall change in rating, facilities at Hemel Hempstead have been moved from ‘inadequate’ to ‘requires improvement,’ and along with St Albans Hospital, it has no more services rated ‘inadequate.’

In addition, the CQC had praise for leadership within the trust, noting that leadership was “strong, supportive and visible” with a team that understood the challenges it faced.

Chief executive Katie Fisher said that the review showed that the trust was committed to change, but warned that, in the future, rising patient numbers could mean the facilities need to be upgraded.

She explained: “It has been a great achievement to reduce the number of services with an overall rating of ‘inadequate’ to just one – urgent and emergency care at Watford General.

“However, we have recently recruited additional consultants and made a small increase to capacity to alleviate pressure in this busy service. Looking further ahead, we will need a new or substantially enlarged emergency department big enough to manage the number of patients who come through its doors.”

Inspectors found that the trust still needed to improve in a number of areas, such as incident reporting, risk identification, and culture within the emergency department.

However, a number of outstanding practices were also highlighted, with the ‘iSeeU’ mother and child initiative and the focused recruitment of junior nurses pointed out as two key areas.

Chief inspector of hospitals, Professor Ted Baker, said: “I am very pleased to be able to recommend that West Hertfordshire Hospitals NHS Trust exits special measures. When we returned to conduct our inspection, we found considerable improvements had taken place since our last inspection, and staff are to be commended for this.

“The change in ratings in a number of areas acknowledges what has been achieved by the trust’s staff and leadership team and we found several examples of outstanding practice.

“Continued improvement had been made to ensure staff and teams worked collaboratively. There was a positive culture which focused on improving patient outcomes and staff were proud to work at the trust.”

Baker wrote for NHE late last year, analysing the last State of Care report and giving an idea of what can be expected from Britain’s health sector in future.

Top image: Steve Parsons

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