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17.12.18

Troubled Cornwall trust remains in special measures despite major improvements

A struggling hospital trust will remain in special measures despite making significant improvements following an inspection from the CQC which identified issues with leadership and use of resources.

The Royal Cornwall Hospitals NHS Trust (RCHT) has been rated by the CQC as ‘requires improvement,’ a step up from its two ‘inadequate’ ratings in 2016 and 2017.

Despite improvements made, the trust’s leadership remained especially concerning, alongside a lasting need for improvements in surgery, maternity, and end-of-life care.

Inspectors found the emergency department at the RCHT was “frequently crowded” with a layout that didn’t always keep patients safe from harm; patients weren’t always assed within the 15-minute target; and patient monitoring processes were not always followed.

The chief inspector of hospitals, Professor Ted Baker, welcomed the improvements to the quality of care, but said that with the trust’s “challenging history” more work needed to be done.

“At our earlier inspection in June 2018 we found real improvements in specific areas, and this wider inspection has now found further significant progress, including diagnostic imaging services which we rated ‘outstanding,’” explained Baker.

“However, many of the executive team are newly in place, and some of their changes will take time to take effect.

“We did find some remaining concerns during the inspection and while we are aware the trust is addressing these, I am recommending the trust should remain in special measures for a further period.”

RCHT declared last week that it spent a total of 134 days on Opel 4, the highest level of alert for a trust used only when a hospital is “unable to deliver comprehensive care.”

Dozens of trusts spent 20 days or more on Opel 4 alert, but the Cornwall trust’s figures represent the highest across the NHS, spending more than a third of the year under extreme pressure.

Responding to the CQC inspection, RCHT chief executive Kate Shields commented: “This is a positive report for us and shows that the work we have been doing to improve care and safety is starting to show through.

“The improvement we have seen is down to our great staff. They are the people who really hold the quality of care for the people of Cornwall in their hands.”

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