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Trust using unregistered nursing staff rated as ‘Requires Improvement’ by CQC

Mid Essex Hospital Services NHS Trust has been rated as ‘Requires Improvement’ after a series of CQC inspections found that unregistered nurses had been treating patients.

A CQC inspection took place on 26, 27 and 28 November at the trust’s Broomfield and Braintree Community Hospitals and inspectors returned to the trust in February in response to further concerns about the Emergency Assessment Unit (EAU).

During the February inspection the CQC found that staff who were not registered with the Nursing and Midwifery Council (NMC) were providing nursing care in the EAU. Due to this an urgent condition was placed on the trust’s registration to ensure only registered nurses provided nursing care to patients.

The inspection team examined each of the core services at the trust: urgent and emergency services, specialist burns and plastic services, medical care, surgery, critical care, maternity and gynaecology, services for children and young people, end of life care and outpatients and diagnostic imaging.  

The trust was rated as ‘Requires Improvement’ for whether its services were safe, effective and well-led overall, as ‘Good’ in relation to whether services were caring and rated as ‘Inadequate’ with regard to whether services were responsive.

Urgent and emergency services, one of the core services CQC inspected, were rated as ‘Inadequate’ as a result of the inspection.

Chief inspector of hospitals, Professor Sir Mike Richards, said: “We found Mid Essex Hospital Services NHS Trust required improvement overall. While there were some areas of good practice, we were seriously concerned at what we found during our inspections and this is why we took immediate and urgent action at the trust. The trust must now make urgent improvements and we will continue to monitor its progress, which will include further inspections.

“People deserve to be treated in services which are safe, caring, effective, well-led, and responsive to their needs and this is what we look at when we carry out our inspections.”

The trust has also been told that it must take action to improve in areas such as:

  • Improvements were required across the Emergency Assessment Unit (EAU) and with regard to end of life care.
  • The trust needed to take immediate action to reduce the number of patients on the waiting list for follow-up outpatient appointments.
  • To ensure medicines are administered in a timely way, especially for patients receiving intravenous antibiotics and time critical medicines.
  • Care documentation, including care plans and risk assessments, must be undertaken accurately, in a timely manner and reviewed when required.
  • Nursing handovers needed to be robust and identify patients at risk.
  • Ensure that systems for providing staff with feedback on incidents, and sharing learning from incidents, are embedded throughout the trust.
  • Work was needed to improve safety and reduce incidents on the labour ward.

Paul Forden, chief executive at Mid Essex welcomed the report, saying that the trust is rapidly undertaking actions to improve the services that require improvement.  

“Taking into account feedback relating to our urgent and emergency services we have already put in place a number of significant investments to provide a better patient experience, including a new surgical emergency ward opened in April, a new paediatric area in our emergency department and opening in May five more patient treatment cubicles in the emergency department. We are also strengthening the clinical leadership for this service,” he said.

“The Trust has seen a significant growth in demand from patients for our accident and emergency services and this service is under pressure to deliver the high quality of care we would expect to achieve. In addition, the actions required to improve our Emergency Assessment Unit are now completed.”

(Image source: Sean Dempsey/PA)

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