06.03.18
Bristol trust told to take action to improve service as patients left waiting for beds
Southmead Hospital must make further improvements to its services, the CQC has determined.
The decision comes following an unannounced inspection in November 2017, which looked at the quality of five core services: urgent and emergency care, medical care, surgery, end of life care and outpatients, as well as the management and leadership of the trust.
North Bristol NHS Trust’s overall rating remains as requires improvement, as do its ratings for safety, effectiveness, well led and responsiveness to people’s needs.
Caring remains rated as good, and end of life care received a rating of outstanding, with the frontline staff found to be caring and considerate at all times.
Previously, inspectors had found that the trust required improvements to manage the flow of patients needing urgent attention, which the trust has made “some excellent progress” with.
However, the commission found that “too many” patients in the emergency department are still waiting for beds to become available or to be discharged.
Inspectors reported that the trust had not taken sufficient action to anticipate increasing demand over the winter months.
Amanda Stanford, CQC’s deputy chief inspector of hospitals, said: “Although managers were aware of the challenges caused by extra operational pressures the plans were not fully tested or signed off at the time of the inspection.
“The use of additional beds and wards had become ‘acceptable’ and the divisional leads were not confident describing plans to cope with winter pressures.”
Stanford also described the effect that delayed transfers of care had on the patient flow around the hospital: “This was affected by delayed transfers of care into the community hospitals and the wider care system.
“At the time of the inspection, there were a high number of patients who were medically fit for discharge.
“This resulted in cancellations for surgical patients and patients booked for radiology procedures.”
She concluded: “As a result of this inspection, we have made it clear to the trust where it must take action to further improve these services.
“Since the inspection the trust has been responding to these safety concerns and making changes to lessen the risks.
“We will continue to monitor the services involved, and we will in any case return in the near future to check progress.”
Andrea Young, chief executive of North Bristol NHS Trust, said that the trust has been exceptionally busy for a period of time, at peak times being “overwhelmed” by the number of patients, and agreed that this needs to be resolved.
She added: “This is a matter we take very seriously and is a priority for us as a trust.
"Later this month we will be launching a development programme for our staff that we hope will help us address many of the issues raised.
“We will also be working with our partners in the community to ensure patients who do not require our care can be safely discharged to other settings, including home and working with them to look at new ways of providing specialist advice and care in the community that could reduce the need for a stay in hospital.
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