Inspection and Regulation

14.06.17

CQC: Eight trusts with significant care turnaround owe success to staff engagement

Reviewing the culture of NHS trusts and addressing disconnects between clinicians and managers within the organisation is key to improving care, a new CQC report has revealed.

The document, called ‘Driving improvement: case studies from eight NHS trusts’, looked into how a number of different trusts improved care and subsequently their CQC rating by making simple changes to how services were run.

The eight trusts analyses included providers like University Hospitals of Morecambe Bay NHS FT, East Lancashire Hospitals NHS Trust and Barking, Havering & Redbridge University Hospitals NHS FT, all of which were previously in special measures. Although the latter is still considered to ‘require improvement’, both Morecambe Bay and East Lancashire are now considered ‘good’.

Another trust, University Hospitals Bristol NHS FT, showed a remarkable turnaround by going from a rating of ‘requires improvement’ to ‘outstanding’.

During its study, the inspectorate found that engaging with staff and allowing for open and honest conversations was vital to making improvements to care delivery.

The CQC also discovered that successful trusts tended to make their chief executives and senior staff more visible by having them spend more time on the ‘shop floor’ – meeting staff and setting up regular channels of communication.

By doing this, leaders were given the opportunity to produce a set of shared value with staff, including tackling equality and diversity issues relating to staff and patients in the wider community.

“Since introducing our comprehensive inspection programme in 2014, I have been encouraged by the number of NHS trusts that have made significant improvements in quality,” said Prof Sir Mike Richards, chief inspector of hospitals at the CQC.

“We know from our inspections that strong leadership and a positive open culture are important drivers of change.”

Sir Mike added that real change did not happen overnight, and that the improvements made by each trust were a testament to the time, effort and determination of staff and local partners.

“I hope their stories will encourage and inspire others in their own improvement journey,” he concluded.

Jeremy Hunt, who retained his position as health secretary during the prime minister’s cabinet reshuffle, said: “Our mission is to make the NHS the safest healthcare system in the world.

“A crucial part of this is the CQC inspection regime which has proved that when challenges are highlighted transparently, the NHS can make dramatic improvements in the quality of care it gives to patients.

“I want to congratulate all the trusts on a remarkable turnaround, and I hope others will be inspired to put these important lessons into practice at their own hospitals.”

Report also highlights increasing challenges for trusts   

But Amber Davenport, head of policy at NHS Providers, argued that though the report was right to congratulate the brilliant work of the trusts that had made significant improvements, it should also be remembered that reform is being carried out under enormous pressures.

“Although each success story is different, there are clear lessons which can be learnt from these their experiences,” she said.

“While it is right that we celebrate the success stories, the report also highlights the funding, demand and workforce challenges facing their improvement efforts. We must urgently address these pressures to ensure the NHS has the resources it needs to continue to improve quality of care.”

And Imelda Redmond, national director of Healthwatch England, also added that it was absolutely vital that patients, frontline staff and hospital bosses work as a team to identify problems and improve care together.

“It's good to see the CQC’s report celebrating where this is already happening, with the examples shared a real endorsement of the value of local Healthwatch in helping hospitals better understand those they serve,” she explained.

“To help us drive these sorts of improvements right across the country I urge people to speak up, share their experiences with their local Healthwatch and find out how they can get involved.”

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