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Troubled Medway kept in special measures after performance worsens

The future of the troubled Medway NHS FT is “extremely concerning”, as CQC today recommended that it remain in special measures after its performance deteriorated further in some areas.

Inspectors, still rating the provider as ‘inadequate’, pinpointed a series of much-need improvements across the trust. The chief inspector of hospitals, Professor Sir Mike Richards, raised several immediate concerns with local commissioners and NHS England at the time of inspection about Medway’s standards of patient safety in the A&E department.

At the busiest times, the A&E department was unable to cope with the amount of patients attending, with people waiting too long to see a doctor or being left unattended while they waited.

The trust and local commissioners were forced to take immediate action following that intervention to ensure there were more staff members available to improve patient flow.

But Prof Richards commented today that, while the CQC has been kept aware of all action taken by local CCGs, councils and NHS England to safeguard improvements in the A&E department, he was still not satisfied that the “underlying issues throughout the trust have been resolved”.

“It is disappointing to report that performance may even have deteriorated in some areas, despite the support which has been offered to the trust up until now,” he said.

“This is extremely concerning, both in terms of the quality of care that people can expect from the trust, and for what it says about the trust’s ability to improve. It is our shared view with Monitor that this situation must not be allowed to continue. It is clear that the trust cannot solve these important issues on its own, and will require continued support for the foreseeable future.”

The CQC and its partner agencies are currently considering the best option available to them to improve services as quickly as possible.

Medway was originally placed in special measures in 2013 after NHS England national medical director Sir Bruce Keogh’s review of mortality rates across the health service.

But after further inspections in 2014, the provider had still not improved enough. Since then, while there has been some advancement, inspectors found that staffing levels were still too low. The trust remains “heavily reliant on the good will of staff” to take on extra shifts, as well as agency and bank staff to ease growing pressures.

Clinical areas were not clean and hygienic and needed refurbishment, and not all staff had access to the system for reporting incidents. The board’s ability to push forward the necessary level of improvement was also questioned, especially in relation to “longstanding poor mortality rates”.