HOSPITAL services in Worcestershire have been rated inadequate and placed in special measures.

The Care Quality Commission published a damning report today (Wednesday, December 2) highlighting “serious problems” at Worcestershire Acute Hospitals NHS Trust and labelling it unsafe.

Inspectors graded the trust inadequate for safety and leadership and requires improvement for effectiveness and responsiveness, resulting in an overall classification of inadequate.

An over-reliance on temporary staff and locum doctors, insufficient consultant cover, overcrowding at A&E and a lack of learning from incidents were listed as particular concerns in the report.

Specialist NHS advisors will now be drafted in to offer intensive support under special measures – a move designed to help the trust turn things around for its target population of 570,000.

Bosses at the trust have expressed disappointment at the health watchdog’s findings but have promised a focus on “continuing to improve”.

They also highlighted success stories including the trust’s good rating for care and the inspectors’ praise for “compassionate and kind” staff.

The Care Quality Commission visited Worcestershire Acute Hospitals NHS Trust, which provided 900 beds and had a budget of £365 million last year, in July.

Inspectors rated more than 50 per cent of the 115 areas assessed as inadequate or in-need of improvement and graded both Worcestershire Royal Hospital and Alexandra Hospital in Redditch as inadequate.

Kidderminster Hospital and Treatment Centre was classified as in-need of improvement.

Sir Mike Richards, chief inspector of hospitals, said a number of “serious problems” were discovered, resulting in the recommendation that the trust be placed in special measures.

He added: “One of the reasons we rated the trust as inadequate for being well-led and safe was because when things went wrong they were not investigated promptly or thoroughly and there was a lack of learning from these incidents to prevent harm in the future.

“This was particularly the case in the maternity and gynaecology service.

“Whilst the trust had a vision and a set of values these were not well embedded or understood by staff. The way some divisional team were run was not effective.”

Jeffrey Worrall, portfolio director at the NHS Trust Development Authority, the body tasked with helping Worcestershire’s hospitals, confirmed “intensive support to embed long-term improvements to patient services” would be provided.

Peter Pinfield, chairman of Healthwatch Worcestershire, which represents patients in the county, described the CQC report as “very disappointing” and called for further improvements.

But Chris Tidman, chief executive of Worcestershire Acute Hospitals NHS Trust, has defended the organisation’s position.

He said: “Everyone working at our hospitals will be very disappointed that overall we are rated as inadequate, especially following the efforts all our teams have made in the last four months since the inspection to improve our services.

“We recognise that we have achieved a great deal in a short space of time, including improving against key performance targets, but we are by no means complacent.

“We still have a great deal of work to do especially around processes and procedures. We remain focused on continuing to improve.

“The added support from organisations in specific areas, as confirmed by the NHS Trust Development Authority as part of the special measures arrangement, are welcomed and we look forward to the additional expertise these will bring.

“We would like to thank our patients, our staff and local people for their loyalty and support and assure them that we are committed to making these improvements so that we can continue to offer caring services to local people.”

The CQC Report

The Care Quality Commission’s damning report into the Worcestershire Acute Hospitals NHS Trust runs to hundreds of pages. These are the inspectors’ key findings:

The bad

• A&E departments were “consistently failing” to meet the national treatments standards

• The number of in-hospital deaths was “significantly higher than expected”

• Difficulties in recruiting doctors were causing high vacancy rates in some departments, an over-reliance on locum staff and rendered some services “fragile”.

• Numbers of consultants in A&E were insufficient to meet targets for consultant presence 16 hours a day, seven days a week • Overcrowding in A&E departments was an “on-going risk”

• Medicines were “not always stored safely and securely to prevent theft, damage and misuse”

• Mandatory training of staff was below the target of 95 per cent across all areas

• Governance systems were “not always effective”, incidents were “not always reported or investigated in a timely way” and lessons learnt from incidents were “not always shared”

• In the maternity service safety was “not a sufficient priority” - in the maternity and gynaecology departments there were a large number of outstanding incidents where investigations had not been completed or reviewed

• A lack of stability at the board level was a “significant concern”

• Delays on decisions about the future service configuration for hospitals in Worcestershire was “impacting on recruitment and services”

The good

• Staff were “caring, compassionate and kind”

• Outstanding ratings for care in the maternity and gynaecology departments

• All clinical areas were “tidy and visibly clean”

• Nursing staffing levels met patient needs on the whole

• The pharmacy department provides an “innovative seven day clinical service”

• “Exceptional care” was provided at Avon 4 ward at Worcestershire Royal Hospital with staff recognised as “extremely respectful and compassionate”

• Good feedback from patients about the availability and quality of food and drinks

• The executive team – despite many being in interim positions and new to the organisation - demonstrated “understanding and commitment to address the issues the trust was facing”

• Access to electronic information held by GPs and community services was ensuring up-to-date information

What are special measures?

Hospitals are placed into special measures when there are problems with the quality of care provided to some or all patients that the leadership of the trust cannot fix in a reasonable time without additional help.

Often the decision that a hospital needs significant support to deliver improvements is made following an inspection by the Care Quality Commission’s chief inspector of hospitals.

There are 15 trusts currently in special measures in England including London Ambulance Service NHS Trust and Cambridge University NHS Foundation Trust.

The NHS Trust Development Authority has confirmed Worcestershire Acute Hospitals NHS Trust will receive intensive support under special measures.

A package of support including advice and guidance from an improvement director, support from high-performing NHS trusts and assistance with recruitment will be provided.