Trust exits special measures after ‘major improvements’
Date: 17 March 2017
Medway NHS Foundation Trust has exited special measures following an inspection by the Care Quality Commission in November. During the inspection, the CQC identified significant improvements in quality and safety at the Trust. The Trust is now no longer rated as inadequate overall, with one area described as ‘outstanding’ and many others as ‘good’.
Secretary of State for Health Jeremy Hunt said:
“I’m absolutely delighted that Medway has exited special measures – and I want to pay tribute to the outstanding staff there who have always sought to put patients first.
“Their journey hasn’t been an easy one – some of the problems at Medway were deeply entrenched, and the Trust was part of the first group to go into special measures – which makes the achievement all the greater. I’m confident the new leadership team will continue to drive improvements, engagement and morale at the trust.”
NHS Improvement Medical Director Dr Kathy McLean congratulated staff at the trust, whom she said have worked hard to improve the quality of the services they provide, and should be proud of their achievement.
She said: “Staff should be immensely proud of this news. Exiting special measures is a significant achievement and reflects a better experience for patients. It is the result of extremely hard work by everyone right across the trust from ward staff, clinicians, admin and support teams, and the trust’s leadership team.”
Chief Inspector of Hospitals, Professor Sir Mike Richards, says: “There is no doubt that substantial improvements have been made since our last inspection. It is apparent that the Trust is on a journey of improvement and significant progress is being made both clinically and in the Trust’s governance.”
He goes on: “The leadership team is now fully established and there is a strong sense of forward momentum and control. In addition it is clear that strong leadership and clear communication are leading to an engaged workforce whose morale is now much higher.”
In a report that is strikingly different from those received following previous inspections, no services are rated as inadequate, and many are commended for the changes that have been made in the past year.
Overall the trust is rated as ‘requires improvement’. However, it is rated as ‘good’ for being ‘caring’, ‘effective’ and ‘well-led’. Medical care services, maternity and gynaecology and services for children and young people are all rated as ‘good’ as a whole, while maternity and gynaecology are rated as ‘outstanding’ for ‘caring’.
Chief Executive, Lesley Dwyer, said: “We welcome this report. It is wonderful news that a decision has been made by NHS Improvement to remove the Trust from special measures. I am so pleased that the improvements that we are all so proud of have been recognised. This is a great tribute to our dedicated staff and the fantastic job they do day in, day out. They really are the best of people, working hard to deliver the best of care.
“We would also like to thank our colleagues at Guy’s and St Thomas’ NHS Foundation Trust with whom we have had a special relationship through our successful buddying arrangement. Their support has been critical to our improvement and we look forward to continuing an enduring partnership with them.
“We accept the findings in the report, and acknowledge there is, of course, more to do. The areas highlighted by the CQC where we need to improve such as staffing levels, condition of the estate, the use of mixed sex accommodation and training rates, come as no surprise to us. We know we need to make progress in treating people in a timely way, ensuring they are able to access services, for example in our emergency department and through our Referral to Treatment Times. We have already made progress in a number of these areas, since the CQC visited in November and our improvement plan sets out a range of initiatives to take us from better to best, and onto brilliant.
“This trust has come a long way in the past year, and we have always said that we wouldn’t get to where we want to be overnight. However, this report is a clear indication that we are moving in the right direction. We have every reason to believe that we can build on this momentum and continue to improve. There is a very exciting future ahead for Medway NHS Foundation Trust and as staff, we are all honoured to be a part of it.”
Interim Chair, Dr Peter Carter, said: “Today is a really good day for Medway, not just for the Trust and its staff, but more importantly for the public that we serve. There have been huge improvements over the past few years, and while we know there is much still to do, I want to pay tribute to the dedication of our staff: clinical and non-clinical, from our support staff, porters, receptionists, domestics and volunteers through to our doctors, nurses and midwives.
“I would also like to pay tribute to the fantastic leadership of our Chief Executive, Lesley Dwyer. She joined the Trust at an incredibly difficult time and through her passion, dedication and vision, has inspired staff to deliver the improvements recognised by the CQC today.
“I’m feeling really optimistic about what lies ahead for Medway. This is a significant milestone and signals a brighter future for the trust.”
Key areas of progress identified by CQC include:
- Significant reduction in mortality rate with Trust no longer being an outlier for HSMR
- Improved care for patients in the Emergency Department, with patients no longer being cared for in corridors
- Staff continue to be praised by patients and carers for their compassionate care
- Support to vulnerable patients significantly improved
- Improved culture of incident reporting
- A well-established Executive Team, working together as a cohesive unit with a shared vision
- Improved staff morale throughout the organisation.
The following areas were highlighted as areas of outstanding practice:
- The neonatal unit improved its breast-feeding at discharge compliance rates from one of the lowest rates in the country to one of the highest
- Critical care services had a research portfolio that placed them as the highest recruiter in Kent
- The award-winning ‘Stop Oasis Morbidity Project’ (STOMP) has reduced the number of first time mothers suffering third degree perineum tears
- Team Aurelia, a multi-disciplinary team supporting women requiring an elective Caesarean section
- Abigail’s Place, the bereavement suite, provides the ‘gold standard’ in the provision of care for patients and families experiencing a still birth
- The care provided for patients experiencing broken hips from admission to discharge.
Medway NHS Foundation Trust was placed in special measures in July 2013 following a review by Sir Bruce Keogh, NHS England’s Medical Director.
The CQC undertook two comprehensive inspections of the hospital in April 2014 and August 2015. The trust was rated inadequate overall on both occasions. Concerns around patient safety, organisational culture and governance were highlighted.
Medway NHS Foundation Trust has exited special measures following an inspection by the Care Quality Commission in November