Hospitals told to improve – but bosses say new rating is ‘no reflection on merger’
PUBLISHED: 00:01 08 January 2020 | UPDATED: 10:49 08 January 2020
The boss of Ipswich and Colchester hospitals is “disappointed” after the NHS trust running them was rated ‘requires improvement’ by a watchdog – but feels it is no reflection on 2018’s merger.
Nick Hulme, chief executive of the East Suffolk and North Essex NHS Foundation Trust (ESNEFT), thinks the organisation's first rating since the two hospitals merged in July 2018 is fair, if a little disappointing.
It comes at a time when it is tackling "incredibly high numbers of patients".
Central Suffolk and North Ipswich MP Dr Dan Poulter feels the merger has played a role in this latest rating.
Dr Poulter, who works in the NHS himself, said it is typical for a poorer-performing trust to merge with a more successful one which then has its rating "dragged down" - particularly in earlier inspections.
He suspects this is what has happened with Ipswich and Colchester.
So what did inspectors say?
The latter was rated 'requires improvement' just before the merger, while Ipswich was 'good' - now both are considered to need improvements.
Care Quality Commission (CQC) inspectors, who visited the trust in June and July last year and published their findings today, found several improvements were needed - in areas such as staffing, risk assessments and processes around cleanliness/infection control.
Chief inspector of hospitals, Professor Ted Baker, said: "While it's encouraging that the trust has areas of outstanding practice and is rated 'good' for being effective, caring and well-led, more progress needs to be made to change the overall rating.
"Some of the issues we found were understandably caused by complications following the formation of a new trust, and one which is the biggest in the locality.
He added: "Risks to patients were not always assessed, monitored and managed effectively.
"In the emergency departments staff did not always complete risk assessments for patients in a timely manner, particularly for patients with mental health needs.
"Despite these concerns, inspectors observed that the leadership across services was mostly effective despite the challenges of managing a newly merged trust."
What did inspectors think the trust did well?
Children and young people's services, maternity and end-of-life care were all considered 'outstanding' by inspectors.
And since the inspection, ESNEFT has pumped £3million into nursing.
Mr Hulme said the 'outstanding' ratings were something to be "really proud of", adding: "I think the (overall) rating is fair, it's perhaps a little disappointing that we haven't managed to get a good rating - we've been assessed as requires improvement overall.
"There were no significant quality or safety concerns at all in any part of the organisation - remembering the size and the scale of it.
"And overall, I don't think it reflects as to whether or not the merger has been successful, or otherwise."
One concern flagged by inspectors, which Mr Hulme did say had been caused by the merger, was that they used two different systems to log mandatory training - but this has since been rectified.
Merger with Colchester 'may have dragged rating down' - MP
Dr Poulter said that while his constituents always had "glowing praise" for Ipswich Hospital, he fears issues continuing to be tackled at Colchester may have pulled both acute hospitals down to a 'requires improvement' rating.
He said: "When the two hospitals merged I was aware of concerns that it may lead to Ipswich performing to a lower standard, and I think what has happened here is what is typical of NHS trusts that have merged which is that ongoing issues at Colchester, which are being tackled, have led to Ipswich going down a rating.
"It has always historically performed well in inspections.
"Constituents who are patients at the hospital are always full of praise, which is often glowing, for both hospitals and I have full faith in the leadership team to bring them both back up to 'good' at the next inspection."
So what happens now?
Looking ahead, Mr Hulme added: "We were inspected six months ago when we were merging systems and process across our hospital sites, and we have now completed most of this work.
"I think our main priority now is to go back to basics and to make sure we're supporting staff to make sure they are providing the best quality care.
"As you know we're dealing with incredibly high numbers, we need to make sure the staffing reflects the numbers of patients we're seeing. "We need to make sure we've got the right staffing with the right skills to make sure the patients get safe care.
"As a system we need to make sure we respond to the increased demand, working with local authority colleagues to make sure we're redesigning healthcare to take pressure off those acute areas.
"The third thing would be to take the learning from those areas of outstanding practice and to see where we can replicate those."
What is Mr Hulme's message to patients in the wake of the rating?
"My message to patients is you can absolutely have the confidence that if you come to any part of our organisation - Colchester Hospital, Ipswich Hospital or indeed in the community - you will receive high quality, safe and compassionate care to every patient, every day."
What has the trust got planned in 2020?
Mr Hulme said the trust has a busy year ahead, with planning for a new A&E at Ipswich due to continue.
The new building, at the Heath Road site, is expected to open in two years' time.
A public consultation into a new orthopaedic centre at either Ipswich or Colchester is due to start as early as next month.
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