CQC finds widespread improvement at United Lincolnshire Hospitals NHS Trust

The Care Quality Commission (CQC) has welcomed widespread improvements at United Lincolnshire Hospitals NHS Trust following an inspection of its medical, maternity, urgent and emergency services and services for children and young people.

CQC carried out the inspection in October at Pilgrim Hospital and Lincoln County Hospital, as part of continual checks on the safety and quality of healthcare services.

As a result of the inspection, the overall trust rating remained requires improvement. The trust ratings for being effective and well-led went up from requires improvement to good. Safe and responsive remained as requires improvement and caring remained as good.

The ratings for medical care and children’s and young people’s services at Lincoln County Hospital from requires improvement to good. Children’s and young people’s services at Pilgrim Hospital went up from inadequate to good. Urgent and emergency services went up from inadequate to requires improvement and maternity services at Pilgrim Hospital went up from requires improvement to good.

Ted Baker, Chief Inspector of Hospitals said:

“Our inspection of United Lincolnshire Hospitals NHS Trust found many areas that had improved since we last inspected which is good news for people receiving care. I would like to congratulate the trust and all its staff for the progress they have made. It is particularly impressive set against the backdrop of the COVID-19 pandemic.

“The trust has had historic issues, particularly regarding concerns with Pilgrim Hospital’s urgent and emergency department and maternity services and was in special measures for several years. Staff and their leaders must be commended for the steps they’ve taken towards improving patient care in these previously troubled areas.

“We rated well-led as good. Leaders across the trust understood the challenges that staff were facing and worked hard to support colleagues in a compassionate way.

“We saw a marked improvement across maternity, medical care and services for children and young people. Staff morale had improved with initiatives in place to promote wellbeing. For example, staff on the maternity ward could share positive messages and feedback to their colleagues by leaving messages in a ‘Ta jar’. These messages were then shared directly with individuals which made them feel respected and valued.

“While widespread improvements had been made, there are still concerns regarding access and flow in the urgent and emergency department at Lincoln County Hospital. People continued to experience delays in accessing the service and receiving care promptly. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients were still below national standards.

“I recognise the enormous pressure NHS services are under across the country, especially in the urgent and emergency department, but it is important they do all they can to mitigate risks to patient safety while facing these pressures.

“We continue to monitor the trust closely and leaders know where we expect to see improvements and where to sustain areas where good patient care is already being delivered.”

At Lincoln County Hospital, inspectors found:

• The children and young people’s service had 24-hour access to mental health liaison support if staff were concerned about a child or young person’s mental health. Staff could access the internal mental health team who could attend to patients at any time, day or night.
• On medical wards, staff knew about and dealt with any specific risk issues. The trust had processes in place to ensure patients received specialist care when required.
• The trust had worked hard over the last year to recruit staff onto medical wards and had recruited several overseas nurses which resulted in reduced vacancy rates.
• When patients transferred to a new area, there were no delays in staff accessing their records. The trust had an electronic system on which staff recorded observations, key information and treatment plans. This was accessible on all wards and enabled staff to quickly identify areas of risk and treatment plans.
• In the maternity department, facilities and equipment concerns were not always responded to in a timely manner to ensure the environment met the needs of women. For example, one woman told us the toilet in their room was out of order and another room had blinds that didn’t work.
• Whilst improvements had been made in A&E, patients could not always access emergency services when needed and receive treatment within agreed timeframes and national targets.

At Pilgrim Hospital, inspectors found:

• Maternity leaders displayed enthusiasm to improve services for women, babies and staff. Staff spoke positively about the culture and were supported to carry out their roles effectively.
• Staff knew how to protect patients from harassment and discrimination, including those with protected characteristics under the Equality Act. Staff knew how to identify adults and children at risk of, or suffering, significant harm and worked with agencies to protect them.
• Staff gave patients emotional support and advice when they needed it. Patients confirmed staff were caring and sensitive to their emotional state. We observed staff reassuring patients and taking time to interact with them despite being extremely busy.
• The design of the A&E department did not always follow national guidance. However, action had been taken to improve the department, including; a new x-ray room, an additional triage room, a waiting room, and a paediatric emergency department.

Inspectors also found the following outstanding practice:

• The trust had been part of the ‘Lincolnshire Stroke Transformation: 100 Day Challenge’. Significant work had taken place to implement a ‘one team’ approach to establishing a community-based stroke rehabilitation service that was able to support stroke survivors seven days a week.
• In the neonatal unit, staff had implemented an electronic ‘ear’ in the nursery. The device was programmed to signal a red light when noise levels increased above a certain level. It was thought that noise levels need to be moderated for neonates to keep them feeling safe and happy.
• The neonatal unit had two transitional rooms where parents stayed with their neonate for a few days to get accustomed to caring for their premature baby. The room was furnished with a double bed, wardrobe, kitchen, lounge area with TV, and bathroom facilities.
• The trust was the first in the country to be formally accredited by the ‘Academy of FAB NHS Stuff’. The trust now had FAB Experience Champions who acted as local leads for patient experience. This work aimed to engage with patients, families and their carers to improve care.

The report for United Lincolnshire Hospitals NHS Trust will be published on CQC’s website tomorrow (Tuesday, 8 February).

Notes to editor

Throughout the COVID-19 pandemic, the CQC’s regulatory role has not changed. CQC’s core purpose of keeping people safe is always driving decisions about when and where we inspect. As the risks from the pandemic change, we are evolving how we regulate services to reflect what we have learnt during this time. You can read more about our current approach on our website.  

CQC is listening to what people are saying about services to help detect any changes in care. If there is evidence people are at immediate risk of harm, CQC can and will take action to ensure that people are being kept safe. People can give feedback about their care to CQC via the details below. 

• Give feedback via website- cqc.org.uk/give-feedback-on-care   
• Telephone - 03000 616161   

Contact  

For media enquiries: 

• Helen Gildersleeve, Regional Communications and Engagement Officer – 07825 939328 or gildersleeve@cqc.org.uk
• Lisa Lloyd, Regional Communications and Engagement Officer – 07789 876470 or lloyd@cqc.org.uk
• Angela Clark, Regional Communications and Engagement Manager – 07821 682 509 or clark@cqc.org.uk
• Alternatively, you can email engagement@cqc.org.uk 

Journalists wishing to speak to the press office outside of office hours can find out how to contact the team on the website.  

Contact Information

Helen Gildersleeve
helen.gildersleeve@cqc.org.uk

Media Enquiries

For media enquiries about the Care Quality Commission, please call the press office on 020 3855 4621 during office hours. Follow the team on Twitter for the latest national announcements: @CQCPressOffice. Journalists wishing to speak to the press office outside of office hours can find out how to contact the team here. Please note: the duty press officer is unable to advise members of the public on health or social care matters.