Measuring up at Tameside Hospital
Thursday 10th September 2015 @ 08:00 by Nigel Skinner
Ashton Community

Tameside Hospital

Political leaders and health chiefs have welcomed a health watchdog’s recommendation that Tameside Hospital should come out of special measures.

The hospital was labelled inadequate two years ago, being one of a number of hospitals investigated for having a high mortality rate in the wake of the Stafford Hospital scandal.

It was placed in special measures in 2013 following a report by Sir Bruce Keogh and ordered to improve critical care, staffing levels and leadership.

A new leadership team was brought in and following a review earlier this year The Care Quality Commission says the hospital should now come out of special measures, having made “significant progress”.

Inspectors changed the rating for critical care services from ‘inadequate’ to ‘good’ and improvements were also recorded in medical care, surgical and outpatient services.

Reaction:

Tameside’s three MPs  welcomed the CQC’s report this week.

Andrew Gwynne, Shadow Health Minister and MP for Denton and Reddish, said:

“We’ve been calling for improvement at the hospital over a number of years now and it’s really pleasing to see the journey the hospital has been on under the new leadership, which is testimony to the hard work, dedication and faith that the staff, management, patients and their families have shown on this road to improvement.

“As the CQC identifies, there are still some issues to be resolved at the hospital and this is only the start of the journey.  Whilst it’s very welcome to see the hospital coming out of special measures, we still need A&E to improve and I want to see the proper integration of health and social care to give a seamless joined-up single service for the residents of Tameside and Glossop.”

Ashton MP Angela Rayner said:

Tameside General needs to get a lot better for local patients. Good progress is being made – but there must be no setbacks to its recovery.

“A lot of work has been put in to turn the hospital around after it was placed in special measures two years ago.

“Strong leadership and a more caring approach have helped to pick it up, but a lot more work still needs to be done to improve the hospital for local people. We cannot afford to be complacent, but at least Tameside General is now moving in the right direction. Staff should be congratulated for responding so well to the enormous challenge they faced. But the improvements must continue.”

Stalybridge and Hyde MP Jonathan Reynolds said:

“I am pleased that the CQC have recognised the progress being made at Tameside General Hospital since it was placed in special measures. This is an important step for the Hospital and it should give confidence to residents in Tameside that the hospital is undoubtedly getting better.

“All I have ever wanted is for my constituents to receive the healthcare they deserve. I would like to praise the hard work and dedication of the staff who have made this possible. From conversations with constituents and through the casework I receive, I have seen first-hand the evidence of improvements that are being made. As the CQC report highlights, there are still areas that need further attention, in particular with A&E waiting times. I will be working to ensure that Tameside Hospital continues to improve in the long-term.”

Tameside Council Leader Cllr Kieran Quinn responded: 

“This is very good news. As a council we have worked alongside Tameside Hospital and Tameside and Glossop Clinical Commissioning Group (CCG) to support the hospital on its journey of improvement.

“I have real confidence in the Chief Executive of the hospital, Karen James, who has overseen a complete turnaround since her appointment in July of last year.

“However, we know there is still work to be done. The CQC will continue to monitor the hospital to ensure continued progress is made. Tameside, as an authority, will maintain its commitment to supporting the hospital on this journey.

“The council will also work closely with the hospital to integrate health and social care services. It is our intention to keep people as healthy as possible so that fewer need hospital treatment.

“We want to encourage people to choose healthy lifestyles and by so doing take more responsibility for their own health.”

Chair of Healthwatch Tameside Dr Kailash Chand, on behalf of Healthwatch said:

We are pleased to see the Hospital’s hard work to improve services recognised in the CQC’s recommendation.

· As the local consumer champion for health and care we have been actively involved in monitoring and shaping the hospital’s improvement plans.

·  Like the CQC, we have noticed a change in approach in the hospital over the past two years. We feel they are now much more aware of the areas where they need to make improvements and more open when things go wrong.

·  We find the new leadership team at the hospital has been very willing to listen to our feedback on behalf of the public and they have made changes as a result of this.

· Our Enter and View visits in December 2014 showed improvements compared with the ones the LINk (our predecessor) had undertaken in January 2013. We had an informal walk-around in May 2015 and saw that some of our recommendations following the 2014 visits had also been implemented.

· We share the CQC’s view that although the hospital has taken a significant step from ‘Inadequate’ to ‘Requires Improvement’ there are still things that need to be done to improve care. Importantly, we know that the hospital’s leaders also agree that more needs to be done and that they already have plans in place to address many of these issues.

· We look forward to continuing to work with the hospital, on behalf of the local population, to ensure that these improvements are made and that patients’ stories are used to shape the improvements and to tell us that they have worked.

· If anyone wants to give us feedback about their experience of NHS care, either at the hospital or anywhere else, they can do it online (http://www.healthwatchtameside.co.uk/content/your-story) or by telephone (0161 667 2526 and ask for a member of the Healthwatch team). We welcome stories about good care as well as experiences where care could have been better.

We continue to work to aim for safe quality care for residents of Tameside!In his report for the CQC.

Professor Sir Mike Richards, the Chief Inspector of Hospitals, said: 

“I am satisfied that Tameside Hospital NHS Foundation Trust has made considerable  progress in those areas where we had concerns last year, which is why I am pleased to recommend to Monitor that the trust should come out of special measures.

“The trust has been going through a period of significant change. On our most recent inspection we have seen for ourselves that there is now a stronger culture which is committed to putting patients and safety first.

“The senior management team has led this programme of change, taking care to involve staff to ensure that this improvement is sustained.  This is a credit to all the staff; we found them to be a highly dedicated workforce,  committed to caring for their patients.

“There is still much to be done. I am particularly concerned that patient flow through the hospital appears to be putting continual pressure on beds, and overall the trust is not yet as safe, effective or responsive as it should be.  But we can see that the trust has the systems in place to support this improvement and it is our view this is entirely within the trust’s grasp.

“We will continue to monitor Tameside Hospital. Our inspectors will return in due course to check that it has continued to make progress.”

CQC report

In 2014, CQC had been specifically concerned about the critical care services, medical care, surgical and outpatient services. This year inspectors found there had been significant improvements in each of these areas.

In critical care, staffing levels now met patients’ needs, patient safety was monitored and incidents were investigated and shared with staff to assist learning and improve care.   Patients received care and treatment by staff working well together in multidisciplinary teams  with a visible leadership.   Inspectors found staff  were enthusiastic about changes taking place.

In medical care, inspectors found that all staff contributed to systems to manage and monitor safety, with an improved culture encouraging them to report mistakes and incidents openly.   Staffing levels had been reviewed and improved.  While patient flow through the hospital was better, too many patients were still transferred during the night and some could not be accommodated on appropriate wards.

In surgery, patient safety was being monitored and incidents were investigated to assist learning and improve care.  While outcomes were positive for most patients, too many operations had been cancelled, although there were plans to improve theatre capacity to reduce waiting times and meet standards.

In the outpatients department, there had been an increased in nursing staff, resulting in more clinics being available.  There was now better management of the waiting lists and improved communication with patients

The emergency department was failing to meet many of the national access targets, although the trust was working closely with commissioners and other agencies to improve flow through the department.  In some areas, inspectors noted a number of omissions in records of controlled medicines

CQC has told the trust it must make improvements in a number of areas:

• The trust must ensure that it has enough doctors to meet the needs of patients at all times including out of hours.

• Patient flow must improve throughout the hospital to reduce the number of patients transferred at night and ensure timely access to the service best suited to meet the patient’s needs, particularly in A&E and medical care services.

• There must be improvements in completion levels of mandatory training and appraisals for nursing and medical staff.

• Medicines, particularly controlled drugs must be stored, checked and disposed of in line with best practice, particularly in A&E and outpatients.

The trust has been rated Good for being well led, and Good for caring. The full reports and ratings are available athttp://www.cqc.org.uk/provider/RMP

Following the latest inspection, which was carried out in April, the Trust has now been rated as ‘Requires Improvement’ overall.

Health regulator Monitor will make the final decision on the Trust’s status.

• Tune into Tameside Radio 103.6FM to hear more reaction to this story at 2pm and 7pm today (Thursday).