Lister Hospital responds to CQC report

A new report by the Care Quality Commission has rated Lister Hospital in Stevenage as requiring improvement.

The inspection was carried out on 20th and 21st June and on 2nd and 3rd August. During their visit the CQC spoke with 87 members of staff including healthcare assistants, nurses, midwives, junior doctors, pharmacy staff, consultants and administrative staff. They also spoke with 10 patients and 4 relatives. They also looked at a wide range of documents including policies, standard operating procedures, meeting minutes, action plans, risk assessments, training records and audit results. Staff handovers and daily safety huddles were also observed.

The CQC report summarises their findings, saying:

We carried out this unannounced inspection of the Lister Hospital location inspecting 4 of the acute services provided:

• Urgent and Emergency Services because we had concerns about the quality of services.
• Medical Care (including older peoples care) because we had concerns about the quality of services.
• Surgery because at our last inspection the safe domain was rated inadequate and the service was rated requires improvement.

We also carried out an unannounced focused inspection of Maternity Services because at our last inspection carried out as part of the national maternity inspection programme, the safe and well led domains were rated inadequate. We also issued a Section 29A Warning Notice. At this inspection we found that the Trust had met the requirements of the Section 29A Warning Notice.

We also inspected the well-led key question for the trust overall.

Our rating of services stayed the same. We rated them as requires improvement because:

However:

• We rated safe, responsive and well-led as requires improvement, and effective and caring as good.
• We rated 4 of the trust’s services we inspected as requires improvement. In rating the trust, we took into account the current ratings of the 4 services not inspected this time.
• Staff did not always complete mandatory training and there were not always enough staff to meet the needs of patients.
• People could not always access the care and treatment they needed in a timely manner. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients were not in line with national standards. The trust had recently agreed a Full Capacity plan describing actions to be taken when there were excessive patient delays. However, this was yet to be embedded.
• The service did not always manage safety incidents well and did not always ensure that lessons were learnt from them.
• Leaders identified and escalated relevant risks and issues but they did not identify actions to reduce their impact. There was no evidence the outcomes recorded, what mitigation actions had been completed or if the risk had reduced or increased.
• The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well.
• Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information.
• Staff treated patients with compassion and kindness, respected their privacy and dignity and provided emotional support to patients, families and carers.
• Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

:: Care Quality Commission Report, 3rd November 2023

In a statement, the hospital said: "Inspectors found that the Lister Diamond Jubilee Maternity Unit has improved – moving from Inadequate to Requires Improvement. The work with the Maternity Voices Partnership was also highlighted as an area of outstanding practice.

"Surgery at Lister has also improved on the safety rating from Inadequate to Requires Improvement.

"This means out of the services inspected, there are no longer any areas which remain Inadequate.

"It was highlighted that improvements are needed in the Trust’s urgent and emergency care services, which have been downgraded to Requires Improvement, and the Trust has already begun work to improve patient flow, reducing pressure on its emergency department, and lessening long waits.

"Many of the improvements will be delivered as part of our new partnership with the world-renowned Virginia Mason Institute. Through this partnership, we will implement a proven approach that improves our processes, reduces waste (of time, effort, and resources) and enhances patient experience."

Adam Sewell-Jones, Chief Executive at East and North Hertfordshire NHS Trust, said: "We welcome this report from the CQC, as we do any external views on the Trust.

“We recognise the areas to improve, and for most of these work is already underway – for example creating an adult Urgent Treatment Centre at Lister which will ease the pressure in our emergency department, and fantastic progress in carrying out more operations than ever – in July we carried out 27% more procedures than the same time in 2019.

“We will continue to focus on providing safe, compassionate care to our communities, and look forward to sharing further improvements over the coming months.”

Theresa Murphy, Chief Nurse at East and North Hertfordshire NHS Trust, said: "I join Adam in welcoming the latest inspection report from the CQC and, although there is still work to do, am particularly pleased that the rating for our maternity service has improved.

“This improvement demonstrates the hard-work and commitment of our maternity team, colleagues across the Trust, and the Lister Maternity Voices Partnership.

“I am looking forward to working with colleagues across the Trust and our partners to deliver further improvements, ensuring we can provide the very best care which our patients expect and deserve.”

Lister Hospital provides a wide range of acute inpatient, outpatient, and minor treatment services, including an emergency department and maternity care, as well as regional and sub-regional services in renal medicine, urology, and plastic surgery. General wards are supported by critical care (intensive care and high dependency) and coronary care units, as well as pathology, radiology, and other diagnostic services.

The full CQC report can read read via the link below.
East and North Hertfordshire NHS Trust Inspection report