Trust in charge of Hull hospitals told it needs to improve following latest inspection
The CQC rated Trust as 'requires improvement'
Last updated 23rd Mar 2023
A diabetic patient who waited 16 hours before getting food or a drink in Hull Royal Infirmary’s emergency department was among the incidents inspectors found before deeming its Trust requires improvement.
Care Quality Commission (CQC) inspectors also reviewed another patient who did not get timely relief despite saying they had high levels of pain during their inspection late last year.
CQC Deputy Director of Operations in the North Sarah Dronsfield said Trust managers needed to do more to ease the effects of staff shortages at Hull hospitals.
Hull University Teaching Hospitals Trust (HUTH) Chief Executive Chris Long said it had faced extreme pressures like others have and apologised to patients who had not received quality emergency care.
The CQC’s requires improvement rating is the same overall as it was after its previous inspection in March 2020.
Inspectors who visited last November and December found there were enough staff in the Trust’s emergency department to keep patients safe.
They also found that while safeguarding referrals they saw were made correctly, some staff did not wear PPE or follow other infection control measures.
Medical services controlled infection risk well, with staff completing assessments of patients on arrival and managers supporting nurses.
But managers did not always investigate incidents in surgery departments thoroughly and were slow in sharing lessons from probes, leading to patients potentially being harmed.
Clinical waste from surgery departments was not always safely disposed of.
Junior doctors also said their workloads were unmanageable and were concerned at feeling stretched.
Inspectors ruled safety had gone down from requires improvement to inadequate, while responsiveness and well-led dropped from good to requires improvement.
Its rating on caring remains good and responsive stayed at requires improvement.
The rating urgent and emergency care fell from requires improvement to inadequate while medical and surgery services dropped from good to requires improvement.
Ms Dronsfield said inspectors found staff generally went the extra mile to make sure people were comfortable and their needs were met.
But the director added that while Trust managers understood the issues they faced, they did not always take decisive action which led to a deterioration of care.
Ms Dronsfield said: “In the emergency department, patients weren’t always checked regularly to see if they had enough to eat and drink, including those with specialist nutrition and hydration needs.
“We reviewed one diabetic patient who waited 16 hours before receiving a drink or food.
“Managers needed to do more to mitigate the impact of staff shortages on people’s care in medical and surgery services, with both areas reporting issues.
“Managers confirmed they’d successfully recruited several new nurses, so we hope this soon starts to make a difference to ensure patients are safe.
“In medical services, staff were frequently moved between wards to cover staff shortages which prevented a continuity of care to people, and nursing levels were consistently below the safe and recommended levels on surgery wards.
“We will continue to monitor the trust, including through future inspections, to ensure the necessary improvements are made so people can continue to receive a good standard of care.”
Mr Long said staff had been working incredibly hard in a challenging environment which the CQC had acknowledged.
The chief executive added staff had also acted on the urgent actions the CQC had delivered in its feedback to the Trust.
Mr Long said: “We were pleased that the CQC acknowledged the compassion and kindness, which our staff and teams demonstrate in the treatment of their patients.
“For care we received a rating of good from inspectors.
“Inspectors rated the key domain of safe as inadequate and they highlighted a number of issues in emergency care and surgery at the Trust, which required urgent action.
“Many of the areas they highlighted for improvement have already been addressed.
“Despite the best efforts of our staff we have seen long delays for patients in our Emergency Department.
“Our goal now is to ensure that the improvements we are making will be sustained.
“We have a plan to open an intermediate care centre at Hull Royal Infirmary for patients who are medically fit to leave.
“This will increase capacity in our hospitals making it easier to discharge and admit patients and therefore reduce delays.”