Hospitals in Gloucestershire told they must make improvements, as rating drops in latest inspection
Findings follow concerns raised by staff whistle blowers at Gloucestershire Hospitals NHS Foundation Trust
Last updated 7th Oct 2022
Hospitals in Gloucestershire are being told that they need to improve after an investigation was carried out in response to concerns raised by staff whistle-blowers.
The Care Quality Commission carried out an unannounced inspection of surgical services at Cheltenham General Hospital and Gloucestershire Royal Hospital and an announced well led inspection of the Trust.
Inspections were carried out in April and June in response to concerns received about the safety and quality of services. Concerns included staff whistle-blowing, and the sizeable number of 'never events', reported over the previous year. A never event is a serious patient safety incident that should not happen if healthcare providers follow national guidance on how to prevent them.
As a result of the inspection, surgery at both Cheltenham General Hospital and Gloucestershire Royal Hospital is now rated inadequate overall. Previously surgery had been rated as good.
Other categories, including Safe and well-led are also now rated as 'inadequate'. Effective and responsive are now rated as 'requires improvement' and caring as good.
Following the inspection, The Care Quality Commission issued the trust with a warning notice to make sure significant improvements in areas of safety, leadership, managing risk and governance for surgical services were carried out to improve patient care.
The overall rating of the trust has now dropped from 'good' to 'requires improvement'. Safe and well-led have also dropped from 'good' to 'requires improvement'.
The rating for responsive remains 'requires improvement' and caring remains 'good'.
Catherine Campbell, CQC head of inspection, said:
“We are very aware of the pressure that the NHS is under and how hard staff are working to provide good care for patients.
“During our well led inspection we found there was a lack of trust in senior leaders and a fear of speaking up. Inspectors were told when staff did raise concerns they were not always supported or treated with respect. Some staff said they had tried repeatedly to raise concerns and due to either a lack of response or a negative response, eventually they had become disengaged and focused instead on day-to-day service provision.
“There was also a disconnect in the governance of the trust, so senior leaders were not sighted and hence had not taken action to rectify issues and matters arising in wards and departments.
“There were some cultural challenges within the trust and leaders did not always promote equality and diversity in day-to-day work.
“During our inspection of surgery services at Cheltenham General Hospital and Gloucestershire Royal Hospital, both hospitals we visited were incredibly busy and we saw the impact that staff shortages were having on the service.
“The trust have shared their improvement plan with us. We will continue to monitor the trust to ensure it is putting the improvements that are needed in place.”
In response, Gloucestershire Hospitals NHS Foundation Trust said its leaders and managers were ‘understandably very disappointed’ with the rating but remain determined ‘to take the necessary steps to restore and rebuild confidence in their services’.
Deborah Lee, Chief Executive, said: “I am incredibly proud of my colleagues for the work they have done over the pandemic. This has been an unprecedented and challenging period of time in the NHS’s history and staff have been selfless in their efforts to deliver the very best care, in very difficult circumstances.
"However, not all of the findings in this report can be explained away and I am determined that this report will provide further momentum and impetus to address these issues."
Ms. Margaret Coyle, Chief of Service for the Surgical Division and Consultant Oral and Maxillofacial Surgeon, said: “Reading this report has been difficult and I feel disappointed that the work of my colleagues throughout and after the pandemic has not been fully recognised.
"We have put our patients at the centre of everything we do and as a surgeon operating in Gloucestershire, I would like to reassure patients that our services are safe. Currently, our surgical outcomes remain in line with other centres nationally and are better in some areas.
"I have excellent medical and nursing colleagues and I would be happy for a member of my family to have surgery here.”
The Trust added that significant improvements have already been made since the inspectors visited the Trust in June.