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Bucks Hospitals Out Of Special Measures

Stoke Mandeville Hospital

12:02am 20th June 2014

The NHS Trust Development Authority (TDA) has today confirmed the Buckinghamshire Healthcare NHS Trust (Bucks Healthcare) is to come out of special measures, but will continue to receive support.

The Trust was placed into special measures in July 2013 after Professor Sir Bruce Keogh inspected the Trust and found poor engagement with staff and patients, weak governance and assurance structures and concerns about nurse staffing numbers.

Since the inspection, Bucks Healthcare has followed a robust improvement plan that's included recruiting more nurses, better engagement with staff and patients and the board being more aware of what is happening on the wards.  They have also recruited over 200 qualified nurses and additional consultant cover.

The TDA supported Bucks Healthcare to deliver key improvements by setting up a relationship between the Trust and the high performing Salford Royal NHS Foundation Trust, appointing an experienced Improvement Director and making changes in the leadership of the organisation.  This has resulted in strengthened leadership with the appointment of a new Chair and a systematic and sustained approach to quality and safety improvement.

After re-inspection under the CQC's new inspection regime, they have recommended that the Trust comes out of special measures with the condition that it continues to receive ongoing support.

Professor Stephen Dunn, Director of Delivery of Development at the NHS Trust Development Authority, said:

"This is excellent news for the patients and staff at Buckinghamshire Healthcare NHS Trust and is recognition of the hard work and scale of improvement that has been achieved.  It shows that the support that this trust has had can make a real difference to improving the quality of services.  

"However, there is still work to be done before the Trust no longer needs support.  It is absolutely crucial that they are able to maintain the momentum and focus that got them this far and continue to deliver improvements for patients."

Trust Chief Executive Anne Eden said:

"Today marks a really important step in our quality improvement journey. This has been a challenging year for us, but we have taken our responsibilities very seriously and I have been heartened by how tirelessly staff have worked to improve standards to ensure our patients are offered the safe and compassionate care we strive for.

I am pleased that the inspection team recognised these improvements and the positive difference it has made to our staff and patients. In particular, I am delighted that they made special mention of how caring our staff are, as this is fundamental to a good patient experience."

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

"We recognise that Buckinghamshire Healthcare NHS Trust has worked hard to improve since being placed in special measures last year.  

New services have been introduced and services reorganised to manage the flow of patients through the hospital and improve emergency care.  We found that staff at all levels were positive about working for the Trust. They told us that real differences had been made in a relatively short time with a sharpened focus now on quality and safety."

The CQC looked at nine service areas across the three main hospital sites: A&E, medical care, surgery, critical care, maternity, children and young people, end of life care, outpatients, and the National Spinal Injuries Centre. Each service and the Trust overall was assessed against five domains: whether they were safe, caring, well-led, effective and responsive. Against this the Trust received three 'requires improvement' and two 'good' ratings for caring and effective.

The National Spinal Injuries Centre received 'outstanding' for being effective and the Trust's critical care team at Stoke Mandeville hospital received 'outstanding' for being caring and effective.Other examples of outstanding and good practice found by the CQC include:-    

  • Services in critical care, maternity and family planning, children's care and the National Spinal Injuries Centre were rated overall as 'good'

  • The 'care and emotional support for patients in the critical care unit and National Spinal Injuries Centre were outstanding'

  • Outcomes for patients who used the stroke and cardiac services at Wycombe Hospital were significantly better than other trusts in England

  • The hydration of patients had improved through an innovative 'Evian Project' introduced across the Trust

  • Amersham Hospital's Neurorehabilitation Unit's approach to multidisciplinary working to coordinate care and involve patients in their treatment

  • Patients said they felt involved in their care

  • The specialist palliative care service provided a 'safe, effective and responsive service' with the Hospice described by one patient as a 'five-star hotel'.

Inspectors identified 10 'must do' actions relating to: urgent care, medicines management, care planning and end of life support on general wards.

Anne Eden added:

"We will not be complacent. We know there is more work still to do and welcome the continued support provided by the Trust Development Authority. We must sustain the improvements already made as well as take swift action against the CQC recommendations, which are part of our ongoing quality improvement plan. Indeed work to deliver them is already underway, including £120k investment in additional equipment in our A&E department.

We have also had very helpful discussions with our local health and social care partners about how we must collectively work to improve access to urgent care services and supporting patient discharge."

Importantly, I am keen that we continue to work with our patients and communities as we make further improvements."

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