INFECTION control practices not always followed in A&E.
Blood banks ‘out of order’ on maternity units.
Medical notes left open and unattended.
Agency staff not trained to use electric medicine technology.
Diabetic patients left with no support after medication changes.
No provisions for expectant mothers with mental health problems.
Dementia patients potentially left to go walkabouts.
More than 1,000 patients missing the 18-week referral to treatment target.
These are just some of the issues highlighted in a damning new report by the Care Quality Commission (CQC) about the level of care at The Heart of England NHS Foundation Trust (HEFT).
The Trust, which oversees the running of Solihull, Good Hope and Heartlands hospitals, has again been slammed a year after it was first given a rating of ‘Requires Improvement.’
Following on from the initial report the Trust missed A&E waiting time targets, missed ambulance waiting time targets and the chief executive Dr Mark Newbold resigned.
Inspectors from the health watchdog returned to the trust, unannounced, between December 8 and 11, 2014 – and the inspection failed to see an improvement in the rating as the Trust kept its status as ‘Requires Improvement.’
The inspection looked at A&E, Medicine, Surgery, Maternity and Outpatients Departments at the three hospitals and their findings were released earlier this week.
CQC’s Chief Inspector of Hospitals, Professor Sir Mike Richards, said while there were some areas of good practice, it was clear significant work was still needed to improve services.
He added: “The main areas of concern surrounded overcrowding in the A&E departments at Birmingham Heartlands Hospital and Good Hope Hospital.
“We were also concerned that learning from incidents was not always communicated to staff across all three hospital sites and we found issues with infection control at Birmingham Heartlands Hospital and Good Hope Hospital. The trust needs to ensure these issues are addressed.
“An interim chief executive and medical director were in post when we carried out our inspection and immediate feedback was given to them on our inspector’s findings so they could begin to make improvements.”
Durning the check the inspectors discovered infection control practices were not always followed, including incidents of staff not being bare below the elbow, wearing ties in clinical areas and wearing the same pair of gloves to deliver care to two patients.
The fridge for storing blood in the maternity unit had been out of order for two months on wards before they arrived and the emergency pre-eclampsia boxes in antenatal clinics, which require weekly checks were checked just twice in a year at Solihull Hospital while staff at Good Hope could not locate it ‘in a timely manner.’
It was also noted there ‘was no specialist diabetic nurse available to support patients at Solihull Hospital’.
Inspectors also noted trolleys were left unattended and open near nurses stations and feared the notes were at risk of being tampered with or removed.
At Good Hope emergency department inspectors noted the area patients waited at for transport was near an exit and those of reduced cognitive function were at risk of leaving the department without staff noticing.
Andrew Foster, Chief Executive of Heart of England NHS Foundation Trust, has vowed to work closely with the regulators and develop a detailed improvement plan to address the concerns raised.
He said: “The past year has been a very challenging one for Heart of England NHS Foundation Trust with multiple concerns over performance, governance, finance, workforce and quality.
“In response to the detailed feedback we received immediately after the CQC visit last December, we took a number of immediate actions to address the specific issues it revealed.
“We have accepted the CQC report in full and agreed to implement all of its recommendations.
“Over the past five months we have worked closely with both of our principal regulators, CQC and Monitor, to develop a detailed improvement plan which will enable us to demonstrate our progress in addressing all of the concerns raised.
“We know that these actions will help the Trust function more effectively for patients and be a better place for our staff to work in.”