Addenbrooke’s Hospital placed in special measures

ADDENBROOKE’S Hospital was rated inadequate in a Care Quality Commission report released yesterday.

Inspectors who visited in April and May found Cambridge University Hospitals (CUH) faced a ‘number of serious problems’ including a significant shortage of staff and large numbers of routine operations frequently cancelled.

The report published yesterday said significant pressures led to regular closures and a midwife-to-birth ratio worse than the recommended level.

Inspectors highlighted one example where high levels of nitrous oxide were detected in the Rosie Birthing Centre – an issue which senior managers had apparently been aware of for over two years.

However, the only action taken to address this risk was to ‘advise staff to open windows where possible’.

Important messages from the clinical divisions were not highlighted at trust board level and inspectors were concerned that identified risks were not always being addressed, with some on the risk register since 2006.

Pressure on surgical services meant routine operations were frequently cancelled and patients were waiting longer for operations.

Some patients experienced long delays in getting outpatient appointments with the longest wait for a first appointment for ophthalmology being 51 weeks.

Inspectors also found there was a disconnect between what was happening on the front line and the senior management team with staff satisfaction poor and plans to support staff and improve the culture not good enough.

Prof Sir Mike Richards, CQC’s Chief Inspector of Hospitals, said: “We found a number of serious problems when we inspected the services run by Cambridge University Hospitals NHS Foundation Trust and I have made a recommendation to Monitor that the trust should be placed into special measures.

“We made Monitor aware of our concerns following the inspection and it has begun to work with the trust to make sure these are appropriately addressed and that progress is monitored.

“We were concerned that in some services, staff were caring for people in areas unfamiliar to them, meaning patient safety and welfare was placed at risk.

“However, staff were hard working, passionate and caring throughout the trust, prepared to go the extra mile for patients, but having to swim upstream against the pressures they faced. Because of the quality of care delivered by the staff, we rated the trust as ‘outstanding’ for caring.”

During the inspection, there was a backlog of 227 ophthalmology and 233 dermatology patients waiting for a call back and a total of 605 across all specialities.

The report also found the introduction of the new £200 million eHospital system had ‘affected the trust’s ability to report, highlight and take action on data collected on the system’ and medicines were not always prescribed correctly due to its limitations.

Inspectors rated the trust’s services ‘inadequate’ in three out of five areas regarding whether services are safe or responsive to people’s needs but rated it ‘outstanding’ for staff care.

The CQC said the trust, which is one of the largest in the country with more than 1,000 beds, needs to make a number of improvements and will carry out further inspections and unannounced visits to check they have been made.

The report comes a week after the trust’s chief executive Dr Keith McNeil and chief finance officer Paul James stepped down in the wake of the ‘very serious challenges’ faced by the trust which is spending £1.2 million more a week than it earns.

Jane Ramsey, chairman of Cambridge University Hospitals NHS Foundation Trust, said: “I would like to say sorry to our patients for a lack of effective systems and processes across our Trust, which has led to the Care Quality Commission today rating our hospitals as inadequate.

“We take this, and being placed in ‘special measures’ by our regulator Monitor, very seriously. Part of Monitor’s enforcement action means we have a number of clearly defined quality, financial and governance failings to rectify as soon as possible. We will take rapid action to address these concerns and maintain our record of safety and high-quality care.”

“We are determined to put this right as quickly as possible, to make sure our processes are robust and transparent, so every step of a patient’s journey can be effectively monitored from the ward to the Board.

“We have already taken action to address some of these concerns, including recruiting more staff and ensuring an effective nitrous oxide extraction system is in place by the end of the year. We will be working with the CQC, Monitor, our partners and staff to develop further action plans to rapidly address the rest of the concerns and we are confident we will have them in place quickly.”