A team of Care Quality Commission (CQC) inspectors visited Portsmouth Hospitals NHS Trust in October and November 2019 to look at the quality of care being provided to people using their services.
Following this inspection, the overall rating of the trust has improved from requires improvement to good. The trust was rated as ‘Good’ for being caring, effective, well-led and responsive to people’s needs, and will remain ‘Requires Improvement’ for being safe.
Five core services
CQC inspected five core services and leadership at the trust. Ratings for medical care (including older people’s care) and surgery had both improved overall and are now rated ‘Good’, outpatients remains rated ‘Good’ overall, whilst urgent and emergency services and outpatients both remain rated as ‘Requires Improvement’.
CQC has also published the trust’s Use of Resources report, which is based on an assessment undertaken by NHS Improvement. The trust has been rated as ‘Good’ in this area.
Campbell: “Staff should be proud of positive progress made”
Catherine Campbell, CQC’s Head of Hospital Inspection for the South East said:
“Portsmouth Hospitals NHS Trust has made improvements since our last inspection. Overall, the trust has improved from ‘Requires Improvement’ to ‘Good’ which is great news for people using these services.
“Our inspectors found that the culture within the trust had improved and patients benefited from more coordinated care with local organisations. We found that care was inclusive, and staff supported people’s needs and preferences.
“All the staff at Portsmouth should be proud of the positive progress that’s been made.
“However, although people told us they were treated with kindness and compassion, further improvements are required in safety to some areas of the trust, which we rated as ‘Requires Improvement’.
“These include the need for rapid improvement in the emergency department where we have concerns about people being cared for safely and in a timely way. I expect to see improvements in this area when we return, and we will continue to monitor this closely.”
Improvements in culture of the trust
Inspectors found that the culture of the trust has improved overall. Leadership were now visible and approachable, and staff felt respected, supported and valued.
Staff treated patients well and with compassion and dignity and they also extended this support to families who were distressed by seeing their loved ones in care.
Care was found to be inclusive of patient’s needs, with their preferences, cultural and religious needs understood by staff. Patients’ care was coordinated and planned within the wider system, including working with local organisations.
Tackling recruitment
The trust was innovative in their approach to recruitment of overseas nurses. This program increased staffing levels, as it helped recruit, train and settle nurses into their role.
The trust had also developed a multi birth facility, which offered a one stop clinic that helped women with continuity of their care.
Emergency department
However, although the rating for being responsive to people’s needs had improved to requires improvement, the emergency department was frequently crowded with patients being held for long periods in ambulances outside the department and some sicker self-presenting patients had to wait for a care space to be available in the major treatment areas.
Where action is needed
We told the trust that it must take action to bring some services into line with four legal requirements. This action related to:
Maternity:
- Care and treatment must be provided in a safe way and processes must be in place to control and prevent the risk of infection.
- Women attending the maternity assessment unit must have timely assessments and care to meet their needs.
Surgery:
- Patients with airborne infections must be isolated effectively in side rooms to prevent the spread of infections.
Urgent and emergency services:
- Patients who attend the emergency department must be able to access care to be seen in a timely way and within the right setting.
- Nursing staff must treat patients with dignity and respect, including those waiting in the corridor or reception areas.
- Staff must ensure that self-presenting patients are seen in a safe and timely manner and they must have an oversight of the wellbeing of patients to identify if they are deteriorating.
- Care and treatment must be provided in a safe way and processes for cleaning must be developed to prevent and control the risk of infection.
The report
Full details of the ratings, including a ratings grid, are given in the report published on the CQC Website.
News shared by John on behalf of the CQC. Ed
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