'Inadequate': Hospitals trust behind Pilgrim Hospital back in special measures

[Isle of Wight, UK] The CQC has found the Isle of Wight NHS Trust's "poor" IT infrastructure for adult community health services had an impact on management of care, placing the organisation in special measures.

Its report gives the trust an overall rating of "inadequate" but Grantham A&E is giving a rating of "good".

England's Chief Inspector of Hospitals has made the recommendation regarding United Lincolnshire Hospitals NHS Trust following the CQC's latest inspection of Pilgrim Hospital, Lincoln County Hospital and Grantham Hospital.

The trust provides acute, ambulance, community and mental health services to around 140,000 people living on the channel island.

At the start of the year, trust leaders told the NHS that the FT's emergency department was on "black alert" as patients were being advised to seek alternatives to A&E as doctors struggled to cope with rising demand.

"In particular, there must be significant improvements in the quality and safety of patient care, leadership and managerial oversight of quality and performance and effective implementation of the existing governance arrangements consistently across all of the services". Staff could not access caseload data, emails or report incidents through an electronic system whilst with the patient on site.

"We have an improvement plan under way which is addressing the areas highlighted by the CQC".

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Last month, ahead of the damning report, Karen Baker, the former chief executive of the Isle of Wight NHS Trust, made a decision to stand down from her role and executive medical director, Dr Mark Pugh, has been appointed acting chief executive. Inspectors also found throughout the trust a culture of subtle bullying from staff.

The CQC report is based on a combination of what inspectors found when they inspected the Trust in late 2016 and early 2017 and information given to them by patients and carers, the public, NHS staff and other organisations.

Meanwhile, not all staff had the skills and knowledge required to undertake their role, with some nursing staff in acute medicine services lacking key competencies to care for patients.

Overall, the CQC has rated the Isle of Wight NHS Trust as "Inadequate". "My inspectors found people were exposed to unacceptable risk of harm". On the mental health wards staff did not always report safeguarding incidents to their local teams and wards were not holding local records of ongoing safeguarding concern. "There was poor communication of safeguarding concerns when patients were transferred between services". "I will be pressing for this to be considered closely in the coming weeks and I hope that we can see further improvement for Grantham residents". The only measure found to be "good" was Caring.

This was true across all eight services inspected. However, that can not and does not excuse the multitude of serious concerns highlighted in these highly critical reports.

Urgent improvements were also needed in services for children and young people, with significant risks having neither been "recognised, assessed or mitigated".

In addition, care and treatment must be provided in a "safe way" by following the British Cardiovascular Society guidance on nurse staffing numbers in the coronary care unit. Staff did their upmost to provide care that was compassionate, involved patients in decision making and provided good emotional support to patients and those close to them.