COVENTRY’S University Hospital is rated as ‘Good’ in a report published today after improving on its ‘Requires Improvement’ rating.
It comes despite ongoing failures to meet waiting targets this winter in A&E, a familiar picture in the NHS nationally.
The Care Quality Commission (CQC) undertook an inspection of clinical services at University Hospitals Coventry and Warwickshire NHS Trust in October and November.
Inspectors rated the trust Good overall, highlighting five outstanding areas.
The trust – which includes Hospital of St Cross, in Rugby – is rated Good for being safe, effective, caring and well-led.
But it rates as ‘Requires Improvement’ for the category of being responsive.
Inspectors have also recommended that governance arrangements, training requirements and assessment processes are further strengthened in Neurosurgery – rated as Requires Improvement. Clear action plans are in place to address all focus areas identified.
In a further assessment by NHS Improvement alongside CQC’s latest inspection, the trust is rated Requires Improvement for using its resources productively.
CQC Chief Inspector of Hospitals, Professor Ted Baker, said: “Our latest inspection found several areas where the quality of care and treatment had improved at University Hospitals Coventry and Warwickshire NHS Trust, compared to our 2018 findings.
“Urgent and emergency care at University Hospital Coventry had enough staff with the right training and skills. The department’s infection risk was well controlled, and staff acted quickly for patients at risk of deterioration. Records were appropriate, and information was used to improve the service.
“University Hospital Coventry’s critical care – which monitors and treats people with life-threatening conditions – helped patients make informed decisions about their care and achieve good outcomes. The hospital’s maternity service worked in a safe and well-designed environment, where staff managed incidents well.
“Outpatient services at the Hospital of St Cross, in Rugby, benefited from leaders who engaged openly with patients, staff, equality groups, the public and local organisations to plan, manage and improve services.
“However, the inspection identified some issues for the trust to address. On University Hospital Coventry’s neurosurgery ward, some staff were not compliant with training requirements and infection risk was not consistently well controlled. There were not enough nursing and support staff with the right qualifications, skills and training. Records did not always follow national guidance.
“I welcome the improvements the trust has made. Its board knows the issues it needs to address. We continue to monitor the trust and will return to carry out further inspections.”
The rating comes after NHS England recorded its worse A&E waiting time performance figure on record in December 2019 – with official data showing only 79.8 per cent of emergency patients were seen within the four hour target.
Like much of the rest of the country, hospital A&E waiting times have been under constant pressure at University Hospital Coventry. Patients were reported to have waited up to seven hours to be seen over one weekend in October.
In total, 77.3 per cent of patients at UHCW were seen within the four-hour A&E waiting target in December. It was 75 per cent in November and 80 per cent in October.
The Hospital of St. Cross in Rugby is rated as Good.
Professor Andy Hardy, chief executive officer, said: “We’re delighted that the hard work and improvements made since our last inspection have been recognised by the CQC.
“We are very proud of our skilled employees and the professional and dedicated way in which they provide the highest levels of care and compassion.
“This was recognised by the CQC, who praised staff for being ‘fully committed and passionate about achieving the best possible outcomes for patients’.
“Our aim is to offer the best possible patient experience and to be a national and international leader in healthcare. This report shows we are achieving real progress on that journey.”
The Trust has been working closely with the renowned Virginia Mason Institute in America over the last five years to further improve patient care and reduce waste through its improvement methodology known as UHCWi.
Inspectors complimented the “very open and transparent” culture of the organisation as well as the high levels of engagement in place with patients, staff, equality groups, the public and partner organisations to plan and manage services.
Inspectors witnessed areas of outstanding practice across the trust, including:
• a new tool to manage referral to treatment waiting times, under implementation. This used seasonal fluctuations to help plan referrals.
• a very proactive patient safety response team, supporting immediate review of all significant incidents.
• an effective process in urgent and emergency care at University Hospital Coventry to escalate patients requiring further assessment.
• exceptional support for staff development in critical care at University Hospital Coventry.
• a world-class centre studying miscarriage, operating in the maternity service at University Hospital Coventry. Tommy’s National Centre for Miscarriage Research includes a biomedical research unit with dedicated midwives recruiting patients for National Institute for Health Research studies.
The trust has been told it must make some improvements, all in neurosurgery at University Hospital Coventry, including:
• ensuring patients who may lack capacity to consent to routine care and treatment are appropriately assessed. This must be recorded in patient records.
• consultants must work within guidelines.
• effective governance procedures must be used – particularly throughout theatres – to ensure quality, risk management and performance is accurately recorded and reviewed.
• nurse staffing must be addressed to ensure patients are safe.