Sherwood Forest Hospitals Out of Special Measures and rated as ‘Good’ for Safety
King's Mill Hospital, Newark Hospital and Mansfield Community Hospital have been lifted out of special measures
Staff at Sherwood Forest Hospitals are today celebrating not only the positive report following the Trust’s recent CQC inspection, but also the announcement that it is officially out of special measures.
NHS Improvement’s decision to remove special measures as a result of the quality improvements made was taken in response to CQC’s recommendation, which, in turn, follows their recent inspection.
The Trust was placed in special measures in 2013 following concerns over mortality rates; and later in 2015, CQC identified specific issues with the Trust’s management of sepsis. Today Sherwood Forest Hospitals is among the best performing in the country for both, and is also performing well in many other areas such as the 4-hour emergency care standard and other waiting targets, tackling C-Diff, and managing patients at risk of cardiac arrest.
The CQC report, published today, sets out findings of the inspection carried out in July 2016. For the area of ‘Safety’ the Trust is now rated overall as ‘Good’, which is two ratings higher than the ‘Inadequate’ rating given last year. For ‘Well Led’ the Trust has also improved, and is now rated as ‘Requires Improvement’, which reflects the need to fully embed and sustain the effective systems and processes put in place over the past year. The Trust’s overall rating has therefore been upgraded from ‘Inadequate’ to ‘Requires Improvement’.
CQC Inspectors visited the Trust this summer to look specifically at the areas flagged as being of concern in their previous inspection in July 2015. Inspectors found that significant improvements have been made and noted a number of areas of outstanding practice, including the management of sepsis and other changing risks to deteriorating patients, and the implementation of a medical care pathway for frail older patients with minor orthopaedic injuries who also have other health conditions. There are also some areas for improvement on which the Trust will focus during the coming weeks, including include staff awareness and understanding of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards.
Peter Herring, Chief Executive, said: “I am immensely proud of what staff have achieved here at Sherwood Forest Hospitals. They deserve to celebrate today’s news and take this opportunity to reflect on everything they have contributed to improving the quality of care over the past year. However, we cannot stand still and there is yet more to be done. We want this Trust to be ‘outstanding’, and our Board committed in this month’s public meeting to focusing on this over the next year. Once today’s celebrations are over, we will turn our attention to building on the improvements we’ve made and addressing our other top priorities, which include recruiting to a significant number of nursing and other clinical roles, establishing a stable leadership team, and engaging with staff to ensure we deliver the very best care possible within our available resources.
“We remain committed to developing a strategic partnership with Nottingham University Hospitals, and I would like to thank colleagues for their support over the past six months. Both parties have benefited from joint working and shared learning, and the excellent work of clinicians from both Trusts has helped support a number of the improvements we have made here at Sherwood Forest Hospitals.”
Carolyn Jenkinson, the CQC’s Head of Hospital Inspection, issued a message to staff at Sherwood Forest Hospitals, saying: “To see your trust being brought out of special measures is a mark of the improvements that our inspectors found when we visited in July.
“Having spoken with many of you I know the challenges you have faced. However you have embraced those challenges and worked hard to get to where you are today. When we came back to the Trust we could see how things had changed, that care was safer and patients were getting better quality care.
“There is still work to be done and improvement to be made but don't lose focus, be proud and keep striving to be the best you can be.”
The news has also been welcomed by Health Minister Philip Dunne MP, who said: “Every patient at Sherwood Forest Hospitals NHS Foundation Trust deserves the best possible quality of care and I am pleased the Trust is now exiting Special Measures.
“The hard work and effort of staff since their last inspection has led to significant improvements – in particular in the management and treatment of sepsis cases and reduced A&E waiting times.
"There is still work to be done in solving some challenges faced by the Trust, but today's announcement is further evidence that placing trusts into Special Measures can lead to positive progress and help with fixing long term problems.”
The service areas inspected in the July 2016 inspection were:
- The safety of Emergency and Urgent Care Services at King’s Mill and Newark Hospitals
- The safety and effectiveness of medical services at King’s Mill, Newark and Mansfield Community Hospitals
- The safety of maternity services at King’s Mill and Newark Hospitals
- The safety of outpatient (but not diagnostics) services at King’s Mill and Newark Hospitals.
For more information on special measures, please visit: www.nhs.uk/NHSEngland/specialmeasures/Pages/about-special-measures.aspx
Key performance facts and figures for Sherwood Forest Hospitals:
Sepsis: Sherwood Forest Hospitals is among the top 30 best-performing trusts for the management and screening of the potentially fatal condition sepsis
HMSR: The Trust’s Hospitalised Standardised Mortality Ratio (HSMR) – the way hospitals measure mortality for the 12 months to July is 94. The HSMR gives a score for each hospital, taking into account the health of the local population. Anything below 100 is better than expected for a hospital of our size and nature.
Infection control: Cases of C. Difficile infections have been reduced by a third each year for the past two years. There have been no recorded cases of MRSA bacteraemia blood infections for 15 months.
Length of stay: The average time spent in hospital by patients during the year ending March 2015 was 7.73 days. During the 12 months to April 2016, the length of stay was down to 6.45 days and during September 2016 the length of stay was 6.07 days.
Managing patients at risk of cardiac arrest: The number of people suffering cardiac arrests while in our hospitals is down from three patients per 1,000 in July 2013 to the national average of 1.8 per 1,000 patients.
Emergency 4-hour waiting standard: For the three months ending 31 September, the Trust achieved the national target of seeing and treating 95% of emergency department attendances within four hours; and in October 2016 the Trust achieved 96%. This puts Sherwood Forest Hospitals among the top 30 performing in the country for the four-hour target. In contrast, in December 2014 the Trust was seeing 86% of patients within four hours and was fifth from bottom among England’s 136 Trusts offering an emergency department service.