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KGH improves its CQC rating – but more work still to do

Date: 27.02.18


Kettering General Hospital has received an improved rating of ‘requires improvement’ in a Care Quality Commission (CQC) report published on February 27, 2018.



The report is based on the most recent inspection of the Trust’s services by the CQC which took place in November and December 2017.



It represents an improved position on the previous rating of “inadequate” which the Trust received in April 2017 following an October 2016 inspection.



The inspection is based on five core questions (also known as domains) that the CQC considers during its inspection regarding whether hospital services are: Safe, Effective, Caring, Responsive and Well-Led.



The Trust is given an overall rating for each of these domains and a rating for each of individual service areas inspected – which on this occasion were Urgent & Emergency; Surgery; Maternity; Children & Young People; Outpatients; and Diagnostic Imaging. Possible ratings the CQC can give are inadequate, requires improvement, good, and outstanding.



Detailed Results – Good for caring


The CQC reported that once again Kettering General Hospital was once again rated Good for Caring both overall and across all six service areas inspected. (*it also achieved this in the 2016 inspection).



It improved its rating for the Safe and Well-Led questions (which last time were rated Inadequate) to Requires Improvement.



It remained at Requires Improvement (the same rating given in the last inspection) for the two remaining categories of Responsive and Effective.



This combination of improvements is why Trust’s overall rating has now gone up from Inadequate to Requires Improvement.



In all of the areas inspected there was not a single domain area in which overall performance deteriorated.



Chairman and Chief Executive Comment



Kettering General Hospital’s Chairman, Alan Burns, said: “I am pleased the work our staff have put into improving safety, and the way we organise and deliver care, has been recognised with an improved overall CQC rating.



“I am also pleased that, once again, the CQC rated our services as good in the caring category both overall and in all of the individual services they visited – as this is at the centre of everything we do and is a key part of our organisational core values.”



Interim Chief Executive Fiona Wise said “The report is a fair representation of where the Trust currently stands and identifies those areas of focus that we are working hard to address and improve.



“We recognise the issues we have in emergency care and diagnostics and continue to work to address them – we are reducing our backlog of diagnostic results and are working on short-term and long term plans to address emergency care, including a bid to completely re-provide the Trust’s emergency department.”



“Overall we also need to ensure that the improvements we have made in risk management and patient safety are embedded across the entire organisation and that we continue to improve the way we learn from mistakes.



“We also need to strengthen our focus on training to enable our staff to consistently deliver the high standards we have set ourselves across all areas of the Trust.”



Responding to issues raised by the CQC



The inspection report also requires the Trust to respond to various areas for improvement (improvement notices) and we will respond to those issues.


They include:



  • Timely care and assessment - In the Emergency Department (A&E) reviewing various internal processes to ensure they are fit for purpose. Improving waiting times.

  • Radiology results waiting times and procedures. The Trust has reviewed its procedures so now only consultant radiologists are allowed to review certain images – previously some of these inpatient images were done by other doctors. We are also addressing a backlog of images reporting delays.

  • Staff training – on safeguarding, mental health and other issues – notably in the Emergency Department (A&E), Surgery, and  Children and Young People’s and Radiology

  • Infection control – improving compliance with Trust’s policies

  • Staffing levels in children and young person’s service and diagnostics

  • Premises and dignity – Facilities for children in A&E not as good as they could be and the outpatients department is not as a private as it could be.



The CQC inspection now includes a Well-Led Review which looks at how well leaders create an environment that encourages improvement.



Inspectors noted: “The Trust was embedding a systematic approach to improving quality of its services and safeguarding high standards of care by aiming to create an environment in which excellence in clinical care would flourish.”



They also noted that leaders mostly had the right skills, knowledge and experience, that they encouraged staff to be open and honest when things went wrong and were embedding Trust core values of being compassionate, accountable, respectful and engaging across all services and staff groups.



They remarked on the Trust having a clear short-term vision and strategy with a longer term one to be developed and that it had established systems to manage risk – but these needed further improvement.



Special measures



Following its Inadequate Rating in April 2017 the Trust was put into Special Measures to enable it to receive additional support in tackling its challenges. The Trust will remain in Special Measures for a while longer - this will enable it to continue to access additional specialist support from NHS Improvement and NHS England.