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Trust recognised as 'good' for caring as long term improvement journey continues

Posted: 28 February 2019

Picture of Watford Hospital, St Albans City Hosptial and Hemel Hemspead Hosptial

Care, commitment and the dedication of hardworking staff have led to West Hertfordshire Hospitals NHS Trust more than doubling the number of ‘good’ ratings since its first Care Quality Commission inspection in 2015.

The trust, which manages Watford General Hospital, Hemel Hempstead Hospital and St Albans City Hospital, now has 45 ‘good’ ratings compared with 20 in 2015 showing how dramatically the balance has tipped towards improvement.

Last autumn’s partial inspection covered urgent and emergency care, medical care, surgery and maternity at Watford General Hospital. The Minor Injuries Unit (MIU) at St Albans City Hospital and the Urgent Treatment Centre (UTC) at Hemel Hempstead Hospital were also inspected.

Inspectors noted that staff cared for patients with "compassion, kindness and respect” and were quick to commend examples of outstanding practice in the children’s emergency department, medical care and maternity at Watford General Hospital.

Bereavement care and support, multidisciplinary working in the dementia and stroke units and the ISeeU initiative in the maternity department (which enables mothers to stay connected to their newborns receiving care in the neonatal intensive care unit) were all praised.

The biggest uplift was in the emergency department (ED) at Watford General Hospital which has improved from ‘inadequate’ to ‘requires improvement’. And its assessment against the ‘well led’ domain has risen significantly by two ratings to ‘good’. The inspectors noted a "strong, supportive and visible leadership” reflecting the determined efforts of staff to make changes.

They also commented on "an improvement in culture”.

In spite of a lower rating in the ‘safety’ domain for maternity, overall the picture at Watford General is extremely positive with a trend of continuous improvement and strengthening of services since 2015. Surgery and Medicine reflect this upwards trend with their improved overall ratings at Watford moving up from ‘requires improvement’ to ‘good’.

Feedback for the MIU at St Albans City Hospital has led to an ‘inadequate’ rating for this service and this has resulted in an overall ‘inadequate’ rating for St Albans City Hospital. The trust acted immediately to rectify issues raised by inspectors and has implemented an action plan for further improvements. The Urgent Treatment Centre (UTC) at Hemel Hempstead Hospital was rated ‘requires improvement’ but inspectors observed "excellent multidisciplinary working” and the compassion of staff.

Surgery and outpatient services at St Albans are rated ‘good’ and these services care for the majority of patients who visit the hospital. Surgical staff were commended for "creating an environment in which excellence in clinical care would flourish”.

Trust chair Professor Steve Barnett said: "We have achieved these positive results in spite of the challenges raised by operating in buildings across three sites that are past their best. I’m immensely proud of the dedication of our staff who continue to deliver the very best care for our patients in a far from ideal environment. I’m delighted that the funding is almost within reach to help us make progress with our redevelopment plans which are gathering pace. The strength of West Herts lies in its people and on my last day as trust chair, I can confidently say that I’m leaving the trust in safe hands and that a bright future beckons for staff and patients.”

Acting chief executive Helen Brown said: "I’m delighted that the inspectors have recognised the work of our hard working and compassionate staff. Congratulations to staff in our children and young people’s service at Watford, and the surgery team at St Albans for achieving ‘good’ for all aspects of their services. And praise must go to the emergency department team at Watford for jumping up two ratings to achieve ‘good’ for leadership. This is remarkable given the pressures they work under.

"I fully recognise that our improvement journey has a long path. Naturally, we’re hugely disappointed with the ratings for our Minor Injuries Unit and the Urgent Treatment Centre and our teams are working hard to make improvements. Local residents should still feel confident that they will receive appropriate care from the two services.”

The CQC assesses five aspects of a site or service – safe, caring, responsive, effective and well-led – and awards them ratings: inadequate, requires improvement, good or outstanding. The full ratings can be found in the summary below.

Ends

Notes to editors

1. The CQC inspection report is available here: www.cqc.org.uk/provider/RWG

2. For highlights of the report, including ratings tables, see below.

3. For more information, please contact the communications team on: 01923 436280 or email: communications@whht.nhs.uk. Out of hours, please call 07900 228031.

4. West Hertfordshire Hospitals NHS Trust serves people from across Hertfordshire, north London and further afield. It operates from three hospitals; Watford General, St Albans City and Hemel Hempstead. The trust has a catchment area of over 500,000 people and is one of the largest employers locally, with around 5,000 staff and volunteers.

5. For more information about our hospitals, visit www.westhertshospitals.nhs.uk. You can also join our followers on Twitter (twitter.com/westhertsNHS) and find us on Facebook (facebook.com/westhertsNHS).

Highlights of the Care Quality Commission report on West Hertfordshire Hospitals NHS Trust published 28 February 2019

Background

This was the fourth inspection of the trust and the first using a new methodology which inspects a select number of core services.

The first inspection took place in April and May 2015. The trust was rated ‘inadequate’ overall and went into special measures.

The trust was inspected again in September 2016 and was rated ‘requires improvement’ overall. It remained in special measures.

The third inspection took place between 30 August and 1 September 2017 when Watford General Hospital, St Albans City Hospital and Hemel Hempstead Hospital were all inspected. Unannounced inspections of all three hospitals took place on 12 September 2017.

The latest inspection took place through a series of unannounced inspections from 16 October to 30 November 2018 where the CQC visited a select number of core services; the trust was also inspected overall under the well-led domain from 28 to 30 November.

The CQC inspected urgent and emergency care, medical care, surgery and maternity at Watford General Hospital. They also inspected the Minor Injuries Unit (MIU) at St Albans City Hospital and the Urgent Treatment Centre (UTC) at Hemel Hempstead Hospital.

Results

The overall rating for the trust is ‘requires improvement’. The trust was rated as ‘requires improvement’ for safe, effective, responsive and well led and ‘good’ for caring.

Of the six core services that were inspected, one was rated ‘inadequate’, two as ‘requires improvement’ and three as ‘good’.

Comparison of the proportion of ‘inadequate’ and ‘good’ ratings shows progression since the first inspection in 2015.

  Inadequate Good
2015 15 20
2018 3 45

Overview of ratings

  Safe Effective Caring Responsive Well-led   Overall
Trust overall Requires improvement Requires improvement Good Requires improvement Requires improvement   Requires improvement

Watford General Hospital

  Safe Effective Caring Responsive Well-led   Overall
Urgent and Emergency Requires improvement Good Good Requires improvement Good   Requires improvement
Medical Care Requires improvement Good Good Good Good   Good
Surgery Good Good Good Requires improvement Good   Good
Critical care Good Good Good Requires improvement Good   Good
Maternity and family planning Requires improvement Good Good Good Good   Good
Children and young people Good Good Good Good Good   Good
End of life care Good Requires improvement Good Good Good   Good
Outpatients and diagnostic imaging Requires improvement Inspected but not rated1 Good Good Good   Good
Overall Requires improvement Good Good Requires improvement Good   Requires improvement
             

St Albans City Hospital

  Safe Effective Caring Responsive Well-led   Overall
Minor injuries Unit

Inadequate

Requires improvement

Good

Requires improvement

Inadequate

Inadequate

Surgery

Good

Good

Good

Good

Good

Good

Outpatients & diagnostic imaging

Requires improvement

Inspected but not rated1

Good

Good

Good

Good

Overall

Inadequate

Requires improvement

Good

Requires improvement

Inadequate

Inadequate

Hemel Hempstead Hospital

  Safe Effective

Caring

Responsive Well-led   Overall
Urgent Care centre Requires improvement

Requires improvement

Good

Good

Inadequate

Requires improvement

Outpatients & diagnostic imaging

Requires improvement

Inspected but not rated1

Good

Good

Good

Good

Overall

Requires improvement

Requires improvement

Good

Good

Inadequate

Requires improvement

             

CQC notes:

1. There is insufficient evidence to rate effectiveness for Outpatients & Diagnostic Imaging.