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It was the best of times

Irish author Derek Landy once wrote “plans are an invitation to disappointment” – an observation many NHS managers can relate to. But thankfully his words do not extend to Dorset Healthcare University Foundation Trust.

In June 2015, inspectors from the Care Quality Commission highlighted concerns about the trust’s child and adolescent mental health services, a lack of clinical leadership at two minor injury units and “inconsistencies in the planning and delivery of a number of services across the trust”.

Handed a “requires improvement” rating overall and in four of the CQC’s five key domains (safe, effective, responsive and well-led), the trust needed to change.

Four years on, it’s clear the trust did exactly that.

The CQC’s report from an inspection in late spring this year – in which the trust was rated “outstanding” – was full of praise for the trust’s “rare” use of restraint, “gold standard” wards for older people with mental health problems, and a “strong patient-centred culture” in adult community health services.

Through many inclusive schemes, such as reverse-mentoring and more leadership support, the trust has achieved a significant turnaround, which will surely be an inspiration for any NHS organisations currently on the receiving end of a less-than-terrific CQC rating. 

It was the worst of times

This week, two private hospitals owned by Priory Group were rated “inadequate” and placed into special measures after inspectors uncovered a catalogue of problems within the services.

Shocking observations were recorded in the CQC reports. Some staff at Kneesworth House in Hertfordshire were accused of being “uncaring and disrespectful”, with patients claiming they felt they had to sleep in trainers as staff used keys to prod their feet and legs to get them out of bed.

Meanwhile, children who were being cared for at Priory Hospital Blandford in Dorset told inspectors they did not feel safe on the wards. Inspectors also raised concerns staff at the hospital for children and young people with learning disabilities and mental health issues “did not have the experience and skills to manage the complex needs of the young people on the wards”.

Priory Healthcare said Blandford has suffered “from being unable to attract suitably-qualified nurses and clinicians with the expertise to meet the needs of this complex patient group”, adding that action had been taken to address the issues.

However, recruitment obviously isn’t an issue exclusive to Priory Hospital Blandford, with countless hospitals facing the same battle across the country, and the idea that vulnerable people are allowed to suffer because the organisation has struggled to recruit staff leaves a bad taste.

Off the back of the inspection, NHS England suspended admissions at Blandford until further notice. Both hospitals now have up to six months to make improvements before another inspection.