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The government-ordered “rapid review” into care quality at Nottinghamshire Healthcare Trust has concluded and the Care Quality Commission has set out a series of recommendations for the trust and for its high secure hospital, Rampton.

The review was prompted by the killings of Ian Coates, Grace O’Malley-Kumar and Barnaby Webber by Valdo Calocane last June. Mr Calocane was treated for paranoid schizophrenia at the trust for a number of years.

While the specific findings of Mr Calocane’s care are due to be reported in the summer, the CQC told the trust to make various improvements, including pairing Rampton with another high secure hospital and forming a relationship that should “go further” than normal. It remains unclear which of the two other hospitals in England and Wales Rampton will be paired with.

The CQC also highlighted concerns within the community mental health division at Notts Health and set out an intention to carry out a bigger piece of work looking at care quality in this area.

The trust can expect continued oversight from NHS England and the health and social care secretary Victoria Atkins, who said she has asked to be updated regularly on the ongoing improvement work at Notts Health. 

However, the problems across the various services the trust provides, from community mental health to its high secure hospital, have been years in the making and will take more than a “critical friend” or pressure from above to fix.

Targets raised, funding secured

Trusts will be instructed to meet the four-hour accident and emergency target in 78 per cent of cases by next year, following an agreement between NHSE and the government, HSJ understands.

The new target represents a modest increase of 2 percentage points from the current year’s target of 76 per cent and is expected to be achieved by March 2025, according to NHS planning guidance.

NHSE will also strive to uphold the average of “core” general and acute beds at 99,000 throughout 2024-25, following the allocation of funding by the government. This level would maintain bed capacity at recent levels but signify a notable increase in the permanent “sustainable” beds within the healthcare system compared to previous years.

The additional capacity aims to enhance performance within the four-hour timeframe.

During much of 2023-24, most trusts have fallen considerably short of the 76 per cent target. NHSE has urged them in recent weeks to make final efforts to approach the target before the March 2024 deadline. Measures have included offering new capital funding incentives for improvement and directing trusts to prioritise non-admitted patients.

Also on today

In Recovery Watch, James Illman explains why a refresh of the elective recovery plan is much needed, and in Comment, Christine Camacho and Rachael McKeown say that a new NHS Providers guide for trusts provides a comprehensive framework for identifying, prioritising and addressing health inequalities.