Special measures for ‘merger’ trust

The Care Quality Commission has today said that the quality of care provided at Heatherwood and Wexham Park Hospitals Foundation Trust was inadequate, leading the watchdog to recommend the move.

This is the third time in two years that the watchdog has found evidence of inadequate care at the trust, which is expected to be acquired by neighbouring Frimley Park Hospital Foundation Trust.

Inspectors’ probe of the trust’s Wexham Park Hospital site in Slough found that unsafe staffing levels were a “consistent theme” throughout the trust.

The trust’s heavy reliance on agency staff and failure to consistently meet national targets to admit, transfer or discharge patients from the A&E department within four hours, were also reported.

While the trust had opened extra beds to meet demand, inspectors found little evidence of initiatives to reduce unnecessary admissions.

Although regulators found the hospital’s children’s department and critical care unit were both providing a good service, a culture of safety was lacking in most of the hospital, they said.

Prior to this announcement, Frimley Park’s acquisition of the trust was intended to be completed by August, subject to regulatory approval. As yet it is unclear what effect the trust being put in special measures will have on this timetable.

The regulator identified a total of 18 areas for improvement. Among these was a need to properly recruit and retain staff, better staff engagement among clinicians and managers and an incident reporting culture must be encouraged at all levels.

Patient flow must be addressed as a priority to improve the poor waiting times in A&E, the high number of surgical cancellations and delayed discharges from the critical care unit.

England’s chief inspector of hospitals, Sir Mike Richards said: “We know that Wexham Park Hospital has had a long history of problems - and the legacy of these problems is all too apparent in the safety culture, the staffing levels, and the overflowing wards.”

Sir Mike added that the situation could not go on and that the trust leadership, in its present form, is not equipped to make the changes needed to turn the hospital around.

“It is in everybody’s interests that we see the improvements process start immediately - and so I welcome the arrangements made with Frimley Park Hospital NHS Foundation Trust to support Heatherwood and Wexham Park NHS Foundation Trust at this time.”

Mark Turner, regional director at Monitor said: “Patients deserve better, and performance to date has simply not been good enough. They want good quality care provided by their local hospital. The best way for this to happen is a takeover by Frimley Park, and we’re working hard to help make this happen.”

An unannounced inspection by the Care Quality Commission at the Wexham Park site last October found evidence of inadequate care, regular short staffing on “almost all wards”, and a culture where “staff did not always feel they could raise concerns”.

Grant MacDonald, acting chief executive at Heatherwood and Wexham Park said the trust fully accepted the CQC’s findings. “We … welcome the help and support that we will now receive as a result of being placed in special measures,” he added.

“We sincerely apologise to all of our patients and local communities for failing to provide the level of service they deserve. We are committed to tackling all the issues in today’s report with a structured and planned approach that will embed good practice and consistently deliver high quality care.

“This potential acquisition [by Frimley Park Foundation Trust] would offer greater certainty around the Trust’s future and make it easier to recruit and retain good staff. We will continue to pursue this with pace and vigour. I welcome the comments made today by Monitor that: ‘Patients…want good quality care provided by their local hospital. The best way for this to happen is a takeover by Frimley Park, and we’re working hard to help make this happen.’”

Frimley Park said in a statement that it is aware of the “complex issues” at Heatherwood and Wexham Park.

It added: “In supporting HWP we will do all we can to help lift its performance and improve services for local people, while continuing to explore [its] potential acquisition.

“The board at FPH continues to work on a full business case examining the prospects of the acquisition in great detail. As previously stated, this stage is due to be finished by the summer.

“Once completed, the full business case will form the basis of the case made to each trust’s Board and Council of Governors and to the Competition and Markets Authority and Monitor, the foundation trust regulator, in seeking their agreement for the acquisition to proceed.”