Major teaching trust to leave special measures

The CQC report, published today, said Norfolk and Norwich University Hospitals Foundation Trust would remain “requires improvement” overall as well as for being safe, responsive, and well-led. However, it was upgraded from “requires improvement” to “good” for being effective, and remained “good” for being caring.

The CQC also published the trust’s use of resources report, which is based on an assessment undertaken by NHS Improvement and attempts to measure efficiency. The trust was issued a UoR rating of “requires improvement”.

The trust was placed in special measures in June 2018. The CQC’s report at the time cited a “deterioration in how the trust was being run” and a “bullying culture”.

The regulator announced last month it was suspending inspections so trusts could focus on the coronavirus outbreak. Today’s report was based on an inspection which took place in December and January, before the suspension came into force.

The regulator said NNUH had made “enough progress to make the recommendation to NHS Improvement to remove the trust from special measures”.

Inspectors said there had been “improvements” in the trust’s culture, but efforts to address some long-standing cultural problems “remained a work in progress”.

CQC chief inspector of hospitals Ted Baker said: “We found pockets of poor culture persisted across some services and staff felt under pressure and were not always able to offer the care which they would like to.

“We have reported our findings to the trust leadership, which knows what it must do to bring about further improvements and ensure it maintains any already made.”

Professor Baker also, however, emphasised some significant material improvements found by inspectors on their return to the trust.

He said: “Inspectors were impressed by improvements made in end of life care services which is now rated as outstanding and outpatients which is now rated as good. The trust’s overall rating for being effective also went up from requires improvement to good.

“We saw excellent multidisciplinary working in most areas we inspected. Patient care was the clear focus of staff discussions and leadership across services was much stronger with teams being clearly sighted on their challenges and risks.

Inspectors visited core services at the trust, including urgent and emergency care, surgery, end of life care, and outpatients.

The trust was served with a fresh notice under section 29A of the Health Act 2008 at its last inspection in May 2019, in which it was upgraded from “inadequate” to “requires improvement” but remained in special measures.

The issues that prompted the enforcement notice, which required the trust to draw up and carry out a plan in agreement with the regulator, had been addressed, the new inspection said.

NNUH chief executive Sam Higginson said in a statement: “[We welcome] the CQC report and we’re very pleased that it recognises the sustained and significant improvements that our fantastic staff have made in patient care here at NNUH. 

“Teams across the whole trust have worked tirelessly with skill and dedication to continuously improve and develop services.   We also welcome the CQC’s recommendation that special measures are removed and look forward to receiving NHS England and Improvement’s decision.

“At requires improvement overall, we still have improvements to make, but these results mark extremely good progress on our journey to outstanding.”