• Medway FT now rated requires improvement, and good for being caring, effective and well led
  • CQC praises “strong leadership and clear communication”
  • Improvements need to be made in urgent and emergency services, surgery and critical care

A hospital which was previously ranked as one of the worst in the country has been removed from special measures.

Professor Sir Mike Richards, the chief inspector of hospitals, said he recommended that Medway Foundation Trust should come out of special measures after “substantial improvements” were made.

NHS Improvement confirmed the trust has been taken out of special measures in recognition of the “major improvement in the services it offers patients”.

It has been rated requires improvement by the Care Quality Commission in a report published today.

The trust was put in special measures in July 2013 following Sir Bruce Keogh’s review of hospitals with higher than average mortality rates.

Sir Mike said: “Two years ago we rated the trust as inadequate overall because of concerns relating to patient safety, the organisational culture and governance throughout the trust.

“The leadership team is now fully established and there is a strong sense of forward momentum. The strong leadership and clear communication are leading to a workforce who are now much better engaged and whose morale is now much higher.”

The trust was rated as good for being caring, effective and well led. Medical care services, maternity and gynaecology and services for children and young people were all rated as good, while maternity and gynaecology were rated as outstanding for caring.

Services rated as requiring improvement were urgent and emergency services, surgery, critical care, end of life care and outpatients and diagnostic imaging.

The CQC report praised Medway for:

  • effective systems to assess and respond signs of deteriorating health;
  • the introduction of “safety huddles” on the wards;
  • a new frailty pathway to enable staff to treat patients quickly and avoid the need for hospital admission;
  • improved discharge planning leading to one of the lowest delayed transfers of care rates in England;
  • effective handovers and safety briefings in the emergency department and improved triaging;
  • patient pathways were well monitored particularly for cancer patients;
  • effective learning systems in place and a culture of openness and transparency; and
  • support to vulnerable patients such as those living with dementia and those with learning disabilities had been significantly improved.

However, concerns were raised about:

  • high levels of bank and agency use in some areas;
  • poor use of facilities and premises in surgery due to lack of available beds; and
  • medical staffing in the emergency department not meeting minimum requirements.

Chief executive Lesley Dwyer was appointed in March 2015. Five months after she started her job as chief executive, trust was rated inadequate overall. She described this moment as “liberating” to HSJ.

Ms Dwyer told HSJ she focused her attention into engaging with staff and making them believe turning around the trust could be achieved.

Interim chair Peter Carter said: “Lesley came in and gave direction, confidence and clarity. She grasped the nettle and dealt with difficult issues. She has only been here for two years but she is the longest serving chief executive in the last seven years.”

Medway was buddied with Guy’s and St Thomas’ Foundation Trust in 2015 to try to help the trust improve its performance

Ms Dwyer said the buddying arrangement was respectful and Medway led. The partnership gave staff “credibility, faith and confidence”, she added.

Dr Carter said buddying also helped the trust recruit staff: “We picked up some excellent staff – a director of nursing and a medical director who had both spent their careers in London teaching hospitals. They came to Medway and saw, worked, liked and applied for the job. It is a tangible demonstration of what a great learning environment Medway is.”