• CQC recommends Royal Cornwall Hospitals Trust be taken out of special measures
  • Trust’s “requires improvement” rating remains same after CQC inspection
  • Strong turnarounds in maternity and well-led domain 

A trust is due to leave special measures, after problems with quality and bullying landed it in the regime more than two years ago. 

The Care Quality Commission has today recommended Royal Cornwall Hospitals Trust should be taken out of special measures, following inspections in November and December.

The trust has retained its “requires improvement” overall rating, and was rated “requires improvement” for safety and responsiveness and “good” for effective and caring. Its rating for well-led was upgraded from “inadequate” to “good”. 

The trust was put in special measuresin October 2017 after the CQC highlighted a string of failings, such as reports of bullying, significant delays in the reporting of serious incidents and never events, backlogs of follow-up appointments, and insufficient capacity within the maternity services. 

Kate Shields, who replaced Kathy Byrne as the trust’s CEO in July 2018, told HSJ she was “delighted” and added the CQC’s decision was a “testament” to the staff.

Asked about the trust’s improved leadership rating, Ms Shields said it had expanded its divisional groups from four to seven, which helped reduce the size of managers’ portfolios.

“The CQC had been critical of the divisional structure in place here for many years,” she said, adding the changes meant anyone working in a leadership role were closer to the risks posed to services.

Ms Shields also highlighted changes in culture at individual services, including maternity. The CQC issued the trust a warning notice in September 2017 over escalation policies in its maternity unit, but the service achieved a “good” rating in the latest inspection. 

Ms Shields said: “We had years of disquiet around our maternity services. We rebuilt our leadership team and we brought improvement methodology to the heart of addressing the CQC’s concerns.

“By encouraging our midwives to tell us how they felt and how they thought they could make things different, we gave them the tools and time to do that.”

Asked what her priority was for the next six months, Ms Shields said addressing the issues in the “safety” domain was at the top of her list.

“I almost don’t see the point in being a well-led organisation if you’re not a safe one,” she said.

“I triangulate safety with our staff survey and the one response from that really bothers me is recommending us as a place to receive care [for which the trust scored 60.3 per cent — the fifth lowest in the south of England].

“We need to ensure we’re as safe as we can be and that people who work here feel comfortable and proud of working here.”

She added overcrowding in the emergency department at Treliske Hospital and tackling delayed transfers of care were two of the most pressing priorities for the trust.

Nigel Acheson, the CQC’s deputy chief inspector of hospitals, said: “While the overall rating of Requires Improvement remains the same, we have identified a number of significant improvements in the quality of services. The trust has embedded a lot of the improvements needed.”

A spokesman for NHS England/Improvement’s south west region said: ”We’ve now…received CQC’s recommendation, so we’ll be looking over coming weeks at whether to release RCHT from special measures for quality and what further support it might need.” 

HSJ Provider Summit

The HSJ Provider Summit, taking place at the Crowne Plaza, Stratford-upon-Avon from 22-23 April 2020, unites 120+ board members from provider trusts across the country with those shaping national policy, to share best-in-class initiatives in delivering cost-effective and high-quality care for their local populations.

Held under the Chatham House Rule, attendees will co-develop solutions to their local challenges with colleagues from across the country. The summit is free to attend for board-level NHS leaders.

  • Story updated at 9.27am on 27 February to include comment from NHSE/I