CQC imposes conditions on major trauma centre

The University Hospitals of North Midlands Trust, which is a major trauma centre, received the formal enforcement action by the CQC amid concerns over the timely assessment of patients arriving at its Royal Stoke Hospital A&E department.

A second condition on its registration for medical care related specifically to safeguarding the rights of patients detained under the Mental Health Act.

The trust told HSJ it accepted the CQC’s conditions and would not be appealing the decision. The conditions were imposed following a planned three-day inspection of the trust last month.

In an update to the trust board this week, chief executive Tracy Bullock told directors the regulator had identified a number of areas of concern, but also areas of good practice. 

She said the trust had reassured the regulator on most concerns but it had been served with a section 31 notice by the CQC “in relation to observations within the emergency department regarding appropriate and timely clinical assessment on arrival, and actions taken to ensure that patients detained under the Mental Health Act would have their rights protected”.

The CQC’s chief inspector of hospitals Ted Baker said: “The inspection identified concerns regarding patient safety at the Royal Stoke University Hospital. We have now taken urgent enforcement action at the trust to ensure people get the care and treatment they should be able to expect. We will provide further information when the legal process allows.”

The trust is providing weekly updates to the CQC and an inspection at the end of June noted some improvement but also areas of continued non-compliance.

Alongside the concerns, CQC inspectors also praised the trust’s maternity service for its culture, processes and evidence-based learning, although they raised a concern over lack of capacity to cope with increasing demand for caesarean sections and pain scores not being documented.

Elsewhere, inspectors were said to praise care in the trust’s outpatients department and that staff were compassionate, caring and always introduced themselves.

In a statement, Tracy Bullock said: ”Given notable improvements in our ED since the last CQC inspection and a demonstrable trust-wide commitment to ensuring the parity of esteem for patients with mental health issues, we are disappointed that the CQC felt it necessary to issue a formal notice following their most recent visit.

“However, we are fully committed to working closely with them to ensure that they have the assurance they need in these important areas.”

She said a number of new processes had been put in place and the trust would be working with Stoke-on-Trent Clinical Commissioning Group and West Midlands Ambulance Service to improve patient assessment.

She added: “We are not a specialist mental health service provider but take the mental health of our patients very seriously which is why we are amongst the minority of acute trusts who have appointed specialist mental health nurses.

“We acknowledge that we need to continue to improve our documentation and processes in order to ensure that we can demonstrate that patient rights are protected at all times. We believe the incident that triggered this concern is an isolated one but remain open minded and committed to making any necessary changes in order to demonstrate that we continue to live up to our reputation for providing safe and effective care for everyone.”

A full inspection report and formal rating for the trust is expected to be published this autumn. 

According to the most recent NHS England data, the trust had 15,112 type 1 accident and emergency attendees in June 2019.