Trust rated ‘good’ two years after merger

The trust was formed in February 2017 when Birmingham Children’s Hospital took over Birmingham Women’s Hospital. It is now rated “good” for being effective, responsive and well-led, “outstanding” for being caring and “requires improvement” for being safe. The CQC reported improvements across many of its main service areas.

The children’s hospital itself maintained an “outstanding” rating, which it was awarded - along with its pre-merger trust - in February 2017. The women’s hospital, which was rated “requires improvement” before the merger, is now rated “good” overall.

The trust achieved a “requires improvement” rating for mental health services provided through the ”Forward Thinking Birmingham” partnership.

As the group’s lead provider, Birmingham Children’s Hospital has run a community mental health service for children since 2016. It took over community mental health services for young people aged 18 to 25 last April.

The trust’s child and adolescent mental health services were previously rated “inadequate” by the CQC after an inspection in July 2017. They came under additional scrutiny in January this year when a coroner raised concerns over referral pathways.

After the most recent inspection, the CQC highlighted improvements in responsiveness, but noted continued problems with patient access and staff workloads.

The trust received “good” ratings for three of its child and adolescent mental health wards, its community-based services for adults and its mental health crisis services.

Ms Marsh told HSJ that children’s mental health was a priority for development. She said: “For the first time since we founded Forward Thinking Birmingham the tide has turned and we’re on the up. But there’s so much more to do and I don’t want to say we’ve done it – we haven’t.”

She added that diagnostic imaging at the women’s hospital had also been an area of focus following the inspection. This was the only service rated “requires improvement” at the site overall.

CQC chief inspector of hospitals Ted Baker praised “highly motivated” staff at the children’s hospital and noted strong teamwork among the women’s hospital’s neonatal employees.

But he added: “Some services at Birmingham Women’s Hospital were rated ‘requires improvement’ for safety and oversight of its diagnostic imaging was poor. Some community mental health services could not always be accessed in a timely manner.”

Ms Marsh told HSJ: “To have a CQC report where we keep the ‘outstanding’ in the original [children’s] organisation and improve all the component parts feels pretty special.

“This is a completely different organisation to the one that was rated in 2017. We’ve been working hard and lots of things have improved, but it’s going to take years and years to try and get everything up to the level of the best potential for each service.”

Ms Marsh wrote in HSJ last month about how the previous Birmingham Children’s FT of which she was chief executive before the merger had taken ”risks to our reputation, rather than protecting the splendid isolation of a smaller, high-performing trust”, by joining with the women’s hospital and getting involved in the mental health service.

She wrote: ”We may not always have achieved straight A’s across the board, but what we have created together is special, unique and making a difference.”

In some cases NHS trusts and leaders have decided against taking over struggling neighbours, because their own ratings and performance could be undermined - something which is mitigated by the option of sharing board members, or forming “groups”, rather than full merger or acquisition.