Exclusive: Under fire trust receives third CQC warning

The regulator has warned the troubled provider about its intensive therapy unit, medical wards and paediatric care, internal sources have confirmed. 

This is the third warning letter sent to the trust since August. Previous letters warned the provider about safety issues within its emergency department and maternity wards.

The latest letter, sent in October, included concerns about:

• risk assessments for malnutrition and pressure ulcers not being carried out in medical wards;
• a lack of consultant cover and appropriately trained nursing staff within the intensive therapy unit; and
• low levels of trained paediatric staff within the accident and emergency department.

HSJ understands the CQC has given the trust until March 2019 to address the issues. If issues are not resolved, the regulator will discuss with NHS Improvement what further action to take, which could include appointing a special administrator to the trust.

Under current guidelines, NHSI can appoint a special administrator “to take control of a foundation trust’s affairs if the trust is either financially unsustainable in its current form or at serious risk of failing to provide high-quality sustainable services”.

The CQC rated SATH “requires improvement” in 2017, but a subsequent inspection took place in August 2018, for which the final report has yet to be published.

Shortly after the August inspection, the CQC told the trust it could face enforcement action, after staff said patients within its A&E were being treated like “animal and cattle”.

The latest warning also comes amid an independent review into more than 100 cases of potentially poor maternity care.

Edwin Borman, the trust’s medical director, said: “In respect of the CQC’s observations on staffing in critical care and emergency department, this serves to highlight what we and our clinicians have been saying for the last three years.

“We know that these services are fragile and this is highlighted by the current discussions which are ongoing around the possible overnight closure of the A&E department at the Princess Royal Hospital in Telford.”

The trust’s recruitment efforts are “showing positive signs”, Dr Borman said, and it is working with providers in Derby to establish a programme to train its doctors to consultant level.

He said there has also been a significant reduction in pressure ulcers over the last eight months.