• Worcester Acute Hospitals Trust achieves “requires improvement” overall rating
  • But trust will remain in special measures until support package has been agreed
  • In 2017, the CQC found patients were routinely cared for on trolleys in A&E corridors

One of the NHS’ most troubled trusts has moved out of the “inadequate” Care Quality Commission rating.

Worcestershire Acute Hospitals Trust achieved a “requires improvement” overall rating in its most recent CQC report, which was published today. The regulator said it found “significant improvements” during its inspections in May and June this year.

However, the trust will remain in special measures, having been in the regime for almost four years – one of the longest stints of any trust.

Ted Baker, the CQC’s chief inspector of hospitals, recommended lifting the trust out of special measures, but only after a major support package from NHS England/NHS Improvement has been agreed and put into effect.

The trust received £36m from the Department of Health and Social Care in 2018-19, £12m of it in revenue support.

The trust made headlines in January 2017 when two patients died on trolleys at Worcestershire Royal Hospital’s accident and emergency department. That April, CQC inspectors noted a “culture” of caring for patients on trolleys in A&E corridors, even when space was available in the department.

A January 2019 inspection found small and cramped conditions meant patients were still being nursed on trolleys. 

While the latest inspection found patients are still regularly treated in corridors, it noted a “dedicated corridor nurse” was deployed to care for those on trolleys.

In the most recent report, Professor Baker noted the emergency care at Worcestershire Royal Hospital still needed improvement. The CQC told the trust to make improvements in a number of other areas including waiting times, staff hygiene and mortality reviews.

He said: “Some staff needed safeguarding and infection protection training, and staffing levels in some departments were not always adequate.

“Leaders were implementing improvement strategies, but these plans needed more time to take full effect.”

Professor Baker praised progress in other areas. He said: “Staff and leaders at Worcestershire Acute Hospitals can be proud of the progress achieved. Our inspectors saw good and improved practice across the trust.”

He noted that most concerns previously raised at Kidderminster Hospital and Treatment Centre, which the trust runs, had been addressed.

He also praised “progress” at the trust’s Alexandra Hospital in Redditch. The CQC recognised the hospital’s diagnostic imaging staff for their “outstanding” work with patients.

Although Worcestershire Royal, Kidderminster and Alexandra all saw overall ratings improvements, the trust’s Evesham site saw its overall rating decline from “good” to “requires improvement.” 

Trust chief executive Matthew Hopkins said: “We have already taken action to address some of the issues highlighted around compliance with surgical safety checks, infection control and mandatory training. In addition, some of the service changes that we are planning for the Evesham site will further support improvements to quality and safety.”

Trust chief operating officer and deputy chief executive Paul Brennan told HSJ: “Reducing waiting times in ED, improving ambulance handovers, better patient flow and eliminating corridor care remain priorities for us. 

“We have made real progress this year in significantly reducing our reliance on inappropriate surge capacity, reducing medical outliers and freeing up our assessment units to work as intended, rather than acting as additional wards.

“All of this is very positive, but we know that there is more we need to do given the continuing high levels of demand on our urgent and emergency care services.”

*Updated at 10.39 am 20/09/2019 with comment from Worcestershire Acute Hospitals Trust. 

*Updated at 10.55 am 20/09/2019 with more information about Evesham Community Hospital’s rating.