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CQC issues warning notice to North Cumbria Integrated Care NHS Foundation Trust

Cumberland Infirmary

The Care Quality Commission (CQC) has told North Cumbria Integrated Care NHS Foundation Trust (NCIC) that it must make immediate improvements to keep people safe following inspections in August and September.

CQC carried out these responsive, focused inspections, due to monitoring work revealing emerging concerns about risks to patient and staff safety.

CQC inspected to assess the safety and responsiveness of emergency and urgent care, medicine, end of life care and community adults’ services.

NCIC was newly formed in October 2019 as a result of the acquisition of North Cumbria University Hospitals Trust by Cumbria Partnership Foundation Trust. As this was a focused inspection, we didn’t inspect enough areas to change any ratings, therefore the previous overall trust rating of Requires Improvement from when they were a different legal entity remains.

Professor Ted Baker, Chief Inspector of Hospitals said: “People using the services at North Cumbria Integrated Care NHS Foundation Trust are entitled to safe and responsive care.

“We inspected as there were escalating numbers of concerns and some evidence of harm that required intervention in order to keep both patients and staff safe.

“We have issued the trust with a warning notice, for Cumberland Infirmary and West Cumberland Hospital because we need to see rapid improvements to protect people from the risk of harm.

“The trust has been very responsive to our improvement requirements and I feel assured that they are taking steps to address these issues, working closely with NHS England and NHS Improvement.

“However, it is also clear that there are several factors within the local health and social care system that are impacting on this trust from improving as quickly as we want them to.

“There are blockages within the system in North Cumbria, especially when it comes to discharging people who no longer need acute care. The wider system in North Cumbria has a responsibility to work with the trust in this area, as they cannot solve this problem alone.

“We hope that our report is used a springboard for this purpose.”

Following these inspections, the trust was served with a warning notice for two of the trust’s locations, Cumberland Infirmary, Carlisle and West Cumberland Hospital, Whitehaven.

The warning notice requires the trust to take action to minimise the risk of patients being exposed to harm as:

  • Patients in the emergency department and in ward areas at Cumberland Infirmary were not always receiving timely and appropriate care and treatment.
  • Delayed transfers of care regarding patients admitted from the emergency department has resulted in significant delays in admitting patients onto wards.
  • There was evidence of insufficient numbers of suitably qualified, skilled, competent and experienced clinical staff to meet the needs of patients.
  • There wasn’t an effective system to mitigate risks, including infection and prevention control in the emergency department escalation areas and on some medical wards.

Lyn Simpson, who was appointed as North Cumbria Integrated Care NHS Foundation Trust, (NCIC) Chief Executive earlier this year, said: “The report shows that the plans we have in place are the right ones, but the pace of change has been too slow.

“We are a relatively new organisation coming together at a time of global pandemic but the bravery and hard work of all our staff, and the efforts and sacrifices of our communities, require that services for patients emerge stronger from COVID-19.

“Importantly, we have already taken swift action to deliver rapid improvements in patient safety.  The inspection in the summer enabled us to identify immediate actions we needed to take to ensure patients can access appropriate care and treatment in a more timely way.”

Anna Stabler, Chief Nurse said: “Since December last year, we have put in place plans to significantly improve our staffing, and have brought in over 100 agency nurses to give us additional capacity while longer term plans are put in place.  We are making good progress on international recruitment with 37 nurses due to be live on the wards by the end of March, and have focussed on growing our own by supporting over 100 people on our apprentice nurse programmes.  We are also implementing a more sustainable plan for clinical staffing and have approved and advertised for additional clinical staffing in the emergency departments.

“Since the inspection in the summer, we have made improvements in triage and ambulance handover times, particularly ensuring clinical oversight where we do experience delays. We are also taking action to improve the flow of patients within the hospital and improve the quality of record keeping.”

A full report detailing the findings from CQC’s focused inspection can be found at: https://www.cqc.org.uk/provider/RNN

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