The Care Quality Commission has today published findings from an inspection at Hull and East Yorkshire Hospitals NHS Trust. Health reporter Emma Wright examines the report and speaks to chief medical officer Professor Ian Philp.
The Care Quality Commission has today published more than 100 pages analysing health care at Hull and East Yorkshire Hospitals NHS Trust. A team of 45 people, including doctors, nurses, midwives, hospital managers, trained members of the public, specialists, inspectors and analysts, spent five days at Hull Royal Infirmary and Castle Hill Hospital, including three planned inspections and two surprise visits. The inspectors rated the two sites as "requiring improvements".![CQC]()
RATINGS: The CQC inspection summary.A&E – Hull Royal Infirmary
Inspectors said: "There were times when the department could not cope with the volume of patients attending. As a consequence, patient safety and the quality of care was compromised.
"When we visited, we had concerns about the levels of staffing in A&E.
"The children's A&E closed at midnight which meant children were being assessed in the same initial assessment unit as adults.
"Staff told us morale in the department was low because staff were under pressure."
One example of poor care in A&E concerned the case of a patient admitted suffering from dehydration. The patient did not receive the required care until the following day, more than nine hours after first arriving.
Inspectors also pointed to an occasion when ten people were left waiting on trolleys in a corridor because cubicles were full.
The report stated: "We saw one person on a bed in a cubicle with the door left open. They were not properly covered by a blanket. We saw a number of staff walk past the room but none went in to cover the person properly. This meant the person was left exposed in view of all the department.
"We also saw a man on a trolley in the corridor who had no top on and no blanket to cover him. He was left exposed in view of all in the department."
The Mail asked chief medical officer Professor Ian Philp to respond to the concerns.
He said: "This is the area that has given me the greatest concern. I've given several interviews to the Mail about pressures over winter and pressures for staff both with the physical environment and the workload.
"The department was designed for a workload about a third of what it is now.
"We've addressed that problem through investing £7m for the new department opening in August, as well putting in extra staff, but we can't solve the problem without working on the whole system. We need the support of our partners from general practice and providers of community services."Surgery – Hull Royal Infirmary
"Ward areas and theatres were clean and guidelines were followed to prevent or reduce risks from infection," the report stated.
"Where there were shortfalls in performance or risks identified, action was taken to address these."
Concerns about staffing levels were again highlighted.
Inspectors said: "Staff on wards told us they were very busy and to meet patients' needs, staff were often redeployed to different areas.
"Theatre staff told us they were also very busy and being moved to cover other areas.
"Patients said, at times, this led to long waits for call bells to be answered, causing distress.
"Patients said staff were caring and compassionate, although very busy."Medical care, including older people – Castle Hill Hospital
The report highlighted problems in staffing. Employees highlighted an occasion when the medical registrar was called to Hull Royal Infirmary one night, leaving junior doctors at Castle Hill Hospital unsupported.
The report added: "We found staff worked hard to care for patients but, at times, were stretched to deliver a service due to staff shortages.
"Staff reported they were frequently moved to cover gaps in other wards' rotas and this was disruptive in their own wards."Staff morale
The report highlighted division between senior managers and those working with patients.
It said: "Many staff did not feel engaged, particularly with the senior management team.
"Some staff felt pressure to meet performance targets and spoke of a bullying culture in some areas."
Prof Philp admitted this was an area of significant concern and an independent organisation was being hired to combat the problem.
He said: "All individual incidents of bullying are investigated.
"If there is a general culture of bullying, that's another matter.
"We've therefore commissioned an independent organisation to work with staff. As a trust board, we're committed to eradicating any culture of bullying."Areas rated 'good'
End-of-life care, critical care and maternity and family planning services were all rated 'good'. Care shown by staff was also praised.
Prof Philp said: "The overall aspect that stood out for me is the quality of our staff.
"We employ 8,000 people and we don't expect every one of them to be an angel but the overwhelming impression is how caring and committed our staff are.
"They are professional in their duties and go the extra mile for patients.
"When I've been around, I have seen how well our staff are coping.
"I am really proud of that and I'm glad inspectors recognised it."
• CQC inspection summary for Hull and East Yorkshire Hospitals NHS Trust• CQC ratings for Hull Royal Infirmary• CQC ratings for Castle Hull Hospital
RATINGS: The CQC inspection summary.A&E – Hull Royal Infirmary
Inspectors said: "There were times when the department could not cope with the volume of patients attending. As a consequence, patient safety and the quality of care was compromised.
"When we visited, we had concerns about the levels of staffing in A&E.
"The children's A&E closed at midnight which meant children were being assessed in the same initial assessment unit as adults.
"Staff told us morale in the department was low because staff were under pressure."
One example of poor care in A&E concerned the case of a patient admitted suffering from dehydration. The patient did not receive the required care until the following day, more than nine hours after first arriving.
Inspectors also pointed to an occasion when ten people were left waiting on trolleys in a corridor because cubicles were full.
The report stated: "We saw one person on a bed in a cubicle with the door left open. They were not properly covered by a blanket. We saw a number of staff walk past the room but none went in to cover the person properly. This meant the person was left exposed in view of all the department.
"We also saw a man on a trolley in the corridor who had no top on and no blanket to cover him. He was left exposed in view of all in the department."
The Mail asked chief medical officer Professor Ian Philp to respond to the concerns.
He said: "This is the area that has given me the greatest concern. I've given several interviews to the Mail about pressures over winter and pressures for staff both with the physical environment and the workload.
"The department was designed for a workload about a third of what it is now.
"We've addressed that problem through investing £7m for the new department opening in August, as well putting in extra staff, but we can't solve the problem without working on the whole system. We need the support of our partners from general practice and providers of community services."Surgery – Hull Royal Infirmary
"Ward areas and theatres were clean and guidelines were followed to prevent or reduce risks from infection," the report stated.
"Where there were shortfalls in performance or risks identified, action was taken to address these."
Concerns about staffing levels were again highlighted.
Inspectors said: "Staff on wards told us they were very busy and to meet patients' needs, staff were often redeployed to different areas.
"Theatre staff told us they were also very busy and being moved to cover other areas.
"Patients said, at times, this led to long waits for call bells to be answered, causing distress.
"Patients said staff were caring and compassionate, although very busy."Medical care, including older people – Castle Hill Hospital
The report highlighted problems in staffing. Employees highlighted an occasion when the medical registrar was called to Hull Royal Infirmary one night, leaving junior doctors at Castle Hill Hospital unsupported.
The report added: "We found staff worked hard to care for patients but, at times, were stretched to deliver a service due to staff shortages.
"Staff reported they were frequently moved to cover gaps in other wards' rotas and this was disruptive in their own wards."Staff morale
The report highlighted division between senior managers and those working with patients.
It said: "Many staff did not feel engaged, particularly with the senior management team.
"Some staff felt pressure to meet performance targets and spoke of a bullying culture in some areas."
Prof Philp admitted this was an area of significant concern and an independent organisation was being hired to combat the problem.
He said: "All individual incidents of bullying are investigated.
"If there is a general culture of bullying, that's another matter.
"We've therefore commissioned an independent organisation to work with staff. As a trust board, we're committed to eradicating any culture of bullying."Areas rated 'good'
End-of-life care, critical care and maternity and family planning services were all rated 'good'. Care shown by staff was also praised.
Prof Philp said: "The overall aspect that stood out for me is the quality of our staff.
"We employ 8,000 people and we don't expect every one of them to be an angel but the overwhelming impression is how caring and committed our staff are.
"They are professional in their duties and go the extra mile for patients.
"When I've been around, I have seen how well our staff are coping.
"I am really proud of that and I'm glad inspectors recognised it."• CQC inspection summary for Hull and East Yorkshire Hospitals NHS Trust• CQC ratings for Hull Royal Infirmary• CQC ratings for Castle Hull Hospital
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