Shropshire hospital trust works to 'change culture' amid CQC inspection

The Care Quality Commission has been inspecting services at the Princess Royal Hospital, in Telford, and the Royal Shrewsbury Hospital, since November 12, and is expected to publish its findings in spring 2020.

Shrewsbury and Telford Hospital NHS Trust (SaTH) transformation and strategy director Beverley Tabernacle told a Shropshire-wide health committee the initial post-visit feedback, though “mixed”, acknowledged improvement in some areas, including maternity.

But she added that she couldn’t say whether the coming report would show an improvement on the CQC’s last trust-wide report, which rated SaTH as “inadequate” overall and below standard in five out of six categories.

Updating the Joint Health Overview and Scrutiny Committee, she said the England-wide regulator paid an initial three-day visit and some unannounced inspections to a variety of services at both hospitals.

“We had two letters of intent from the CQC following those, outlining a number of areas of improvement,” she said.

“The initial feedback sessions we had was mixed.

“There was acknowledgement that, in some areas, there were improvements. One of those was in our maternity services.

“We expect further improvements to be outlined in the final report in the springtime.”

'I hope that we have seen improvement'

She told the committee – which consists of councillors and co-opted experts from the Shropshire and Telford & Wrekin council areas – the “letters of intent” put SaTH under “enhanced requirements” to report its improvement plans.

“Some of the themes that were reported through the regulatory requirement were regarding the care and treatment of our mental health patients and looking at our emergency services,” she said.

“The other themes were in regard to acute medicine and how we manage our deteriorating patients. There were also some things in there around our paediatric patients and streaming them from our A&E departments.”

Dag Saunders, a former chairman of Healthwatch Telford and Wrekin, pointed out that a previous CQC report – published in November 2018 and based on inspections that summer – rated SaTH “inadequate” overall. Of the six specific areas, two were rated “inadequate”, three “required improvement” and only one was “good”.

Mr Saunders asked: “Would they be likely to produce the same rating?”

Ms Tabernacle said: “I hope that we have seen improvement and those domains may change. We did get some positive feedback from the CQC and those areas that were highlighted in the November 2018 report.

“Whether that is enough to get us out of the ‘inadequate’ assessment, I wouldn’t like to say.”

Mr Saunders pointed out that, in its assessment of the trust’s leadership, the 2018 CQC report said “staff reported a disconnect between them and the senior management team and board”, and he asked: “Have any of the board members resigned?”

Mr Saunders acknowledged chief executive Simon Wright had left, with replacement Louise Barnett due to start next February. Ms Tabernacle said she had herself been appointed to her role permanently, and the medical director had changed.

“I can’t comment on any resignations; some of those roles changed prior to me being there,” she said.

“But we are working very hard to change the culture of the organisation.”