RLI patients “still at risk” says watchdog

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A HEALTH watchdog says patients at the Royal Lancaster Infirmary are “still at risk” of receiving poor care.

The Care Quality Commission (CQC) has published the findings of its March investigation into the delivery of emergency care at the RLI and Furness General Hospital in Barrow by the University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT).

It found that:

* Patients were waiting too long to be seen.

* Patients were accommodated in mixed sex wards.

* Neither hospital was meeting the national target to admit, discharge or transfer 95 per cent of patients within four hours of admission.

* The hospitals were not working together and had limited plans for cross-site working.

* Staffing levels were inadequate.

In one incident a security guard was stationed outside the room of a female patient to ensure she did not fall, a situation the trust said was regrettable and would not happen again.

The CQC said: “Our findings show that patients are still at risk of receiving poor care, however, recent changes to the management of the trust have resulted in positive actions to address many of the issues highlighted in our investigation report.

“We will review these changes to test their impact on people that receive care.”

It said that the trust must now firm up leadership and systems to improve governance and the way care is provided and added that it would review how the trust has addressed its recommendations in six months time.

Sir David Henshaw, the trust’s interim chairman, said: “We accept the findings of the investigation report by the Care Quality Commission and the trust board sincerely apologises for the way in which patients have been let down.

“This report is a snapshot in time, from an investigation that began nearly six months ago.

“Significant progress has been made since then to ensure services are safe as patient safety is our number one priority.

“In this time, a new trust board has been established and we will shortly be announcing our new chief executive.”

Sir David said that like the CQC, he had identified a “disconnect between clinicians and managers” and had since ensured that doctors, nurses, midwives and allied health professionals now ran clinical services with support from managers rather than vice-versa.

“This trust will not preside over unsafe services,” he added, stressing that more needed to be done to improve care.

“Whilst progress has been recognised, such as the immediate actions we took as a result of concerns being raised and the significant steps taken by ourselves and Monitor to improve governance, it is distressing to read in the report examples of care that took place that fall below anyone’s acceptable standards of care...the new trust board will not accept or tolerate this level of care for our patients.”

Interim chief executive, Eric Morton, said: “We believe that when the Care Quality Commission follows up the investigation, they will find a team off committed, caring staff who have worked hard to make the necessary changes to ensure services are safe and that the trust is on the road to

recovery in collaboration with local health and social care providers.

“A significant number of improvements are well underway, including the £1.5m investment to extend the emergency department at the Royal Lancaster Infirmary, which will greatly improve the patient experience with a new minor injuries unit.”

Mr Morton said that clinical staffing had been increased since February and that 20 extra band 5 nurses had been appointed this year.

He added that the trust had already presented the first part of its plan to turn around the hospitals to foundation trust regulator Monitor, and that the second phase of the plan would be complete by autumn.

Other changes at the trust have included changes to the outpatient booking system to prevent delays to appointments and to a patient flow which had led to mixed sex wards.

A mobile operating theatre and extra beds have been introduced at A&E at the RLI, and patients referred by GPs now initially go to the medical assessment to ensure that they and patients already in A&E are seen more quickly.

Workshops have taken place with patients, staff, governors and GPs to look at how the patient experience can be improved using a £1m fund.