Royal Lancaster Infirmary A&E unit still needs ‘great deal of work’, health watchdog says

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The troubled trust which runs the Royal Lancaster Infirmary (RLI) has met seven of 40 recommendations made after a critical report of its accident and emergency unit.

Care Quality Commission (CQC) chiefs said there was still a ‘great deal of work’ needed to make services safer and more effective at University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT).

The health regulator today published the results of a follow-up visit made in April to check on progress after concerns arising from its 2012 investigation.

Although the 11-strong team found the trust had improved safety and care standards, governance and management, they said they were concerned about the sustainability of the progress.

The UHMBT accepted the findings, but said it had made ‘good progress’ to improve patient services, with further improvements made in the six months since the inspection took place.

The CQC has ordered early action to:

Ensure suitably qualified and experienced paediatric staff are available at all times to treat children within the A&E department;

Improve complaints handling systems to make sure complaints are responded to fully and in time;

Ensure a cultural change programme is in place across the organisation that promotes an identity of a fully-merged trust.

Today’s report concludes the CQC’s investigation into the running of A&E departments at the RLI and Furness General Hospital (FGH), Barrow, which found patients being at risk of poor care, inadequate staffing levels and a ‘shared helplessness’ among department staff.

Malcolm Bower-Brown, the CQC’s northern director, said: “Although we are pleased to report evidence of improvement since our original investigation last year, with only seven of 40 recommendations met in full, there is still a great deal of work to be done to deliver and sustain the further improvements in the safety and effectiveness of services that are required at the trust.

“We will continue to monitor the trust closely over the coming months until we are assured that the required service improvements are fully embedded and patients are receiving safe and effective services on a sustainable basis.”

Jackie Daniel, UHMBT chief executive, welcomed the findings.

She said: “We accept that we still have work to do in the areas highlighted. However, it is important to note that this report is based on visits that took place in April this year – nearly six months ago.

“Since then, we have taken positive steps forward in these areas. We have done a lot of work around culture and inter-divisional working to ensure staff work as a team – across wards, departments, divisions and hospitals.”

She added that the RLI’s recently-refurbished emergency unit was meeting the ‘four-hour standard’ - the time within which admitted patients should receive attention.

Meanwhile, Health Secretary Jeremy Hunt has pledged a full investigation into care failings at the trust, including mother and baby deaths at FGH’s maternity unit.