Inadequate

DARK clouds . . . over the Royal Oldham Hospital

URGENT improvements are needed at the Royal Oldham after the Care Quality Commission rated the hospital and Pennine Acute Hospitals NHS Trust as "inadequate".

Pennine Acute, which runs the hospital alongside Rochdale Infirmary, Fairfield General Hospital and North Manchester General Hospital, was rated as "inadequate" overall, the lowest rating, after inspectors raised serious concerns with staffing levels, infrastructure, safety systems and leadership.

In the five main areas of inspection, the trust was rated as "inadequate" in the "Safe" and "Well-led" categories, and was told it "Requires Improvement" in the "Effective" and "Responsive" categories.

Only the "Caring" category recording a positive rating of "Good" after inspectors saw Trust staff "treating patients in a compassionate and sensitive way" during their visit in February and March, this year.

Individual hospitals were also given ratings by the CQC with North Manchester and the Royal Oldham both rated as "inadequate" while Fairfield General Hospital in Bury was deemed as "Requires Improvement". Rochdale Infirmary, and all community services run by the Trust were rated as "Good". The Trust also received the top "Outstanding" rating for the Caring domain in the community End of Life Service.

Despite reporting concerns about the systems and procedures that are in place to keep people safe and free from harm, inspectors stopped short of recommending the Trust to be placed into special measures.

Pennine Acute must now implement substantial improvements and actions in order to maintain safer and more reliable care at all of its hospitals.

Following the CQC report, Sir David Dalton, Chief Executive of The Pennine Acute Hospitals NHS Trust, said the Trust will be better, stronger and more determined than ever to drive up improvements so that it becomes one of the best and safest NHS Trusts in the country.

Sir David Dalton, Chief Executive of The Pennine Acute Hospitals NHS Trust, said: "The CQC report doesn't make comfortable reading and whilst staff will be very disappointed with the Trust's overall rating, we welcome this report which I believe is a fair assessment of the issues facing the Trust.

"Encouragingly, CQC inspectors found that the Trust was a caring organisation and found staff treating patients in a compassionate, caring and sensitive way.

"The CQC report is holding up a mirror to the organisation and reflects very much what staff have been saying for some time on issues related to staffing pressures, inadequate systems, culture, leadership and resources.

"We know improvements must be made not only in the short term to stabilise pressured services, but in the longer term to ensure services are sustainable. We want all services to meet the high standards that our patients expect and deserve."

Sir David, who took over as Chief Executive in April, added that he is determined to apply learning from Salford Royal Foundation Trust, one of the top performing in the country and where he has been chief executive since 2001, to Pennine Acute.

Salford Royal, which prides itself as the safest organisation in the NHS, is only one of five Trusts in the country to achieve an "Outstanding" rating by the CQC and this rating and is first in the North of England.

Under his leadership and working closely with Salford Royal, PAHT's new management team has put in place a comprehensive action plan to deliver improvements, including a finance package of £9.2 million with local commissioners and regional and national health and social care partners to spend on staffing and service improvements.

Sir David continued: "We have not waited for the publication of this report to put an improvement plan in place to support staff and patients.

"Our priority is to keep our services running safely and to ensure patients receive good safe treatment in a timely manner.

"We will not allow this organisation to run unsafe services. It is recognised that for this Trust to make services safer and more reliable, it requires the support from our health and social care partners to provide over the next six months and to consider longer-term solutions for services across Greater Manchester.

"The Trust needs stability in its services and its leadership. This week will be the start of a new journey and a new focus for staff here. The Trust and the 9,000 staff who work across the four hospitals and our community services will be stronger, better and more determined than ever to drive improvements as a consequence of the publication of this report so that Pennine Acute Hospitals Trust, like Salford Royal, becomes one of the best and safest NHS Trusts in the country."

Since April 2016, the Trust, which is one of the largest NHS Trusts in the country, has been led by a new executive management team after Sir David and Chair of Salford Royal Jim Potter agreed to provide leadership and support to Pennine Acute.

In March 2016 a newly appointed Medical Director, Professor Matthew Makin, started in post days after the CQC inspection and earlier this month Elaine Inglesby-Burke CBE was appointed to Chief Nurse whilst also continuing her role as Nurse Director and Deputy Chief Executive at Salford Royal.

Professor Makin said: "The majority of the patients receive excellent care and a good patient experience from committed staff.

"But we know we have to do more to ensure patients and their families receive safe and effective care much more reliably.

"The CQC inspection carried out five months ago reflects a particular moment in time and we have taken immediate actions to strengthen the leadership and staffing arrangements across a number of our services, particularly those that are pressured and fragile."

Key areas that the Trust must take action in have been highlighted as A&E - reflecting the Trust's failure to meet Government waiting times - as well as maternity and paediatric services, which have already been addressed under the Trust's Maternity Improvement programme and collaborative working with colleagues from Central Manchester University Hospitals NHS Foundation Trust.

The recruitment and retention of maternity staff has been a major focus for the Trust over the last few months following an investigation into the deaths of seven babies and three mothers in maternity units at the Royal Oldham Hospital and North Manchester General between December, 2013, and July, 2014.

A new management team has been put in place and the Trust recently recruited a further 33 midwives and 25 healthcare support workers to enhance its midwifery staffing establishment, which includes over 350 midwives.