Pennine Acute Hospitals turn major corner after CQC rate Trust as ‘Good’ from ‘Inadequate’ within three years under NCA Group

Raj Jain web
Pennine Acute Hospitals turn major corner after CQC rate Trust as ‘Good’ from ‘Inadequate’ within three years under NCA Group
07 February 2020

PENNINE Acute Trust hospitals are now providing safer, more reliable higher standards of care than ever before as confirmed by the Care Quality Commission (CQC) following its latest inspection.

Staff who work across the hospitals are being recognised for the significant improvements made over the last three years after the heath regulator today published its report, rating the Trust to be ‘Good’.

The CQC’s assessment means that Pennine Acute’s rating and standards of care have improved, year on year, from ‘Inadequate’ in 2016 to overall ‘Good’ in just three years. Of the service areas inspected across the CQC domains, 90% are Good or Outstanding.

The Trust has been on a quality improvement journey since 2016 after it joined with Salford Royal as part of the formation of the Northern Care Alliance NHS Group (NCA).

CQC inspectors visited the Trust from 3 to 26 September 2019 to assess the quality, care and safety in six core services across North Manchester General Hospital, The Royal Oldham Hospital, Rochdale Infirmary and Fairfield General Hospital in Bury. These were: urgent and emergency services, surgery, medical services, critical care, end of life care and community inpatient services.

The Trust’s maternity, neonatal and children’s services at The Royal Oldham and North Manchester General Hospitals were not inspected on this occasion. This means that although both maternity units retain their Good rating and Requires Improvement for children’s services from 2017, the way the overall rating for each hospital is worked out by the CQC’s algorithm means that both sites could not improve on its overall rating.

CQC Rating and findings

The CQC can give one of four ratings to NHS Trusts and services: ‘Outstanding’, ‘Good’, ‘Requires Improvement’, or ‘Inadequate. The Trust was previously inspected in October 2017 and rated ‘Requires Improvement’.

They rated 15 services, 3 as outstanding, 11 as good and one as requires improvement.

Fairfield General Hospital and the Trust’s End of Life Care are rated Outstanding.

As a result of its latest inspection, the CQC found Pennine Acute Trust, has:

  • maintained its Good ratings for being Caring and Well-led
  • improved its rating for Effective services from  Requires Improvement to Good
  • improved the overall rating for Fairfield General Hospital to Outstanding
  • rated the Trust’s End of life Palliative Care services as Outstanding
  • rated community health inpatient services provided across Rochdale as Good
  • improved medical care services (incl. older people care) rating for North Manchester General and The Royal Oldham Hospitals to Good 
  • maintained Good rating for urgent and emergency services at both The Royal Oldham and North Manchester General Hospitals despite increased demand
  • improved rating for critical care and surgery services at Royal Oldham to Good
  • improved surgery services across all CQC domains at North Manchester General
  • maintained overall Good rating for Rochdale Infirmary following last inspection

The CQC looked at management and leadership under its well-led domain. Inspectors found leadership teams were experienced, capable and strategically aware, supporting staff and a collaborative approach to ensure patients receive high-quality care.

Commenting on the CQC report Raj Jain, Chief Executive at the Northern Care Alliance NHS Group which runs Pennine Acute Trust hospitals and services, said:

“This is fantastic news. We are really pleased for our staff to receive this positive CQC report. It rightly recognises the hard work and continued commitment staff have demonstrated over the past three years in providing high standards of care and also in driving the improvements that were needed.  

“Since 2016 we have benefited from the strength and scale of our NCA group by bringing together Salford Royal with Pennine Acute Trust. We have put in place group-wide systems and processes, invested in medical equipment and our workforce, recruited more staff, and strengthened leadership teams at each hospital (Care Organisation) to empower and support staff.

“We know we have caring and compassionate staff, but by working together, by learning from each other and by putting the patient experience at the heart of everything we do, we have been able to really improve on the quality of care and reliability that was required. There is a completely different culture now – we are more open, honest and transparent, and benefit from a real positive learning culture. 

“I am also extremely proud of staff who have made these improvements despite the challenges, increased demand on services and the historic underinvestment in IT systems and estates infrastructure. I must also recognise the contribution our commissioners have made.  We have been successful at establishing effective working in each locality and through these partnerships we are continuing to drive forward 21st century care. Working together we will secure the much needed investment that will provide our staff and patients with modern infrastructure. 

“We owe this improvement to our staff, patients and the communities we serve. We will not rest on our laurels; we will use this report to build on and improve further. Thank you to our staff; this report is a testament to their care, hard work and a can do team effort.”

Jim Potter, Chairman of the Northern Care Alliance NHS Group, said:

“The improvements made across our Pennine Acute hospitals have been incredible and very real. It’s been a challenging three years and has meant a lot of hard work and willingness of staff and our leadership teams to make the changes and progress improvements whilst meeting the increased demands facing NHS services. 

“On behalf of the Board and our Governors, thank you to our amazing staff for the care, compassion and skill they give to the thousands of people they treat and look after every day, 24/7. This is positive news for our staff, our partners and our local communities.”

Outstanding practice

CCQ inspectors found a number of outstanding practises including the Trust’s End of life Palliative Care service which is rated ‘Outstanding’ overall. The ‘Swan model’, created by Salford Royal, is now firmly embedded across the NCA group of hospitals and includes extensive training open to all staff around all aspects of end of life care provision. The Swan symbol is used to indicate a patient who is at the end of their life or for recently bereaved relatives. The model had been implemented in several hospitals nationally. End of life services are engaged continually with local religious communities to tailor the service and worked collaboratively in carrying out people’s religious and spiritual wishes.

The Royal Oldham Hospital urgent and emergency service has improved its paediatric area by including play specialists and asthma and respiratory nurses. The pop-up pharmacy in the discharge lounge has significantly improved discharge times for people.

The CQC has also praised Rochdale Infirmary’s medical care for dementia friendly signage and decoration to help people easily navigate the service, and for its dedicated support available to ensure people had a safe and timely discharge from hospital, helping people maintain good continuity of care when leaving hospital.

Further improvements

Increased demand on services and the challenges facing The Royal Oldham and North Manchester General Hospitals in relation to A&E performance and elective waiting times and other key national standards has prevented both hospitals reaching a Good rating. 

The CQC highlighted further improvements the Trust needs to make. Improvements are needed to guard against last minute cancellations to operations and to improve surgery waiting times. Staff understanding and recording of people’s mental capacity are needed to increase as well as documentation relating to deprivation of liberty safeguards.

The Trust has been rated as Requires Improvement for using its resources productively.

The full report is available on the CQC website at https://www.cqc.org.uk/provider/RW6