5 April 2022

Sheffield Teaching Hospitals devastated at CQC downgrading but vow to make improvements

Sheffield Teaching Hospitals Chief Executive has reassured patients they will continue to get safe good care following a report published today (5th April) from the Care Quality Commission which has downgraded the Trust from 'Good' to 'Requires Improvement'.

Chief Executive, Kirsten Major also vowed to do everything in her power to support staff to be able to deliver care and make improvements in response to the issues raised by the CQC following a 3-day inspection in October 2021.

Inspectors visited a selection of areas of the Trust during the inspection, including some wards and services at the Northern General Hospital, Royal Hallamshire Hospital, Jessop Wing and Beech Hill Assessment and Rehabilitation Unit. They did not inspect Charles Clifford Dental Hospital, Sheffield Dialysis Unit, Community Health services and several other services including critical care, end of life care and outpatients and these areas retain their current ratings many of which are Good or Outstanding.

Kirsten Major, Chief Executive of Sheffield Teaching Hospitals NHS Foundation Trust said: “We are all devastated with the outcome of the inspection because there is not one person within the Trust who does not want to do the right thing for our patients and has not worked hard to try and deliver that in exceptional circumstances. That is why we are taking it extremely seriously and I will be doing everything in my power to support our staff and make the improvements we need to deliver. We have already taken action that will help us improve including recruiting over 500 new nurses who are now working on the wards, and there have been changes to our maternity services including investing in more midwives. We are also in the process of buying a new electronic patient record system which once implemented will be less onerous for staff to use and join up different bits of patient information into one place. We have listened to feedback from staff and the CQC and are simplifying many of our processes including how incidents are reported and risks are managed so that we can be more responsive and share learning quicker than at present. Everyone in the Trust has given their all during the past two years to manage the demands of the pandemic and we are determined to address the issues raised in this report with the same commitment.

"I want to assure our patients that our top priority will always be to do our very best for everyone who needs our care. We are pleased that the CQC felt our staff treated patients with compassion and kindness, worked as a team to benefit patients, were committed to improving services and that we had enough medical staff to care for patients and keep them safe. They also recognised that leaders supported staff to develop their skills and infection risks were managed well. Our outcomes for treatment, mortality rates and patient feedback are testament to this, but there is no denying that the last two years have turned so much of what we did as routine on its head. We have asked our staff to rise to unprecedented challenges and change the way they worked on almost a daily basis as COVID surged and declined in waves. We have had less staff at times including when the inspection took place because of high staff COVID sickness and there is no doubt that some of our normal ways of working or delivering care suffered because of the focus we had to have on dealing with the immediate crisis in front of us at the same time as continuing to deliver emergency and cancer care plus as many planned operations as we could and leading the vaccination programme for South Yorkshire.”

The Care Quality Commission said:

• Staff treated patients with compassion and kindness
• Staff were committed to improving services.
• Staff worked well together for the benefit of patients and advised them on how to lead healthier lives.
• The trust had enough medical staff to care for patients and keep them safe.
• Staff understood how to protect patients from abuse.
• The service-controlled infection risk well.
• Leaders ran services using information systems and supported staff to develop their skills.
• Staff understood the service’s vision and values, and how to apply them in their work.

Some of the areas for improvement and progress so far:

• Recruitment of more staff in some areas including nursing.
We had already been working on this prior to the inspection and over 500 new nurses are now working on our wards now. Recruitment is ongoing.

• Improvement in maternity care and staffing
Following the inspection of maternity services in May last year we have already made several improvements, recruited some more midwives, and changed how we provide care in some areas. We recognise there is more to do and remain committed to deliver further improvements and recruitment continues to be a priority although a challenge locally and nationally.

• Improvement in care for patients with mental health conditions
This was another area where we had already started to make improvements internally but also with partners across the City who also have responsibility for the care of people with mental health conditions. This work continues as a priority.

• Improved waiting times for treatment or care
None of us have been happy that so many of our patients' care had to be paused due to COVID and that our previously good record on waiting times has deteriorated like most other NHS Trusts. We still have COVID to deal with, but our recovery work has started and will be the focus of all our attention moving forward as some of the restrictions we have been under are being removed.

• Improved risk assessment processes including recording and mitigation of potential risks.
The CQC when talking about ensuring safe care are mainly referring to the systems and processes in place to report and mitigate potential risks to patients or staff. We recognise that our current processes are complex and often the practical actions to recognise and mitigate risks are taken by staff but that this is not always recorded as expected because we don’t make the process as simple or quick as it could be. We will be looking to improve understanding of the risk assessment processes and systems as a priority.

• Improved record keeping
This was based on a small number of records which were not fully completed at the time of the inspection. It is important that we keep records up to date and complete to inform patient care and a key requirement of our new Electronic Patient Record system will be to make this a simpler and quicker process for staff to undertake.

• Increased incident reporting and more timely response to share learning or make changes.
Our staff survey results show this is an area where we are better than many other organisations in terms of staff feeling able to report incidents, but we need to be better at responding to the reports, making changes where it is appropriate more quickly and sharing learning from incidents more widely and as soon after the incident as we can.

• Increased involvement of patients, staff and local communities in planning and developing services or care and more easily accessible opportunities for patients to give feedback.
This is an area we were aware we wanted to improve but was paused due to the operational demands we had to prioritise during the last two years. We will be picking this back up and asking our local communities how we take this forward.

The Trust is required to submit an action plan to the Care Quality Commission and provide progress reports. A further inspection will then be carried out at a future date to reassess the Trust and its rating.

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