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Inadequate rating lifted by Care Quality Commission on Sheffield’s maternity service following significant improvements

The Care Quality Commission have lifted all previous inadequate ratings at Sheffield Teaching Hospitals, including maternity services, following a re-inspection which showed there had been significant improvements.

The Trust’s overall rating for the Caring and Effective domains in the inspection also both increased to Good but Chief Executive Kirsten Major has stressed that there is no complacency and improvement work will continue as a priority to return all services back to a Good rating or better. Overall the Trust is rated as Requires Improvement but with many services now rated as Good or Outstanding.

She paid tribute to all 18,500 staff across the Trust who had worked so hard to make the required improvements in such a short timeframe for patients.

The improvements the CQC found meant that none of the Trust’s services are now rated as inadequate across the five domains they conduct inspections under - safe, effective, caring, responsive or well-led. The Care Quality Commission required significant improvements to be made following publication of its inspection report in April 2022, including maternity services. They re-inspected those services including maternity in September 2022 the findings of which are detailed in the report issued today (22nd December 2022).

Sarah Dronsfield, CQC head of hospital inspection, said:

“When we returned to Sheffield Teaching Hospitals NHS Foundation Trust, it was promising to see that several improvements had been made. Throughout our inspection we saw staff treating patients with compassion and kindness and delivered care which respected people’s individual needs. We were pleased to see significant improvement regarding how staff assessed and managed the risk to patients including those presenting with the risks a deterioration of physical or mental health. In maternity services, CQC previously identified that there were difficulties requesting additional assistance when women deteriorated. During this inspection we saw a specific emergency bleep number had been created for staff to respond to deteriorating women, which had improved response times and intervention. In urgent and emergency services, people’s observations were undertaken in a timely manner, and we observed good multidisciplinary team communication. Most staff told us they felt respected, supported, and valued. Leaders had improved systems to identify and manage risk, issues and performance. It is promising that trust leaders and staff have begun to make improvements which have improved patients experience of care at the trust. We will continue to monitor the trust and expect to see the improvements have been sustained and embedded, and that the trust has addressed the areas where further improvement is still needed, by the next time we inspect.”

Kirsten Major, Chief Executive, Sheffield Teaching Hospitals NHS Foundation Trust said:

“I want to pay tribute to all our staff who have worked so hard to address the issues the CQC raised in April. The significant progress that has been recognised in today’s report is a reflection of their commitment to do the right thing for our patients. It has been one of the most challenging periods the NHS and our Trust has experienced with continued COVID, recovery of paused care and increased emergency demand but none of this has stopped staff from making the improvements required in less than 8 months because we all want to do the very best for our patients. We are not complacent because we know we have more to do but we are on the right track and determined to go even further to embed the positive changes. We have already recruited more staff with 450 new nurses and midwives and in total we have 1,000 more staff in post than we did pre COVID. We have introduced Safety huddles on wards where staff come together to discuss patients with particular needs or potential additional risks to their well-being and health, such as falling. We also have safety information and learning clearly visible on every ward for staff and patients to see. In maternity services we have improved triage and assessment facilities to ensure women receive timely care, we have upgraded our facilities to be less cramped at busy times and we have overhauled our monitoring and checking processes including adopting the ‘fresh eyes’ approach which provides an additional check on decisions and monitoring of women and their babies. We have recruited additional midwives and also created new support roles to help support women and babies immediately following birth.

We are creating a £5m dedicated orthopaedics surgery centre at the Hallamshire Hospital to help reduce surgery waiting times. Since April we have already carried out 82,000 operations despite increased emergency demand. We are also introducing a new electronic patient record system which will bring huge safety benefits because a patient’s records including maternity will all be in one place and able to be accessed easily by different healthcare professionals involved in their care.”

Key points the CQC raised were:

• Most services had enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment.
• Staff assessed and managed the risk to patients including the risks presenting due to deterioration in patients’ physical or mental health.
• The trust had implemented new and regular audits and reviews to ensure care met fundamental standards.
• Leaders had reviewed and improved governance systems and oversight of risk, issues and performance in frontline services.
• Staff supported and involved patients, families, and carers to understand their conditions.

Areas where further work is underway:

• Training more staff to ensure physical restraint of patients who require it for safety or clinical reasons can be undertaken safely and appropriately.
• Storage for medication and oxygen cylinders
• Reducing waiting times so that patients can access services when they need it and receive care promptly. Since April we have already carried out 82,000 operations despite increased emergency demand which has an inevitable impact on the beds we have available for planned care.
• Strengthening further processes for identifying and reporting serious incidents and expediting investigation and learning from incidents and never events.
• Embed the requirement that all patients who have Deprivation of Liberty Safeguards must have a recorded capacity assessment or decision recorded in their best interest. 
• Improved physical health monitoring after administering rapid tranquilisation.

The CQC report can be accessed on their website from 22nd December.

For more information about this media release please contact Julie Phelan, Communications on 07507888647 or Julie.phelan5@nhs.net.