9th December 2020 ❘

CQC Trust Investigation

A Care and Quality Commission (CQC) Investigation report has been published following an inspection of North Cumbria Integrated Care NHS Foundation Trust (the Trust). The Trust is responsible for The Cumberland Infirmary in Carlisle, West Cumberland Hospital in Whitehaven and a number of community services in Cumbria. The overall assessment of the Trust is “Requires Improvement”.

There have been concerns about risks to patient and staff safety and the inspection resulted in a warning notice requiring that action be taken to minimise the risk of patients being exposed to any form of harm. Particular concern was raised with regard to care provided in the emergency department and ward areas at The Cumberland Infirmary, where patients were not always receiving timely and appropriate care and treatment, and there was evidence of there being insufficient numbers of qualified and experienced staff to meet the needs of patients. Further concerns were raised about ineffective systems to mitigate risks, including infection and prevention control.

The Trust was also criticised for the length of time patients were being kept in ambulances before being admitted – against a national standard of 15 minutes within arriving at hospital. The North West Ambulance Service recorded 1,624 ambulance attendances at The Cumberland Infirmary in the period from 20th July to 21st August 2020, with 171 of these patients experiencing a turnaround time of over 1 hour and the longest turnaround time being 246 minutes.

During the COVID-19 pandemic, demands on the NHS have been extremely high. The problem has been compounded by the cessation of recruitment of international staff, who form a significant proportion of the work force. At the time of the inspection the Trust had 188 nursing vacancies. However, many of the issues at the Trust are longstanding and the 2020 CQC report reflects a similar situation to the 2018 CQC inspection, which also found the Trust’s predecessor (North Cumbria University Hospitals NHS Foundation Trust) to be in the category of “Requires Improvement”. It is therefore essential that in addition to working to fill staff vacancies, the Trust takes active steps to improve internal systems to ensure that patients in Cumbria are kept safe.

Sadly, a number of our clients have suffered as a result of failures at the Trust. We have seen patients who have not received prescribed medication, not had adequate monitoring and supervision and have had inadequate assessments leading to misdiagnosis. The consequences of these failures are devastating for the patients affected and it is important that the findings of the CQC are acted upon quickly.

Since the warning notices were issued, the Trust has worked extremely hard to make the required improvements. Lyn Simpson, Chief Executive for the Trust has highlighted that “the report shows that the plans we have in place are the right ones, but the pace of change has been too slow… the inspection in the summer enabled us to identify immediate actions we needed to take to ensure patients can access appropriate care and treatment in a more timely way”.

The Trust have shown their dedication to improving the services provided by strengthening their escalation processes to make sure patients are transferred from the emergency department to an appropriate ward or department sooner and have received approval to increase the number of staff in their A&E departments to prevent the build-up of ambulance handovers to the A&E departments. This has led to the number of ambulance handover delays over 60 minutes being halved since October this year.

Improvements have also included appointing a senior nurse to triage 24/7 to ensure that weekly and daily audits of triage times are being undertaken; updated electronic systems with warning prompts; and new electronic patient records which ensure that patient information is readily available to clinicians.

Although the Trust have made considerable improvements in the short period since the inspections carried out over August and September 2020, many patients will have suffered as a result of a delay in receiving timely and appropriate treatment caused by the areas identified in the CQC report.

At Burnetts we have a wealth of experience assisting clients who have suffered harm as a result of a delay in diagnosis or delay in receiving treatment. We have specialist medical negligence solicitors who are accredited by the specialist AvMA and Law Society Panels who can investigate your claim and help you with securing compensation to assist you through what can be an extremely difficult and distressing time.

If you would like to speak to someone within our team to discuss whether you may have a clinical negligence claim then please contact our offices on 01228 552222.