Cambridge University Hospitals Trust to be placed in special measures
PUBLISHED: 17:50 21 September 2015 | UPDATED: 17:50 21 September 2015
One of the biggest NHS trusts in the country is to be placed in special measures after inspectors deemed it “inadequate”.
Cambridge University Hospitals NHS Foundation Trust, which runs Addenbrooke’s Hospital, has been told it requires improvement to ensure services are safe and effective.
While staff were found to be caring, inspectors from the Care Quality Commission (CQC) found staff shortages and long-standing “serious” problems that had been ignored.
In maternity, inspectors raised “serious concerns”, including over a low midwife to birth ratio, and noted wards were closed regularly.
In one example, high levels of nitrous oxide - also known as laughing gas and used for pain relief in childbirth - were detected in the Rosie Birth Centre.
Experts have linked high levels to feelings of dizziness, while other risks include unconsciousness or death if there is a lack of oxygen.
The CQC inspectors said senior managers had been aware of the high levels of gas for more than two years.
However, the only action taken to address this risk was to advise staff to open windows where possible.
In their report, the inspectors added: “The equipment in the maternity unit was old and we witnessed the unacceptable practice of a member of staff supporting a birthing mother’s leg as the lithotomy pole (stirrup) was broken.”
The team also found that best practice guidelines were not always followed, including on continuous foetal heart rate monitoring during labour, and the risk of blood clots.
Across the entire trust, inspectors said too few staff meant there was not enough cover on wards, including critical care, and staff were moved from ward to ward to make up shortfalls.
This meant staff sometimes worked in areas where they lacked training, while some rotas had empty spaces and others were filled with agency workers
Inspectors also noted a “disconnect between what was happening on the frontline and the senior management team.”
Many patients were waiting for follow-ups, the CQC found. During the inspection, there was a backlog of 227 ophthalmology and 233 dermatology patients waiting for a call back and a total of 605 across all specialities.
The pressure on surgical services also meant routine operations were often cancelled and patients were waiting longer than the Government’s 18-week target for treatment.
Overall, some risks identified by the trust had been on the risk register since 2006 and there was a lack of action plans to deal with them.
The CQC has now recommended that Cambridge University Hospitals NHS Foundation Trust be placed in special measures.
It also recommended that East Sussex Healthcare NHS Trust be placed in special measures.
Once the financial regulator Monitor or the NHS Trust Development Authority approve the CQC recommendations, the total number of NHS trusts in special measures will be 15.
Cambridge University Hospitals NHS Foundation Trust is already under scrutiny by Monitor over its financial dealings. The trust is reported to be running a deficit of £1.2 million per week.
Former chief executive, Dr Keith McNeil, who resigned last week from his post, has defended Addenbrooke’s as “phenomenal”.
“Everywhere across the country people would be very envious of the sort of results we get day in day out,” he said.
“People’s lives are saved every day by that hospital. I cannot see why anybody would want to describe it as inadequate.”
Asked before the report was published whether the assessment by the CQC was wrong, he told BBC Radio Cambridgeshire: “I believe so.”
He said he did not think there was “any sane or rational interpretation of the word ‘inadequate”’ that would describe any aspect of the operations at Addenbrooke’s.
The hospital’s chief finance officer, Paul James, also quit ahead of the CQC report.
The CQC’s chief inspector of hospitals, Professor Sir Mike Richards, said: “We were concerned that in some services, staff were caring for people in areas unfamiliar to them, meaning patient safety and welfare was placed at risk.
“However, staff were hard-working, passionate and caring throughout the trust, prepared to go the extra mile for patients, but having to swim upstream against the pressures they faced.”
Prof Richards said trust managers had told the CQC they had listened and begun to take action.
Addenbrooke’s hit the headlines last week after it banned ice from patients’ water jugs in a bid to save £39,000 per year.
That decision was later suspended while a review is undertaken into the issue.
The trust is one of the largest in the country, with over 1,000 beds.