South Tees Hospitals NHS Foundation Trust is undertaking a series of changes as part of its recovery from last winter’s record-breaking Omicron wave following a Care Quality Commission (CQC) focused inspection undertaken earlier this year.
Since the start of the pandemic, the trust has cared for almost 7,000 patients with COVID-19. and last winter’s surge in community infections saw more than 500 COVID-related staff absences due to the virus.
The focused CQC inspection took place on 9-10 February in response to risks around a number of the areas which the trust is focused on as part of its pandemic recovery. Most of the areas identified by the CQC during their visit last winter related to ward-based documentation, nutrition and hydration, and discharge from hospital.
What has the trust done?
On ward-based documentation for example, more than £8million is being invested in new digital systems which will eliminate clinical teams’ historical reliance on burdensome paper-based recordkeeping and ageing IT systems – removing more than 5 million pieces of paper which colleagues currently have to use each year and freeing up more doctors and nurses’ time.
One of these digital tools has now started to replace the paper-based recording of nutrition and hydration assessments.
In addition, a transfer of care hub has been created in collaboration with local authorities to support ward colleagues and social workers to return people safety home after their hospital treatment and help to ensure social care support is available in the community.
An audit of ward-based forms and documentation
A patient experience-led review of mealtime menus
Strengthened protected patient mealtimes
Following the focused inspection visit, the trust’s overall CQC rating remains Requires Improvement.
This rating dates back to the organisation’s last full inspection in 2019.
Since then, the trust has undergone a number of significant changes which were not examined by the CQC and are expected to be covered at the organisation’s next full inspection.
For example, since 2019, the trust has been empowering its clinicians to make the decisions about how the organisation allocates resources and delivers care.
This clinically-led approach has been at the heart of the organisation’s response to COVID-19.
The measures taken by the trust’s experienced clinicians to separate its hospitals into COVID and non-COVID patient pathways helped to achieve some of the lowest hospital infection rates in the North of England, and recovery rates for the most critically ill coronavirus patients have been amongst the highest in the nation.
In the last two years, the trust has also permanently recruited more than 200 extra nurses and midwives, and the most recent CQC patient experience surveys rated the trust consistently above the national average for inpatient medical care and significantly above the national average for the experiences of children.
The number of people waiting a long time for a non-urgent planned procedures disrupted by the pandemic has been reduced by more than two-thirds, and this year the trust was ranked again in the top-two most improved trusts in the country in the national NHS Staff Survey.
Hilary Lloyd, chief nurse at South Tees Hospitals NHS Foundation Trust, said: “We fully accept the findings detailed in the Care Quality Commission report and our experienced doctors and nurses acted immediately on inspectors’ initial feedback this winter.
“As just one example, we have strengthened our approach to protected mealtimes to make sure ward-based colleagues have the time and space to ensure patients receive the right meal at the right time with the right amount of support, and that food and drink is properly recorded.
“I am pleased that inspectors also found that doctors and nurses worked well together for the benefit of patients across multidisciplinary teams, and treated patients with compassion and kindness. The CQC also praised the responsiveness of colleagues at all levels of the organisation, and we are determined to continue making the necessary changes and learning and improving as part of our recovery from the pandemic.
“Despite the success of the vaccination programme and development of new treatment options, Omicron played a big part in this winter being one of the most challenging we have ever experienced, and I want to say an enormous thank you to all our colleagues for again going above and beyond.”
Mike Stewart, chief medical officer at South Tees Hospitals NHS Foundation Trust, said: “As a clinically-led organisation, safety has been at the heart of our response to COVID-19 and the enormous work of all our teams has helped to achieve some of the lowest hospital infection rates in our region, which has saved lives.
“However, the measures required to maintain strong COVID-19 infection prevention for patients and service users – combined with the impact this winter’s record-breaking community infection rates had on our colleagues, with more than 500 COVID-related absences at the Omicron wave’s peak – meant that not every patient always had the experience we would want. It’s also the case that while Omicron caused particular challenges this winter, this pressure has been continuous since July of last year due to the Delta variant.
As the Omicron wave reduced, we moved quickly to make immediate changes as part of our clinically-led recovery from COVID-19 and will continue to take forward the actions we need to make in response to inspectors’ feedback.”Mike Stewart, chief medical officer