An acute trust which had previously struggled with both financial and performance problems will come out of special measures following a Care Quality Commission inspection.
NHS Improvement has confirmed that Wye Valley Trust will exit special measures following a recommendation from the CQC’s chief inspector of hospitals.
The trust had been rated inadequate since October 2014, but there was strong evidence that Wye Valley Paddy improved its operation.
Progress made at the trust led to it being rated good for such areas as critical and end of life care.
However, as with most assessments there are still areas of improvement required by the trust, and thus it was rated inadequate for the level of responsiveness demonstrated.
Surgery, gynaecology and outpatient appointments also require attention.
But the Care Quality Commission was satisfied that sufficient progress had been made for the trust to be removed from special measures, with a process of assessment ongoing in accordance with this recommendation.
CQC Chief inspector of hospitals, Professor Sir Mike Richards, outlined the view of the commission.
“There clearly remain areas where further work is needed, in particular with regard to the trust’s responsiveness in accident and emergency, bed occupancy concerns and referral to treatment times, but we found considerable and positive change had taken place. Morale had significantly improved and there was a sense of pride amongst staff towards working in the hospital who felt respected and valued.”
Richards went on to state that those working at Wye Valley Trust deserve accreditation.
“The trust’s staff and leadership should be proud of their achievement so far and they know what to do now to ensure those changes takes place. We will continue to monitor the trust and this will include further inspections.”
NHS Improvement delivery and improvement director, Jeffrey Worrall, was equally keen to acknowledge the developments and progress made by the trust.
“Today’s news shows just how far the trust has come and recognises the hard work of staff at all levels of the organisation. We have to make sure that the trust can build on the excellent progress that’s been made in improving services and ensure the trust is sustainable in the longer term. Strengthening the partnership between Wye Valley and South Warwickshire NHS Foundation Trust is an important step forward.”
Trust chief executive Richard Beeken reflected on a job well done, while also outlining plans for the future.
“This outcome is great news for the residents of Herefordshire and those across our borders who use our services. The report confirms that substantial improvements have been made in many areas – and once again our quality of care has been rated as good throughout the trust. However, these improvements are only part of the answer to the sustainable delivery of high quality, safe services in the county.”
NHS Improvement is the operational name for an organisation that brings together: Monitor, NHS Trust Development Authority, Patient Safety (from NHS England), National Reporting and Learning System, Advancing Change Team and Intensive Support Teams, formed on 1st April this year.
Norfolk and Suffolk Foundation Trust has been removed from special measures after demonstrating a serious improvement in its performance.
The FT had been in the unenviable position of being the only mental health trust to receive the lowest Care Quality Commission rating back in October 2014.
Following this inspection, the trust was placed in special measures in February 2015.
NHS Improvement has now indicated that it will remove the special measures mandate, after the Norfolk and Suffolk Foundation Trust improved in several categories.
Nonetheless, the trust was still rated inadequate for whether services are safe.
NHS Improvement and the trust will now agree an action plan to address the safety concerns, which include:
– a number of environmental safety concerns including ligature points;
– mixed sex accommodation not meeting national guidance;
– concerns about the design of seclusion and places of safety, and seclusion not being managed within the Mental Health Act code of practice; and
– staffing levels being insufficient on inpatient wards.
NHS Improvement’s delivery and improvement director for the East of England, Frances Shattock, outlined some of the positive progress made by the trust since it has been reported on so damningly.
“There is clearly much more to do to ensure that the trust sustains and builds on these improvements. We will continue to provide the trust with extensive support to ensure it is able to give the standard of care patients expect.”
Following further inspections at the trust in July and August, CQC investigators discovered that “considerable progress” had been made, in line with the recommendations of the inspectorate.
And Chief Inspector of Hospitals, Professor Sir Mike Richards, recommended the trust be taken out of special measures after finding it had “clearly gained from the intensive support of the regime”.
Richards was pleased that the mental health trust is heading in the right direction.
“Our return to Norfolk and Suffolk Foundation Trust showed significant improvement had taken place. There clearly remain areas where further work is needed, in particular with regard to how the trust manages risks to people’s safety, but we found considerable and positive change had taken place”.
The Chief Inspector of Hospitals particular noted the improvement in the perspective of staff.
“Morale had significantly improved, there were better systems for recording and learning from incidents and people’s needs were assessed, with care and treatment planned to meet those needs.”
Chief executive of the Norfolk and Suffolk Foundation Trust, Michael Scott, noted that “what we have done is engage much more with our workforce – that has been the secret of our success. That has allowed us to deliver the quality improvements the CQC have seen. What we done already is a significant cultural change, that’s what’s most pleasing.”
The Care Quality Commission (CQC) has agreed to review recommendations made by a High Court judge regarding its inspection process.
It had been indicated by the High Court that the complaints process should be made fairer for GP practices, with the judge ruling over the case suggesting that this could reduce litigation costs for the NHS.
The CQC was told to appoint an independent expert to review GP practices’ requests for factual corrections before publishing their inspection report, rather than leaving it solely up to the lead inspector.
High Court judge Mrs Justice Andrews commented in her ruling that there was “little point in giving someone an opportunity to make factual corrections, if there is no procedural mechanism for safeguarding against an unfair refusal to make them”.
Andrews rejected the position of the Care Quality Commission, which was that there should be no mechanism for complaining against decisions taking during the 10-day window for factual corrections.
Justice Andrews was ruling on a judicial review claim brought by private APMS provider SSP Health.
The organisation had suffered three practices being placed in special measures in 2015, following a CQC inspection which considered their services to be inadequate.
But Andrews considered the burden of expectation on the inspected party to bring a legal claim into court as being disproportionate.
“It is well established that judicial review should be a course of last resort. Moreover, this court is generally an inappropriate place to resolve disputed issues of fact. Legal proceedings are time-consuming and costly for all concerned. Both the regulator and the regulated body will be subject to financial, as well as time, constraints.”
Andrew also believes that clinical commissioning groups should benefit from an internal independent process, having stated that she was convinced that the lead inspector of the Care Quality Commission should be the sole arbiter of whether changes should be made to a report.
“An independent person within the CQC ought to be able to tell fairly swiftly whether there is or is not a legitimate grievance about the lead inspector’s failure to correct the report. Such a person should be much better placed to resolve that grievance than the court is.”
Responding to the court verdict, a spokesperson on behalf of the Care Quality Commission indicated that they would be reviewing their processes.
“As part of CQC’s strategy for the future regulation of general practice, we are looking at all aspects of our methodology to determine what needs to be improved.”
Dr Robert Morley, chair of the GPC contracts and regulations subcommittee, indicated that the attitude of the CQC had been less than desirable.
“This High Court judgement only goes to provide further proof of what so many people who have had any dealings with CQC have been saying for a very long time- the organisation needs to take a long hard look at its own processes and procedures before it continues to pass judgments on others. It’s a huge and completely unnecessary burden on general practice and as an immediate step all its GP inspections and ratings should be suspended until it has shown in can get its own house in order.”
The first NHS hospital to be placed completely under private management has been rated as good as following two years in special measures.
But regulators still ruled that Hinchingbrooke Hospital must improve its emergency care.
Hinchingbrooke was placed in special measures in September 2014.
At that time it was run by Circle Health, but the hospital returned to NHS control in April 2015.
But the Care Quality Commission (CQC) inspected the hospital back in May, and discovered that significant improvements have been made to the condition of service.
Hospital chairman Alan Burns believes that the verdict of the Care Quality Commission represents “a terrific vote of confidence in our staff”.
While the Accident and Emergency department still requires improvement, Burns stated that the rapid escalation in the number of patients, coupled with national staff shortages, had scuppered attempts at Hinchingbrooke to improve the situation.
But in assessing the quality of care at the hospital, the commission discovered that there is outstanding practice at the trust.
The CQC report particularly focused on its end-of-life care for patients at a local prison and the employment of an Admiral Nurse to support people with dementia.
Inspectors also reported that the quality of conduct from staff had impressed them, with a caring and compassionate attitude particularly prevalent.
Management of the hospital also received praise, despite the criticism of Accident and Emergency.
The A&E department “is as good as any around,” sccording to the aforementioned Burns.
And the Chief Executive suggested that the 50,000 patients it was forced to deal with over the last year is simply unrealistic and has led to difficulties.
Indeed, Burns went as far as praising those working in A&E at the hospital, assessing that they “have done remarkably well shifting the department from inadequate to needs to improvement”.
The hospital chairman commented that “[demand] has gone up 8% this year and we have two-and-a-half consultants on our books, compared to the six we should have. The problems here are problems in every A&E department in the country”.
CQC deputy chief inspector of hospitals Edward Baker stated that “the trust leadership knows what it must do now to ensure further positive change takes place.”
Recent statistics have indicated that very few organisations in the existing NHS have been able to acquire an outstanding rating from the Care Quality Commission.
Some experts have thus criticised the assessment process of inspecting organisations as being excessively stringent.
Pennine Acute Hospitals Trust has been rated inadequate by the Care Quality Commission.
The inadequate rating followed the first inspection of its facilities.
Staffing levels, infrastructure, systems, culture and leadership were all considered cause for concern by the regulator.
Pennine Acute Hospitals Trust operates services across four sites in Greater Manchester.
Inadequate services were reported at both North Manchester General Hospital and Royal Oldham Hospital.
Fairfield General Hospital was rated as requiring improvement, while Rochdale Infirmary and the trust’s community services were considered to be good.
The Care Quality Commission was particular critical about the levels of safety and leadership demonstrated by the trust.
Already the Pennine Acute Hospitals Trust Has acquired over £9 million worth of financial support from local commissioners and regional and national health and social care partners.
It is hoped that this will play a major role in improving the safety and reliability of the way services are delivered at the trust.
CQC deputy chief inspector of hospitals Ellen Armistead reflected on the issues which had led to the inadequate verdict.
“We had serious concerns about the systems and procedures that are in place to keep people safe and free from harm. The trust did not have a robust understanding of its key risks at departmental, divisional or board level. In a number of services including A&E, maternity, children’s and critical care, key risks were not recognised, escalated or mitigated effectively.”
It is already well known that major concerns have been raised regarding such issues during an impromptu inspection which was conducted earlier this year.
Sir David Dalton of Salford Royal Foundation Trust was subsequently installed as the interim Chief Executive as a result of problems which were identified at that time.
The Care Quality Commission has now confirmed that the organisation will be placed into special measures as a result of these ongoing difficulties.
Dalton accepted the findings of the Care Quality Commission in a statement:
“The CQC report doesn’t make comfortable reading and whilst staff will be very disappointed with the trust’s overall rating, we welcome this report which I believe is a fair assessment of the issues facing the trust. The CQC report is holding up a mirror to the organisation and reflects very much what staff have been saying for some time on issues related to staffing pressures, inadequate systems, culture, leadership and resources.”
Recent data indicated that the Care Quality Commission has tended to file scathing and critical reports on trust across England, with a relative handful of organisations being considered outstanding.
A serious incident report from the Care Quality Commission has revealed that the NHS regulator has lost 500 files relating to GPs and practice managers.
The incident occurred as part of a process of checks being conducted in order for the individuals involved to become the CQC registered provider of their particular practice.
Unfortunately, the Care Quality Commission has conceded that it has lost a significant amount of personal information.
The information misplaced is part of ‘disclosure and barring service’ files, previously referred to, and more commonly known as, criminal records bureau checks.
This data includes information from the primary medical services, according to media reports.
The files contain personal data, but also mental health information.
With the Care Quality Commission having publicly acknowledge the data breach, the organisation has already written to individuals affected to apologise for the mistake.
There will be particular concerned about this error considering that the regulator has recently announced practices which will lead to strengthen inspections on the data security processes at the commission.
Many will believe that this review cannot come a moment too soon, as the NHS overhauls the way that it deals with sensitive information.
A statement on the CQC website acknowledges the problem, and outlines the extent of the issue.
“During a planned refurbishment of its office in Newcastle earlier this month, it appears that a locked filing cabinet containing up to 500 DBS certificates was wrongly marked for removal and destruction,” the Care Quality Commission concedes.
Although there will be considerable concern about the information getting into the wrong hands, the Care Quality Commission has stated that theft is an unlikely explanation for the issue.
CQC chief executive David Behan wrote to affected individuals earlier this week to notify them of the breach, and an independent review of the CQC’s security arrangements has been launched.
The report on the leak concludes that issues related to contractors can be blamed for the difficulties.
“The root cause of the loss of these documents was the last minute verbal changes to the requirements for the contractors made on 7 July, the lack of adherence to the documented plan and a misunderstanding between CQC staff and the primary contractor team. Should the information contained in the missing folders fall into unscrupulous hands then is has the potential to cause further harm and distress to the individual data subjects.”
The recent breach relates to applications between July 2015 and March 2016.
A major NHS trust has been forced to apologise to over 1,000 patients who have been denied surgery for over 12 months due to NHS delays.
Barking, Havering and Redbridge University Hospitals Trust (BHRUT) released an official apology to the group of patients who have been waiting for year and a month for routine treatments such as knee surgery.
The trust is one of the most significant in the south of the country, and clearly its performance has been below par in recent months.
Responsible for the Queen’s Hospital in Romford and King George Hospital in Goodmayes, BHRUT failed to reach requisite standards when recently assessed.
Indeed, the trust received ‘requires improvement’ in its most recent Care Quality Commission (CQC) inspection.
And the reasons behind this unsatisfactory performance could perhaps be considered particularly worrying.
In its final report on the subject, the CQC painted a picture of hospitals that were unable to meet some of the most fundamental requirements of any healthcare institution.
Both hospitals were “persistently failing to meet national waiting time targets, and some patients were experiencing more than 18 weeks from referral to treatment time” according to the CQC.
BHRUT’s chief executive Matthew Hopkins admitted that the views of the Care Quality Commission where valid, and outlined the resolve of the trust to improve the situation in the foreseeable future.
“It is crucial that patients are seen as quickly as possible and we are sorry that a lot of patients are waiting too long for treatment. We are taking urgent action, working with our local partners and stakeholders, to ensure high quality, accessible care for our patients.”
In addition, Hopkins also suggested that some of the urgent action being taken by the trust had begun to have a positive effect on the overall running of the hospitals that was responsible for.
Hopkins pointed to the fact that the backlog of patients waiting for treatment had been reduced significantly since the CQC report was carried out.
He also stated that the inspection had taken place 12 months ago, and that significant progress had been made in the year since the commission visited, and that the overall picture is now somewhat improved.
However, Hopkins also conceded that there is still “much more work to do”, and that the trust must review all of its procedures in order to deliver a more efficient and effective service to patients.
With regards to those patients still waiting for treatment, Mr Hopkins indicated that “they have been contacted and we are booking in their appointments for the coming weeks.”
Inspection by the Care Quality Commission has resulted in a major NHS service being placed into special measures.
England’s Chief Inspector of General Practice found that the performance of the Peterborough out-of-hours service was below the required standard, and instantly imposed the extraordinary conditions with the hope of improving the situation.
The out-of-hours service provides urgent medical care outside of normal GP hours.
Inspections of the service found that it was utterly inadequate, with safety, efficiency and leadership problems all cited as being problematic.
There was only one crumb of comfort for the Peterborough-based service; it was rated as good for providing caring services.
This does at least suggest that the fundamental purpose of the organisation is being met to a certain degree.
However, the report from the Care Quality Commission identifies a number of areas where improvements must be made.
Nurses did not have access to adequate guidance and there was no evidence that they had been properly trained to deal with certain types of demanding calls.
There were also massive problems with recruitment procedures, and staff files were not kept up to date adequately.
Inspectors were also concerned that the service failed to deliver efficient and timely care and treatment to patients, with response times also rather inconsistent.
And despite the inadequate service that the out-of-hours service is currently providing, there was no evidence of a coherent plan to improve the situation.
Following the inspection, the Care Quality Commission shared its concerns and conclusions with numerous key stakeholders including Trust Development Authority, NHS England and Cambridgeshire and Peterborough CCG.
The trust has already submitted an action plan in response to these concerns, which attempts to address the issues raised by those who inspected the facility.
Commenting on the issue, Janet Williamson, Deputy Chief Inspector of General Practice and Dentistry in CQC’s Central region, provided her take on the problems.
“We found that patients were at risk because systems were not always in place to keep them safe. The provider must ensure that all staff who triage patients have been adequately trained to make clinical decisions by telephone and have been assessed. The service must ensure that the time patients wait for thorough clinical assessment is properly monitored to ensure patient care does not suffer. There must be enough staff on site to keep people safe.”
Williamson also outlined what the commission expects to see achieved in the future.
“Clear arrangements must be put in place to ensure that managers have effective oversight of the performance of the out-of-hours service at all times so that they can take appropriate action to minimise the risks to patients. It is important that the people who use the GP out-of-hours service for Peterborough and surrounding area can rely on getting the high quality care which everyone is entitled to.”
And concluded by explaining the situation going forward.
“We will continue to monitor this service and we will inspect again in six months to check whether improvements have been made. I hope that the service will take the necessary steps, but if we find that the service remains inadequate, we will consider taking further action.”
Dr Neil Modha, Chief Clinical Officer for the Cambridgeshire and Peterborough CCG, acknowledged the problems and resolved to make improvements.
“The CCG has worked closely with CCS since the inspection to ensure implementation of their recovery plan and we have been pleased with the progress and improvements in areas where quality of care were of concern. We will continue to monitor this progress so we can be assured that patients are receiving the high standard of out-of-hours care that we expect.”
The Care Quality Commission has concluded that a care home in Lincolnshire has failed to come up to the requisite standard.
After recently inspecting Lindum Court in Scunthorpe, the Care Quality Commission concluded that the care home needs to make significant improvements immediately.
Lindum Court currently provides residential care for 19 people, along with respite care for two others.
Although many elements of the care home could be considered up to standard, inspectors nonetheless found that the service required improvements related to safety, efficiency and leadership of the institution.
Numerous problems were found at the care home, and these included the following oversights.
Firstly, at some key areas of the care home doors were left unlocked when they should have been secured. This was considered a major security risk by the commission.
The care home has failed to carry out staff appraisals on an annual basis, and audits were found to be insufficiently robust.
Nonetheless, the Care Quality Commission acknowledged that systems had been put in place in order to improve the situation in the foreseeable future.
And the commission also acknowledged that staff at Lindum Court were knowledgeable, kind and caring, understood the principles of safeguarding and people felt safe.
Staff numbers were also satisfactory and they had been recruited in a safe way. They received supervision and were well supported, indicating that employees at the institution were largely up to speed.
However, under the terms of the Mental Capacity Act 2005, the Care Quality Commission insisted upon significant overall improvements being made to the practice of the care home over the next 12 months.
Responding to the verdict of the watchdog, a spokeswoman for Lindum Court suggested that the institution was proud of the care that it gave, but acknowledged that the Care Quality Commission had made valid points.
She went on to reiterate the fact that Lindum Court had made improvements before the publication of the Care Quality Commission report, and are already confident that they will be fully compliant with the requisite standards of care by the time of the next inspection.
Lindum Court comes under the umbrella of the Northern Lincolnshire and Goole NHS Foundation Trust.
According to data acquired by the Care Quality Commission, over 40% of hospitals in the NHS are currently offering palliative care that could be described as the poor or indifferent.
Official figures from NHS inspections have revealed that care for the dying leaves considerable room for improvement.
Data from the Care Quality Commission reveals that 67 hospitals have been rated as “requiring improvement” for their end-of-life care while a further seven have been branded “inadequate”.
Clearly there have been logistical difficulties for the health service recently, but the severity of these figures underline the scope of the problem.
Commenting on the issue, Katherine Murphy, chief executive of the Patients Association, indicated that she is deeply concerned about the issue, and that it must be addressed in the immediate future.
“For patients receiving palliative care, there is only one chance to get treatment right and give patients safe and compassionate end-of-life care. There must be increased leadership and training to help staff provide humane care for dying patients,” Murphy stated.
In addition to the number of hospitals considered to be inadequate, it is also clear that there are few truly outstanding performers in the NHS.
Indeed, only eight of the 176 services services inspected since 2013 were able to achieve this ranking.
94 hospitals were rated as good, indicating that just over 100 institutions in the NHS are offering a standard of care that could be considered acceptable.
Rabbi Julia Neuberger, who led an investigation into care of the dying in 2013, is of the opinion that standards in the NHS across the country are patchy, and have considerable room for improvement.
“I still think there is some poor practice,” Neuberger commented. “They need to get their act together.”
Neuberger also suggested that specialised palliative care advice should be available 24 hours a day, 365 days a year, in order to provide the dying with dignity and satisfactory support.
Professor Sir Mike Richards, the Care Quality Commision’s chief inspector of hospitals, indicated that the inspectorate had decided in 2014 to make end-of-life care one of their priorities due to their awareness of the problem in the NHS.
Three of the seven hospitals rated inadequate for end of life care are part of the Barts NHS Trust in London.
The trust stated that it recognised that some aspects of its end of life care were not as good as they should have been.
“We recognise there is still more to be done and we are committed to meeting our aim for every person to be treated with dignity and humanity.”
Inspectors have condemned the level of safety in a hospital based in Swindon.
The A&E department at Swindon’s Great Western Hospital has been rated “inadequate” by the Care Quality Commission.
Among the problems founded by the health regulator were patients queueing in corridors due to a lack of cubicles.
While there were clearly a lack of provisions in the accident and emergency department, there were also insufficient staff available to care for those waiting, according to a report from the commission.
In addition, the Care Quality Commission said the layout of A&E made it difficult to keep an eye on patients, which “posed unacceptable risks to patient and staff safety”.
Responding to the criticisms, the trust that oversees Swindon’s Great Western Hospital indicated that improvements were being made in line with the report.
The inspection of the facilities was carried out back in October.
Since that date, the Care Quality Commission has been investigating the Great Western Hospitals NHS Foundation Trust, which runs the main hospital and four community hospitals – Chippenham, Savernake, Trowbridge and Warminster.
On a more positive note, both community hospital and children and young people’s services were rated more highly.
Community hospital services were rated “good”, while children and young people’s services were rated “outstanding”.
But Chief Inspector of Hospitals Sir Mike Richards, believed that’s the “marked variation in the quality of services” between those hospitals and the Great Western Hospital was a major cause for concern.
Richards particularly noted the fact that the observation unit at the Swindon-based hospital was unreasonably isolated, ensuring that children waiting for treatment could not be watched adequately.
And Richards also stated in the report that there were insufficient staff to attend to patients queueing in corridors, with employees of the hospital often failing to adhere to “good hand hygiene practices or using protective personal clothing”.
Overall the trust’s services “require improvement”, the inspectors found.
Commenting on the performance of the hospital, Richards indicatied that overall the Swindon institution had performed in a less than satisfactory fashion.
“Although these issues were recognised and known, we found that the necessary improvements had not been made or sustained.”
Richards also acknowledged that the trust had been under financial pressure, and leadership was “open” about challenges and “must now work hard to meet the demands required”.
Responding to the report, the trust’s chief executive Nerissa Vaughan commented that safety was the number one priority of the trust, and that the criticisms made by the Care Quality Commission would certainly be assessed in the immediate future.
“We know we need to do more to build on the improvements we have already made,” Vaughan stated.
Vaughan also added that measures identified by the report had already been implemented in an attempt to improve the situation.
This included new initial nurse assessments, meaning “patients are likely to be seen sooner”, while improved training for staff was also being put into practice.
The Care Quality Commission (CQC) has rated the performance of Colchester Hospital as poor for the second year in succession.
Staff were praised for being “dedicated” but inspectors said they “felt let down” because many agency workers did not show the same level of commitment.
Patients were at a “high risk” of harm according to the commission, and equipment utilised by the hospital was notably out of date.
Additionally, end-of-life patients did not always receive “safe or effective care”, according to an investigation conducted by the watchdog.
Operations were regularly cancelled and some cancer patients had to wait more than 100 days for treatment, the CQC discovered.
But the hospital contested the findings of the CQC, arguing that the final report failed to take account of the massive improvements it had made recently.
The CQC also suggested that the hospital had failed to make tangible improvements in the area of equipment, despite having received previous warnings on this matter.
It was asserted by the CQC that numerous items of equipment at Colchester Hospital had not been tested for many years.
Yet this had previously been raised as an item of concern at previous inspections.
And outpatients were often placed “at high risk of avoidable harm” because of a “real lack of understanding” of waiting lists.
Colchester Hospital University NHS Foundation Trust had originally been placed in special measures over cancer data inaccuracies back in November 2013.
And the latest assessment from the CQC follows the hospital being rated inadequate by the CQC almost exactly one year ago.
At that time the assessor had indicated that Colchester Hospital must take “urgent enforcement action”.
Yet evidently there has been insufficient progress over the last twelve months, despite the recent chief executive appointment of Frank Sims.
Commenting on the performance of Colchester Hospital, Prof Sir Mike Richards, the Chief Inspector of Hospitals, stated his belief that the hospital has a “serious number of problems” and has shown “only limited capacity to improve”.
“While the staff have been working hard through many issues to drive improvements locally, their efforts have been affected by poor leadership and a high use of agency staff, some of whom are unsuitable in terms of their skills and knowledge,” Richards asserted.
Responding to the concerns of investigators, the aforementioned Sims indicated that he was disappointed with the findings of investigators, and to some extent disagree with them.
Nonetheless, Sims also acknowledged that the report had made numerous valid points, and that it would be utilised as a “blueprint for improvement” by the hospital.