North Bristol NHS Trust – 2008/09 CQC Annual Health Check

North Bristol NHS Trust has been rated ‘good’ for its quality of financial management and ‘weak’ for the quality of its services in the 2008/09 Care Quality Commission (CQC) Annual Health Check.
As part of the quality of services rating, the CQC looks at how well trusts are achieving national priorities such as stroke care, cancer waiting times and positive patient experience. It also rates existing commitments including inpatient and outpatient waiting times and access to services such as A&E and chest pain clinics.
NBT scored an ‘excellent’ rating for its progress with national priorities and the CQC confirmed that existing commitments have been ‘fully met’.
The other element to the quality of services rating relates to the CQC’s core standards for hospital care.
Earlier this year North Bristol NHS Trust, with the aim of delivering exceptional health care, completed a rigorous self-assessment of all 44 core standards. Following this the Trust decided to declare non-compliance with four and insufficient assurance with a further five.
Because we did not fully comply with all of the core standards when this declaration was made in April, this has resulted in a ‘default’ weak rating overall for quality of services.
The declarations were around the evidence base to assume compliance in infection control systems and practices, decontamination of medical devices, supervision and leadership, employment checks, recruitment, training and the hospital environment.
This was also partly driven by an Improvement Notice placed on NBT by the CQC back in April that raised concerns about the adequacy of corporate training records and the Trust Board not having an appropriate assurance framework around infection control and prevention.
Sonia Mills, Chief Executive of North Bristol NHS Trust, said: “Robust action and collection of evidence has since taken place to address all the concerns we declared.
“By the end of this month we aim to be compliant with all core standards bar one which relates to the poor quality of our estate. For this we will remain non-compliant and is why we are looking forward to the opening of the new super-hospital at Southmead.
“The issues raised by the CQC in its Improvement Notice were addressed by the end of June and the notice was lifted in August. This means that NBT is now fully registered with the CQC alongside most other NHS organisations in England.
“In addition, a surprise visit by the CQC in September resulted in very positive comments about our hygiene practices and we got a clean bill of health for 2009/2010.
“Based on all of this, the Trust would achieve at least a ‘good’ rating for quality of services in 2009/10.
“The Trust receiving ‘excellent’ and ‘fully met’ ratings for national and existing targets shows the commitment to high quality healthcare that all our staff have.”

The Trust also received a ‘good’ rating for its quality of financial management.
Miss Mills added: “The financial rating is a further improvement for NBT and shows that our financial standing is now extremely sound.
“We have consistently continued to meet our financial targets and, together with our on-going high performing services, we actually have many positive achievements to celebrate.”

Notes to Editors:
North Bristol has taken robust action to address the issues arising from the Core Standards issues.
In Summary:
1. Strategic Board level objectives and approach have been put in place around Infection Control and Prevention.
2. Clear, concise monitoring of all appropriate quality measures is now in place, and a new Quality Committee has been introduced.
3. A full review of all mandatory training has taken place policies reviewed and revised programmes of training put in place.
· All staff are being issued with a new training passport to provide a personal record of their training, as well as the centrally held record.
· All staff are scheduled to receive the mandatory training they require, starting with infection control training.
· Innovative ways to deliver and record training have been introduced including film, electronic learning and the use of the training “passport”.
4. A detailed review of all Core Standards has taken place to ensure that all standards have the evidence and practice in place to assure the Trust Board that the Trust is compliant with the core standards.
5. All required staff have received suitable levels of child protection training.
6. Appropriate equality and diversity policies and procedures are now in place and up-to-date.
7. Evidence is in place to show cleaning practices and processes are now in use and information about these are now cascaded to relevant staff and contractors throughout the organisation.
8. Appropriate practice around the checking of professional registration is now in place and able to be demonstrated.