North Bristol NHS Trust’s response to CQC report (April 2016)

We welcome the publication of today’s report from the Care Quality Commission (CQC).

Although we are still rated overall as “requires improvement”, the significant progress that has been made across the Trust over the past year has been recognised - nowhere more so than our Emergency Department (ED) which has increased its rating from “inadequate” to “good.”

This is a reflection of the hard work of all staff within the department and I know they are justifiably proud of the new rating. It shows that the changes that have been made since the last report are working – particularly around patients receiving more timely assessment on arrival at ED.

We are particularly proud of the improvement to “good” in the ratings for Maternity and women’s health services and critical care, reflecting the high quality care delivered in both areas.

There were a number of areas of outstanding practice highlighted including our regional major trauma unit which has the best survival rates of any trauma unit in England and Wales and our work around dementia care, inspectors noted that not only did we have good plans but that dementia practice was high quality at every level in the organisation.

Inspectors noted that frontline staff continued to be passionate about providing high quality care with a continual drive for improvement.

Another key area that saw a marked improvement was around services being well led – where the Trust was ranked as “good.” This is reflective of our strong culture of promoting high quality, patient centred care with improved governance systems and clear visibility of risks at Trust Board level.

Improvements were also recognised in terms of patient flow throughout the hospital – which, of course puts additional pressure on the beds we have available for people coming through ED – but more work needs to be undertaken as bed occupancy was consistently high and there were a large number of delayed transfers of care.

We continue to work with our partners to improve the flow of patients through the hospital and increase the numbers of patients cared for in the community, freeing up hospital beds where appropriate. The implementation of the discharge lounge in October 2015 and a relentless focus on improving discharge processes was also positively noted.

More work needs to be completed on tightening up security around paper records, particularly in the theatres and outpatient departments and around increasing the number of staff undertaking mandatory training.

The report also picked up on the higher than acceptable numbers of cancelled operations and long waiting times for some procedures.   Some cancellations have been due to winter pressures and capacity in the hospital and clear plans are in place to restore long waits to national standards, however this has also been a national issue in some of our specialities.

Overall we are very pleased with the report as it accurately reflects our ongoing journey since the move into the new hospital. We are not complacent and are determined to make further improvements which we hope will be reflected in future CQC reports.

Andrea Young
Chief Executive
North Bristol NHS Trust