England’s Chief Inspector of Hospitals, Professor Sir Mike Richards, has published his report on a focussed inspection at Mid Staffordshire NHS Foundation Trust.
The Care Quality Commission carried out the inspection, between 30 June and 2 July, at the request of Monitor, the Trust Development Authority (TDA) and the Trust Special Administrator (TSA).
The inspection looked specifically at whether the trust’s clinical services, at both Stafford and Cannock Chase Hospitals, were safe and sustainable.
It concluded that while services were safe, staffing levels were only just adequate in some areas at that time, particularly on medical wards.
Professor Sir Mike Richards said:
“Following our inspection I wrote to Monitor, the Trust Special Administrators and the Trust Development Authority with details of our findings.
“I reported that senior managers at the trust, including the chief executive were spending inordinate amounts of time ensuring individual nursing shifts were adequately filled and that sufficient numbers of medical staff were available for different services. They had just been able to do this, but I would emphasise the word just.”
During the inspection some examples of high quality care were found, but staff, who were seen to be caring and committed to their roles, were fatigued due to the relentless external scrutiny on the trust and uncertainty about the future.
The trust had difficulties recruiting and retaining medical and nursing staff because of continuing uncertainties about its future and its previous poor reputation. There was a significant reliance on using temporary nursing and medical staff, all of which was seen to have a destabilising influence across the organisation.
Sir Mike previously told Monitor, the TSA and TDA that people working at the trust needed clarity about what was to happen next as CQC felt the uncertainty contributed to the fatigue and fragility amongst staff.
The transition plan for the trust also needed to include a commitment by the acquiring organisations to support medical and nursing staff levels so that services could remain safe.
“Inspection team members were unanimous in their view that services would be unsustainable should any degree of winter pressures arise. If recruitment or retention fell by even one or two people in some key posts, services would become unsafe,” added Sir Mike, “It is therefore imperative on safety grounds that the transition should not be delayed.”
Services at Mid Staffordshire NHS Foundation Trust are to transfer to new providers, from 1 November when responsibility for Cannock Chase Hospital is due to fall to the Royal Wolverhampton Hospital NHS Trust (RWT), while Stafford Hospital will go to University Hospitals of North Staffordshire NHS Trust (UHNS).