Improvements Made At Royal Bournemouth Hospital

A report's found there have been big improvements in the level of patient care at the Royal Bournemouth Hospital.

Inspectors had identified four areas for improvement following an inspection of the Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust in October 2013 under the Care Quality Commission's in depth inspection programme. They included staffing levels and treating patients with respect.

A further unannounced inspection which took place in August 2014 has concluded that the trust has now addressed the main issues.

Inspectors found that since the original inspection the trust had taken steps to improve leadership at all levels, with a focus on improving the quality of its services to patients.

- There were increases in staffing levels and increased support for junior doctors. The appointment of clinical matrons and support for ward sisters to focus on supervision of staff on the wards now supported planning and the delivery of safe and effective care.
- The speed of access to diagnostics and the stroke unit had improved, although the trust still needed to review out of hours cover to ensure these patients had access to specialists once on the stroke unit.
- Improved security arrangements meant that staff on A&E were better protected from abuse.
- Further training had led to improvements in patient care, particularly for those living with dementia.
- The introduction of an Elderly Care Directorate with a new assessment ward and pathways had improved the care for older people and the flow of patients through the hospital.
- The practice of using extra beds to cope with high demand  - which were not always safe - was no longer used.
- The complaints policy and processes had been reviewed and the trust was working more closely with local Healthwatch and patients to listen to their views and experiences.

The Chief Inspector of Hospitals, Professor Sir Mike Richards, said:

"Our inspection last year highlighted some real concerns, particularly about the quality of care on some wards, the staffing levels and the trust's strategy to cope with high occupancy rates.   So I am very pleased to see that our latest inspection has found definite progress, which has led to a much better service for patients.  

"At the time, we said that the impact of poor care on patients outweighed the many positive comments we had received about the hospital.   It is now clear that the trust took our findings to heart, seeking external advice to help it improve leadership across all services, particularly in the A&E department and medical services, which we have now found to be much more responsive to the needs of patients.

"It is encouraging that we found that staff were proud of the improvements achieved since the last inspection, but they recognised that there was more to be done to ensure the changes were embedded and the quality of services sustained.    I shall continue to monitor their progress."

Basil Fozard, Medical Director at the hospital, said:

"I would like to start by thanking colleagues for all of their hard work which has been recognised in such a positive way by inspectors. It reassures us that the improvements made over the past year are making a difference.

"While it's important that we do recognise the huge progress made in the past year, the follow-up inspection is part of a longer improvement journey to ensuring we provide consistently high quality care across all areas of our hospitals.
"We know that further work is needed to reduce the demand on staff and our services and to strengthen recruitment even further. We also need to ensure the improvements we have made are sustained," added Basil.

Tony Spotswood, Chief Executive, said:

"Leadership within the organisation has been a crucial focus for the Board of Directors in ensuring we provide quality care for all patients. Our nursing leadership is more focused with the appointment of 14 matrons. We have also appointed over 30 consultants since October 2013 in a range of specialties in medicine, radiology, surgery and care of the elderly."

"We have been engaging with staff and patients to develop, and begin to embed, a new set of values. Our staff say they feel better engaged, more supported and part of a learning culture. Together we are creating the right culture that promotes excellent care for every patient, every day, everywhere. We look forward to continuing this important work which is the foundation for all improvement."

Director of Nursing, Paula Shobbrook, added her thanks to the public:

"We would also like to thank our patients and the public for continuing to tell us when we get it right - this is appreciated by our staff - and when we could do better. This has informed our improvement and will continue to do so in the future as we make the changes that we need to.

"We know there is further improvement to make. As well as continuing to work on improving the flow of patients, strengthening the out of hours crisis support  and continuing with our recruitment, we have work to do to improve our stroke service response time out of hours. There are areas where the CQC have said in its report we should make improvement, which we accept and are addressing."

The full report is available at http://www.cqc.org.uk/location/RDZ20.

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