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Team NUH is 'Outstanding' for Caring

We’ve been rated ‘Outstanding’ for Caring and ‘Good’ overall by the Care Quality Commission (CQC) in our latest inspection, which is fantastic news for our patients, their families and staff at our hospitals.

Nottingham University Hospitals NHS Trust (NUH) - which includes Nottingham City Hospital, Queen’s Medical Centre, Ropewalk House and services run from the National Centre for Sports and Exercise Medicine at Loughborough University - was rated ‘Outstanding’ for Caring and ‘Good’ in the Well-Led, Effective and Responsive domains, as well as Overall.

In the CQC’s words: “Feedback from people who use the services was continually positive and there is a strong, visible person-centered culture.” The Report, published on Thursday 14 March, goes on to say that: “Staff were motivated and inspired to deliver care that was kind and promoted dignity, were consistently compassionate about patient care and strived to go ‘above and beyond’.”

Tracy Taylor, NUH Chief Executive, said: “We are absolutely delighted that the CQC have rated NUH as a ‘Good’ organisation and ‘Outstanding’ for Caring, knowing the confidence this will give our patients, their families and carers in the quality of care and services provided by their local hospitals.

“We are very fortunate in Nottingham to have so many passionate, compassionate and talented staff and volunteers who make up Team NUH. Nottingham can and should be very proud of its local hospitals and I hope the city will join us in celebrating this brilliant achievement.

“The CQC said our staff were motivated and wanted to provide the best possible care for patients and were proud to work for the Trust. Inspectors praised our staff for working together as a team to benefit patients and for supporting each other to provide good care. They also commended the Trust for its approach to continually improving the quality of its services and high standards of care by creating an environment in which excellence in clinical care could flourish. We pride ourselves at NUH on ‘listening and caring’ and receiving recognition from the CQC that we consistently do so demonstrates that we take this seriously.

“As an organisation that remains committed to continuous improvement and learning, we will celebrate the areas of good and outstanding practice (not least our caring staff) and importantly, use this inspection to further improve patient safety, care and experience for those we serve and our staff.”

Areas of outstanding practice identified by the CQC included:

  • Our unique Junior Doctor Liaison role (which offers pastoral support to over 1,000 trainees and trust grades across the Trust)
  • Our approach to Shared Governance which is the most established programme in the NHS and strengthens staff engagement & empowerment
  • Strong local community engagement to drive improvements such as seeking input from patients to develop the Memory Menu
  • Strong ethos of learning & training (Emergency Medicine)
  • Integrated Discharge Team – including training for teams across NUH re: excellence in discharge practice
  • ‘Outstanding’ for end of life care for patients and their families (City Hospital)
  • At forefront of national best practice in Critical Care, including NHS Blood and Transplant Guidelines
  • Praise for making hospital fun for young patients who are cared for in our Nottingham Children’s Hospital (Giggle Doctors, Therapy Dogs and Spiderman)
  • Strong digital culture  (how the Trust embraces technology to improve safety and quality of care)

Tracy added: “We are disappointed that our rating in the Safe domain remains as ‘Requires Improvement’ and we are all determined to make the required improvements in this area. The CQC found that patient safety incidents were managed well and recognised much good practice, including how our staff work with other agencies to protect our patients, patient risk assessments and escalation of deteriorating patients. However, the CQC had some concerns about consistency of prescribing, giving, recording and storing medicines and compliance with mandatory training as well as cleanliness and staffing levels in some local areas to ensure optimal patient care.”

CQC identified one area where we must take rapid action, and this is ensuring we fully, clearly and consistently document Do Not Attempt Resuscitation CPR decisions.

Other areas that the CQC have advised we make improvements in include:

  • More consistent application of the principles of the Mental Capacity Act
  • Improving compliance with medical equipment checks
  • Ensuring equipment and environment is consistently visibly always clean
  • Keeping clinical bins locked at all times
  • Compliance with Mandatory Training

A team of over 30 inspectors, made up of patients, doctors, nurses, other healthcare professionals and managers visited QMC and City Hospital over 15 days (announced and unannounced) between November 2018 and January 2019. They closely examined seven clinical pathways/services; end of life care, urgent and emergency care, medicine (including Healthcare of Older People), Critical Care, Children & Young People, Maternity and Neonatal Services. Our processes were properly tested (notably complaints, patient involvement, governance).

CQC spoke to patients, carers, staffside leads and staff of all levels. They also sought views and perceptions of NUH from external partners as part of the inspection.

The inspection comprised three parts:

  1. Core service review
  2. Well-led review (over three days)
  3. Use of Resources review

Our full Report is available here.