Patient safety compromised as staff morale plunges at New Cross and Cannock hospitals

The Care Quality Commission has rated the The Royal Wolverhampton NHS Trust was rated as 'requires improvement' following their visit and warned it relied too much on agency nurses to fill rotas.

Key findings by inspectors found nurse staffing issues have had a negative effect on staff morale. They also found that staffing was having a negative impact on patient safety and care, raising concerns over patients falling at Cannock Chase and night time nurse shortages at New Cross.

Despite the call to improve, inspectors found that care in general was good.

• Nurse staffing issues were starting to have a negative effect on morale.

• Staffing levels were having a negative impact on patient safety and care. The report said there had been a number of instances which had resulted in harm to the patients.

• Sickness and staff shortage was taking a toll on morale but the culture within the trust was one

• where the staff were proud to work for RWT and felt empowered and supported.

• Safeguarding adults training compliance was not meeting the trust target by a large margin

• At Cannock, the trust must put in place effective systems to monitor outcomes for patients.

• At Cannock, the trust must tighten up on safety issues and insure that governance systems improve

• At Cannock, the trust must insure that there is clear ownership of responsibilities to ensure the radiology department is working within best practice professional guidelines and regulations.

• At New Cross, the trust recruit extra workers so that they can transport blood more quickly.

• At New Cross, the trust should improve public information about making a complaint in the emergency department.

• At New Cross, the trust should improve the attitude and approach of some staff to patients in their care.

The report states: "We found various safety issues at ward level on our inspection. Where we found that the issues needed to be escalated the trust responded extremely quickly.

"Nursing staffing was an issue with both bank and agency use increasing. This was having a negative effect on staff morale and had also been a contributory factor in some incidents which had resulted in harm to the patient."

The New Cross report added: "Nurse recruitment within medical services was a known challenge for the trust. There were initiatives in place to recruit additional nurses but nursing staff shortages especially at night compromised patient safety."

New Cross was told to ensure the medicine room is locked to reduce the risk of unauthorised people accessing medicines

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Download the full Wolverhampton report

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Medical care was rated as 'requires improvement' at Cannock Chase Hospital. The report added: "The ward's track record on safety showed that improvements were required to protect patients from harm."

"There were many patients falling and some had sustained harm. Some poor infection control practices were seen during the inspection."

It added: "The ward was covering their own nursing staffing shortfalls on a continual basis with limited access to bank or agency cover which was unsustainable."

However, the trust was praised in a number of areas for 'outstanding' practice, including at New Cross Hospital's emergency services department.

A group text system used in the surgery department, which ensures the availability of staff and beds on the day of the operation to avoid any cancellations, was also highlighted.

Meanwhile, staff also told inspectors they were proud to work within the trust and that their colleagues were supportive and friendly.

The trust as a whole also achieved good or outstanding ratings for care, except within medicine for which they required improvement.

"We found staff recognised how their behaviours of compassion and inclusion resulted in better patient outcomes. Patients were treated holistically and relatives and carers needs were also taken into account," the report added.

It comes after the trust, which runs New Cross Hospital in Wolverhampton and Cannock Chase Hospital, was rated as 'requires improvement' in an inspection by the Care Quality Commission.

Chief executive David Loughton, said: "Obviously I am very pleased that 75 per cent of our services are rated as good or outstanding.

"But I am concerned, particularly in the 'safe' domain and particularly for medicine, that the report questions the safety of medicine and we don't agree with that.We consider it to be a safe service, but I acknowledge we have significant staffing issues. We have recruited over 130 nurses from Europe, however that has dried up and it is down to the Government to acknowledge there is a problem in terms of nursing and change the immigration rules, because we could recruit nurses from the Philippines, we successfully did that 10 or 12 years.

"There also needs to be something done about the immigration rules that state that after you have been in this country for seven years you have got to be earning more than £35,00 a year." However, Mr Loughton added he was aware that there were areas that called for improvement. He said: "I wouldn't disagree with some of the areas that they have highlighted.

"We have been under massive pressure since Mid Staffs was wound up and we have had to deal with an increased workload. Generally speaking, I agree with the conclusions with the exception of medicine. That is 1,000 staff on 14 wards and I don't agree with the conclusion."

Following the report senior hospital managers and other bodies held a meeting with CQC representatives and the trust is considering its options. Mr Loughton would not confirm if this meant the trust would be appealing the rating.