Enforcement notice on hospital trust lifted after improvements are made to emergency department

The “Section 31 condition” was issued to University Hospitals of North Midlands (UHNM) NHS Trust, which runs Royal Stoke and Stafford’s County Hospital, after the Care Quality Commission (CQC) found a number of issues with the emergency department during an inspection in 2019.

Concerns raised included time taken for clinical assessment on arrival and protection of rights of patients detained under the Mental Health Act. But now the CQC has decided to remove the condition, members of UHNM’s board heard at their latest meeting on Wednesday.

UHNM Chief Executive Tracy Bullock said: “The condition related to the triage of patients within 15 minutes of arrival to our Emergency Department at Royal Stoke. Since the Section 31 condition was issued we have had to provide a weekly report to the Care Quality Commission on actions we have taken to make the necessary changes and the improvements these have made for our patients.

“There has been multiple and significant reviews of what we do in A&E and how we do it, the workforce we have in A&E and how we triage. It’s almost constant monitoring and if our performance starts to deteriorate we want to understand why.

“Our progress has now meant that the CQC has advised us that this enforcement notice has been lifted. My thanks go to all staff involved in making and sustaining the improvements needed which currently put our performance at one of the top five in the country.”

The trust is also aiming to improve its performance against the A&E four hour waiting time target. The national target is for 76 per cent of patients to be admitted, transferred or discharged within four hours of arrival at A&E, but this has not been met by UHNM since April 2021.

In April this year the percentage reached 70.1 per cent, but was 69.4 per cent in June and 68.8 per cent in July, a report to the board meeting said. It added: “Four hour performance remains below the 76% target but consistently during 2023 above the two year average.”

The trust is aiming even higher however, and has set its sights on an 80 per cent target. But non-executive director Gary Crowe asked: “Is this target of 80 per cent realistic?”

Deputy chief operating officer Oliver White replied: “The short answer is yes in non-admitted performance; 80 per cent would be high achieving but there are sites that do it. It’s certainly ambitious and we are having conversations about the scale of improvements and the level of work we are going to have to do to achieve our trajectory.

“The ultimate aim is 76 per cent for our performance by March and I think that’s currently achievable. The 80 per cent for March is specifically for non-admitted patients.”

Non-executive director Leigh Griffin said: “The June data shows only one system hitting 80 per cent – Kent and Medway – and 80 per cent is a significant step. None of us are comfortable with patients waiting longer, that’s a given.”