Inspectors from the hospital regulator, the Care Quality Commission (CQC), visited Great Western Hospitals NHS Foundation Trust (GWH) from 11 to 13 February 2020, assessing the care and treatment received by patients.
But on 16 March 2020, all routine inspections were suspended due to the COVID-19 pandemic. As a result, the CQC could not complete their inspection of GWH. They have, however, issued a report based on findings from four completed service-level inspections: urgent and emergency care, medical care, surgery and maternity.
“Inspectors found improvements in all the services inspected. Medical care showed significant improvement and achieved an overall rating of Good. Maternity services retained their overall rating of Good, with improvements seen in safety. Urgent and emergency care and surgery did not change from the last inspection and remain rated as Requires Improvement.”
The well-led inspection – which considers the leadership, management and governance of the organisation – was not completed.
Under its rules, the CQC can only update a hospital trust’s overall rating when a well-led inspection is completed. So GWH’s overall ratings remain as specified after the CQC’s previous comprehensive inspection in 2018, when it was given the overall rating of ‘Requires Improvement’: “The trust remains Good for being effective, caring and well-led and Requires Improvement for being safe and responsive.”
Across all GWH’s services, 87 per cent are now rated as Good, including maternity and medical care. Staff in the Emergency Department were recognised for their resilience and compassion in delivering safe care to patients under significant operational pressures, and a number of improvement projects were highlighted in the report as outstanding practice.
The Trust will receive its final rating in due course, when the ‘well-led’ element of the inspection can be completed.
Kevin McNamara is GWH’s Chief Executive: “I’m pleased that the CQC has recognised the huge steps forward we have taken on our improvement journey and I’m proud of how far we have come. Inspectors found improvements in all the services they visited and for such a high percentage of all services to be rated as Good, is a huge achievement.”
“We mustn’t lose sight of the fact we have made all these improvements while treating more and more patients, and having also taken on additional services such as our primary care practices to support the wider health system.”
“It’s also important to remember that the inspection was carried out when the reality of COVID-19 was starting to become apparent and we were preparing for the pandemic.”
“We are already working to address the areas for improvement highlighted by the inspectors and I’m confident that this will be recognised when the CQC visit next.”
Nigel Acheson is the CQC’s Deputy Chief Inspector for Hospitals in the South: “[GWH] has worked solidly to embed a number of the improvements we requested at our last inspection. I want to congratulate them for this work and their improvements at previous inspections against a backdrop of year on year increases in patient numbers.”
“The trust has also taken on a number of failing services within the [Swindon] community to help support the local healthcare system. I am particularly pleased that during this inspection we were able to see the trust not only embedding improvements within its hospital-based services but also driving and embedding improvements in the new primary care services it has acquired.”
“We fed our findings back to the trust and its leadership knows what it needs to do to bring about further improvements and we will return at a later date to complete the inspection process and to check on the progress that has been made.”
This interruption to their inspection will be disappointing for GWH especially as each inspection costs a hospital a significant amount of money.
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