'Significant' improvement for Liverpool hospitals following CQC inspections

The CQC carried out an unannounced inspection of urgent and emergency care services at University Hospital Aintree last December, as well as an infection of medical care (including older people’s care) at the New Royal Liverpool University Hospital in October, as part of routine monitoring of services.

Following the December inspection University Hospital Aintree, it’s urgent and emergency care services have improved from inadequate to good overall and for being well-led.

The responsive category rating has moved up from inadequate to requires improvement, and safe and effective have improved from requires improvement to good. Caring has been re-rated as good.

The CQC said: “Patients, their family, and carers were positive about interaction with staff and the treatment they received in the emergency department.

“All said they were treated with compassion and kindness. All patients felt communication was good and that they were informed of care options and treatment plans. Patients and their families felt there was adequate and visible staff in the department, and that it was clean and tidy.”

While many patients said they were treated with dignity and respect, the CQC noted issues with maintaining confidentiality when patients were waiting in areas not designed for clinical care.

While the service did improve on responsive, the CQC said: “People experienced long wait times and felt that there was a lack of clarity regarding how long they would wait to help manage their expectations and relieve any uncertainties they had.”

The overall rating for University Hospital Aintree remains as requires improvement.

Karen Knapton, CQC deputy director of operations in the North West said “signifcant improvements” had been made since the previous inspection but noted that patients arriving at the urgent and emergency care department faced “long waiting times for a bed”.

The New Royal Liverpool University Hospital’s medical care services were inspected between October 1 and 15, resulting in its overall rating improving from requires improvement to good, as well as for being responsive and well-led. Effective and caring have been re-rated as good. Safe has been re-rated as requires improvement.

According to the CQC’s report, patients and any family or carers with them were all positive about the staff treating them with warmth and kindness and providing effective care and treatment. Patients said they were seen quickly by staff and care and treatment plans explained to them.

Healthwatch had been contacted by some people with concerns over delays to be admitted to a ward, but most people reported they received good care.

The safe category retained its requires improvement rating, with the CQC stating: “Staff managed medicines well and involved people in planning any changes.

“However, trust policy was not always followed when administering rapid tranquilisation medicines and some medicines were not always stored correctly. We fed this back to leaders at the time of inspection and assurance was provided that action was taken to address these areas. The division experienced higher levels of hospital acquired infections.”

New Royal Liverpool University Hospital has been run by Liverpool University Hospitals NHS Foundation Trust since October 2019. As not all key services in this hospital have been inspected since this date, it does not have an overall rating.

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Discussing both hospitals, Karen Knapton said: “When we inspected urgent and emergency care at University Hospital Aintree, and medical care at New Royal Liverpool University Hospital, it was positive to see that significant improvements had been made since our previous inspections, and both services are now rated as good.

“In both services, people told us about their positive experience of the care and treatment they’d received. They felt staff treated them with compassion and kindness and communicated clearly to them about their care and treatment, so they could make informed decisions about their care.

“However, when people arrived at the urgent and emergency care department at University Hospital Aintree, they experienced long waiting times for a bed when they needed to be admitted onto a ward. This was due to pressures in other parts of the hospital.

“There were also delays with people’s care being handed over to hospital staff, when they arrived by ambulance. However, the trust is aware of these concerns and have told us about improvements they’re making to address the issues.

“The trust should be really pleased with the improvements they’ve made and their new good ratings. They should use them as a foundation to keep building on.”

Peter Turkington, Executive Managing Director of Aintree University Hospital, said: “This report speaks volumes about the dedication and resilience of our teams in delivering high-quality patient care. It’s a significant achievement to improve their rating from inadequate to good, particularly following an inspection during a very busy winter, and our teams should be very proud of this.

“I’m pleased the CQC recognised our work with system partners to enhance services and foster a culture of continuous improvement. While challenges remain around patient flow in the Emergency Department and timely admissions, we’re working with local authorities and social care providers to speed up safe discharges and improve overall patient experience.”

Natalie Hudson, Executive Managing Director of the Royal Liverpool University Hospital, added: “This good rating is a result of the hard work by dedicated and highly skilled colleagues across our medical care services to make improvements since their last inspection, so that patients can be assured they are getting the best care possible.

“I’m particularly pleased that the CQC recognised the collaborative work we are doing with our partners, to reduce admissions and improve discharge processes, and ensure that patients receive care in the most appropriate place for their needs.

“The CQC did highlight areas for improvement around hospital acquired infections and medicines management. We are taking steps to address these and will continue to focus on these areas, but this improved rating is a significant achievement that our teams should be very proud of.”