A CHIEF hospitals inspector has called for further improvements to be made in health services in north Cumbria following an inspection.

The concerns were made by England’s chief inspector of hospitals, Professor Ted Baker, after an inspection by the Care Quality Commission (CQC) of the North Cumbria University Hospitals NHS Trust in July and August.

Staff from the CQC looked specifically at urgent and emergency care, plus medical care at the Cumberland Infirmary in Carlisle, the West Cumberland Hospital in Whitehaven, and the Birthing Centre at Penrith Hospital.

Inspectors also examined services for older people, plus surgery, maternity and children and young people’s services. The management and leadership of the trust was also reviewed.

As a result, the trust maintains its rating of Good for being caring, although safe, effective, responsive and well led are rated as Requires Improvement.

The CQC has also published the trust’s Use of Resources report, which is based on an assessment undertaken by NHS Improvement.

The trust has been rated as Requires Improvement for using its resources productively.

Overall, the combined rating for the trust, taking into account CQC’s inspection for the quality of services and NHSI’s assessment of Use of Resources, is Requires Improvement.

Speaking about the findings, Professor Baker said: “Since our last inspection, North Cumbria University Hospitals Trust has not been able to consistently sustain the pace of improvements that we had previously seen.

“I am concerned that the patient flow through Cumberland Infirmary and West Cumberland Hospital has deteriorated.

“Patients were left without treatment for too long in these hospitals’ urgent and emergency departments, which resulted in a number of serious incidents.

“However, patients’ feedback was positive and we saw that staff were providing compassionate care.

“Everyone was clearly working hard to deliver the best care they could under pressure.

“We do recognise that recruitment remains a long running challenge for the trust and I am satisfied that the leadership team are responding to the concerns we have raised.

“The trust has come a long way but further improvements are needed.

“We will continue to monitor the trust closely and return in due course to reinspect its services.”

Inspectors visiting the Cumberland Infirmary and West Cumberland Hospital found that patients experienced long waits for treatment because bed availability across the trust was limited, placing pressure on other departments and preventing patients from being admitted quickly.

There had been several serious incidents at West Cumberland Hospital because patients were not being transferred quickly enough to their specialist wards.

Across the trust nursing staff vacancies continued to go unfilled and the trust’s use of locum doctors was high.

Staff sickness was also high and several ward shifts were not fully supported, which risked staff safety.

In both Cumberland Infirmary and West Cumberland Hospital mental health assessment areas, they failed to meet best practice guidelines.

The rooms contained inappropriate equipment and a number of ligature risks, that made the rooms unsafe for patient use.

The trust took immediate action after these concerns were raised by inspectors.

A number of improvements have also been outlined following the CQC’s inspection.

In the Use of Resources report, published after an assessment by NHS Improvement, the area was also rated as requires improvement.

However, the CQC noted outstanding practice in joint working to reduce delayed transfers of care (patients who are medically fit to leave hospital but experience delays), innovative recruitment efforts, use of technology and a significant reduction in musculoskeletal (MSK) referrals thanks to earlier screening.

Several areas for improvement were also raised by the CQC and the trust says work is already underway to address these.

Stephen Eames, chief executive of NCUH and Cumbria Partnership NHS Foundation Trust, said: “The report shows that we have made some significant improvements since the last inspection in 2017 despite the pressures our services are under.

“In particular, our surgery and maternity services have both received improved ratings of good which is fantastic news for our staff and patients.

“I said throughout the inspection that we were aiming for good and although we didn’t achieve this overall, we have made real progress which we should all be proud of.

“The fact that all services were rated as ‘good’ for caring is testament to our hard working staff, I want to thank every one of them for the dedication they show day in, day out.

“We know the pressures that these services are under not just in north Cumbria and as we move into winter we have plans in place to improve patient flow and to ensure patients are being treated in the right place at the right time.

“It was encouraging to see the report highlighted the impact that working together across the health system is already having and by continuing to do this we will ensure people are treated in the best place for their needs.”

Full details of the report, with ratings for all core services given, are online at www.cqc.org.uk/provider/RNL