Birmingham NHS trust in charge of four hospitals 'requires improvement'

The trust which runs four Birmingham and Solihull hospitals has been rated as "requires improvement" by a Government health body. The Care Quality Commission (CQC) inspected urgent and emergency services, medical services and surgery at University Hospitals Birmingham NHS Foundation Trust, following 'concerns' regarding the quality of the three services.

These concerns were said to be unfounded when inspectors visited. While the overall rating for University Hospitals Birmingham NHS Foundation Trust remains as requires improvement, individual services were largely rated as good.

The trust is one of the largest teaching hospital trusts in England and is responsible for Birmingham Heartlands Hospital, the Queen Elizabeth Hospital Birmingham, Solihull Hospital, and Good Hope Hospital.

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Following the inspection, the following ratings were given:

• Urgent and emergency services at Solihull Hospital : The service is rated as good overall, as well as for being safe, effective, caring, responsive and well-led. This is the first time the service has been inspected.
• Surgery services at Birmingham Heartlands Hospital : Due to the focused nature of the assessment in surgery, the service’s overall rating, as well as the areas of safe and responsive remain requires improvement overall from their previous inspection. Effective, caring and well-led remain rated good.
• Medical services at Heartlands Hospital : As in surgery the overall rating, as well as the areas of safe, effective and well-led remain requires improvement overall from a previous inspection. Caring and responsive remain rated good.

Charlotte Rudge, CQC deputy director of operations in the Midlands, said: "When we inspected University Hospitals Birmingham NHS Foundation Trust, we found staff who put people first to deliver the best possible care. Whilst improvements were needed in some areas, we saw managers putting improvement plans in place, mitigating risks and learning from incidents.

“In surgery, people told us the level of care they’d received was excellent and that all staff were responsive, caring and helpful. However, there were frequent staff shortages with some staff saying they felt care was unsafe as a result.

"Managers took appropriate steps to address vacancies with the resources they had available, and recruitment was ongoing. In urgent and emergency services, people were usually seen within four hours and staff acted quickly if someone was at risk of deterioration.

"Staff worked effectively in a multidisciplinary team to discuss and improve people’s care, and a therapy team was available for people needing support once they returned home. In medical services, people spoke positively and passionately about the care they received.

"Leaders were present on the wards and staff felt comfortable raising concerns with them. Staff were delivering person-centred care on the wards we visited and involving people in their own care to ensure they understood their condition and treatment plans.

“We will continue to monitor the trust, including through future inspections, to ensure the standard of care is sustained and any required improvements are made so people can continue to receive safe and appropriate care.”

Inspectors found:

In urgent and emergency services at Solihull Hospital:

• There was evidence of a learning culture and people were cared for in a safe environment.
• Staff provided personalised care and treatment based on people’s individual needs.
• People felt staff made them feel safe in the environment where they were cared for and included them in decisions about their care and treatment.
• Staff knew what incidents required reporting and how to report them.
• The service controlled infection risk well.

In surgery services at Birmingham Heartlands Hospital:

• There was evidence of a learning culture and people were cared for in a safe environment.
• The service was managed well and staff knew their roles and responsibilities.
• People were fully included in their treatment plans and decision making and were made to feel like partners in their care.
• Staff carried out daily safety checks of specialist equipment to ensure they were in good working order.
• Managers mitigated risks of short staffing by using supernumerary staff and bank staff to support teams.

In medical services at Birmingham Heartlands Hospital:

• People felt safe and staff included them in decisions about their care.
• Healthcare assistants felt confident to raise concerns with the ward sister and when they needed to.
• Incidents were discussed as part of regular huddles and meetings, and where learning was required, there were processes to follow for staff.
• The service had a clear and effective management structure.
• Staff spoke positively and passionately about the care and the service they provided.

A spokesperson for University Hospitals Birmingham NHS Foundation Trust (UHB) said: "Delivering safe and high-quality care, whilst supporting our colleagues to do their very best for our patients, is what matters to us at University Hospitals Birmingham.

"We are very pleased that the CQC has rated Urgent and Emergency Services at Solihull Hospital as Good, Surgery at Heartlands Hospital as Good across the effective, caring, and well-led domains, in addition to Medical Services at Heartlands Hospital rated Good for the effective and responsive domains. We are also pleased that it is recognised that our colleagues put patients first, and leaders enable them to deliver the best possible care.

"We will use the learning and insights in the CQC’s report, and from our ongoing relationship with them, to continue to improve services for local people."