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North Cumbria University Hospitals NHS Trust - 70 years of the NHS

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Home > News > Response to Dr Foster Hospital Guide

Response to Dr Foster Hospital Guide

Posted on Monday 3rd December 2012
cumberland infirmary flowers

The Cumberland Infirmary

The Dr Foster Hospital Guide has highlighted that there are concerns relating to a higher than expected level of mortality rates weekdays and at weekends as a result of the care delivered in our hospitals in 2011 - concerns which are being taken very seriously within the organisation.

We have been working closely with Dr Foster to understand the figures and putting in place the improvements we need to make.

The operational issues that have been presented to North Cumbria University Hospitals Trust for some years are immense, and have placed the Trust in the position that it needed to be acquired by a Foundation Trust. Since the interim management arrangements were put in place in September 2012 by Northumbria, the Interim Chief Executive Ann Farrar with staff from North Cumbria University Hospitals Trust have identified the safety and quality priorities that need to be addressed urgently.

For example, there are a number of clinical services manned by teams that often struggle with temporary or insufficient consultant and junior medical cover. The clinical leaders are starting to work on plans for their services for the future which will help with the recruitment of permanent staff to ensure our services are sustainable and provide high quality care.

Staff survey results indicate that the pressure of the current situation has impacted upon the staff experience and this is known to be a key driver of problems with clinical quality and patient experience.

We have taken an open and transparent approach since we learnt about our high mortality rate and this has included a review of the medical records of the patients who died within the hospitals over these 12 months. Over 50 clinicians embraced this project devoting their clinical expertise to this work in their drive to improve the safety and quality of the care they deliver. From this review, they have identified that harm can be reduced by 50% within the next two years with the introduction of a whole range of hospital-wide improvements.

The review and investigation has demonstrated that whilst the workforce remain committed to delivering high quality patient services the standards they are able to deliver in the current circumstances has not always been at the level they would wish in their hospital.   This standard has been directly affected by financial issues compounding the problem despite the real drive that the clinical team have had to make real improvements.

The results of this are now being used to focus on learning for the future with an even greater emphasis and rigour placed firmly on delivering safe and quality services to the communities we serve.  This will be delivered by refocusing the organisation ensuring it is clinically-led and patient centred.

Our plans will address leadership and culture, clinical care, end-of-life care and clinical information.

Clinical Business Unit Directors have now been appointed and will provide strong clinical leadership, drive up local clinical performance and ultimately drive up the quality of the care we provide. We have introduced a Trust-wide plan to ensure the hospitals have robust systems in place to reduce harm by 50% in two years.

Dr Foster has extended the whole hospital HSMR model by applying it to patients admitted at the weekend. It has found that the HSMR nationally is higher at weekends and Dr Foster has linked this to reduced weekend staffing (measured by survey). Consequently, we are improving weekend staffing by increased senior presence of permanent staff.

We are launching a hospital-wide safety and quality campaign to engage all our staff on our priorities for the coming year in delivering harm-free care.

While there are challenges ahead, as a result of working closely with our acquiring partner Northumbria Healthcare we are confident that, once the acquisition takes place, as one unified organisation, we will be able to deliver a broad range of healthcare services at the highest level of quality to the communities we serve. 

Northumbria Healthcare have an proven track in delivering this and, by working together, our collective vision will focus on delivering safe, high quality services to the communities we serve.