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


Home > News > Trust shares progress on keogh recommendations

Trust shares progress on keogh recommendations

Posted on Friday 27th September 2013
cumberland infirmary

Following publication of Sir Bruce Keogh’s review into the quality of care provided by North Cumbria University Hospitals NHS Trust, a progress report has been published online at NHS Choices to highlight improvements underway. 

North Cumbria was one of 14 NHS trusts across England identified as having a higher than average mortality ratio for the past two consecutive years. The Trust is now one of 11 NHS organisations across England that has been put into ‘special measures’ with the NHS Trust Development Authority (TDA).

In July 2013, the Keogh Review made several recommendations to help improve the quality and safety of services for patients in North Cumbria. With the support of the TDA, significant progress is now being made. Key progress since July includes:

An urgent nursing review launched in August to address the current skill mix imbalance which exists across some wards. Consultation is now underway with staff to ensure appropriate nursing leadership and safe and effective nursing care at all times, for all patients. Changes will ensure wards have a dedicated ward manager who is responsible for providing clear leadership and accountability at ward level and two senior nurses who can also provide appropriate guidance to the nursing team. 

A continued positive increase in the number of serious incidents that are now being openly reported by staff, with robust mechanisms now is place with the TDA and NHS Cumbria CCG to ensure appropriate reporting and widespread learning. This can be seen as evidence towards an open reporting culture where all staff are supported to report incidents and ensure continuous quality improvement. 

Important changes to pathways of care to improve patient safety, deliver the best clinical outcomes and, ultimately, help reduce mortality. This includes the transfer of emergency high-risk trauma and orthopaedic patients from West Cumberland Hospital in Whitehaven to the Cumberland Infirmary in Carlisle which began in June and more recently, complex high-risk surgery. 

A new middle management tier within the organisation to provide appropriate clinical and corporate leadership. This new structure echoes successful structures in place at high performing NHS Trusts and includes the appointment of general managers, matrons and operational managers whose primary focus will be to support an enhanced clinical management system across North Cumbria.

An organisational development programme is underway with specific leadership training for ward managers. All newly appointed general managers, matrons and operational managers have also embarked on a leadership programme entitled ‘high performing clinical leaders’.

Moving towards seven day consultant working and early warning systems being implemented to improve safety on hospital wards. Additional surgeons and consultants have already been appointed, and continue to be recruited to deliver better continuity of care and reduce dependency on locum support.  

Recruitment to 20 consultant posts and over 100 nursing posts with permanent consultants bringing years of skills and experience to the Trust. This is helping to shape the future development of specialist services across North Cumbria whilst also helping to reduce costs of locum doctors which the Trust has historically had to incur.

A comprehensive review has taken place in estates and facilities since the Keogh Review with al theatres now fully compliant with national guidelines and a process in place to review regularly. A formal process to deep clean all wards and theatres is also in place and ongoing to ensure the highest standards of infection control. 

All of this work, and more, is being delivered in partnership with the TDA, NHS Cumbria Clinical Commissioning Group (CCG) and Northumbria Healthcare NHS Foundation Trust to ensure the actions, as detailed within the Keogh review, are addressed and impact positively on patient care as soon as possible.

Ann Farrar, Interim Chief Executive at North Cumbria University Hospitals NHS Trust, added: “We continue to work very closely with all of our partners to implement positive changes and improvements in the way we deliver services for patients. At the very heart of all of this work we are focussed on patient safety and transforming the quality of the care we provide.

“I would like to thank all of our staff in Carlisle and Whitehaven for their ongoing hard work and clear commitment to transforming the quality of the care we provide for people in North Cumbria. We will continue to keep all stakeholders fully updated as we progress our safety and quality improvements.”