BASILDON Hospital has taken immediate action over its children’s services after a health watchdog branded its care “completely unacceptable” and issued two warnings to the trust demanding improvement.
YT revealed earlier this month how a ten-year-old girl died and a baby received incorrect doses of medication in October.
The Care Quality Commission’s (CQC) action follows an unannounced inspection at Basildon University Hospital on Saturday, 3 November that was prompted by a number of serious incidents involving the care of children at the trust.
Chief Executive Clare Panniker told YT how the Hospital has taken immediate steps to change the way it delivers some of its children’s services.
During the visit to the acute hospital, in Nethermayne, Basildon, inspectors identified a number of serious concerns including a lack of senior staff being available after 5pm during the week and at weekends, some children having to wait longer that recommended to be seen by a doctor or nurse and reviewing expire dates on medicines.
Andrea Gordon, CQC deputy director of operations (regions), said: “What our inspectors found at the trust on 3 November was completely unacceptable. We have taken this action to assist in driving through improvements which have a positive impact on the people being cared for at the hospital. It is imperative that the trust now ensures it makes changes which are sustainable, embedded and maintained for the future.”
The warnings have been issued in relation to the essential standards, the care and welfare of service users and assessing and monitoring the quality of service provision.
Inspectors found, although guidelines meant all children attending the paediatric ward were seen by a nurse within 15 minutes of arrival, staff confirmed some waited more than an hour to see a doctor.
Staff said there were often considerable delays in children receiving appropriate medical attention when concerns over their condition deteriorating were escalated to doctors particularly after 5pm and at weekends.
Complaints had been made by staff about the lack of senior medical and nursing staff available on the ward and the inadequate skill mix of nursing and medical professionals on the children’s ward, on occasions. Despite this CQC could find no evidence of any effective action having been taken.
The trust recently carried out an audit of expired medication at the trust but CQC inspectors still found medicines that should have been discarded during their visit.
Inspectors saw reports showing a significant drop in permanent paediatric consultants’ availability in the last few weeks but it was not clear what action had been taken with regard to this.
The trust was found to be failing to plan and deliver care to meet the needs of children in a way that ensured their welfare and safety.
It is not the first time CQC has warned the trust. In July this year it was told to make improvements in relation to the same two essential standards, but in relation to inspections of the accident and emergency department and adult wards.
When CQC carried out its follow up inspections, in August and September, improvements had been made.
Andrea Gordon added: “It is highly disappointing that the trust is again in breach of the same two regulations albeit in relation to different parts of the service it offers. That is why we have asked the trust to look deeper at its own processes, policies and procedures by commissioning an investigation.
“Our inspectors will return in the near future and if we find the required progress is not made we won’t hesitate to use our legal powers to protect the people who use this service.”
Clare Panniker, a former nurse and mother-of-three was keen to highlight the changes that have taken place at the troubled trust as a result of the serious incidents last month and in light of the CQC’s report.
The chief executive who only took on the role two months ago said: “I don’t want people to feel they can’t bring their children here because it’s a terrible service, because that is simply not true.
“The service today is greater than it was a few months ago because we have made some very important changes.”
She added: “This is a good hospital, the reason I came here, I think it can be a great hospital.”
The Hospital is currently conducting its own internal review into the incidents of last month and is also working to address the ever increasing number of patients being admitted.
A&E is dealing with nine per cent more patients than this time last year which has resulted in admissions being up eight per cent as the population of Basildon continues to grow.
CQC inspectors also found expired medicines on their visit including antibiotics.
Clare Panniker stressed that under no circumstance would these medicines have been issued to patients, highlighting how all staff check dates before administering medicine. She said: “There was no danger of that medicine being given to a patient, however it should not have been in the stock.”
Pharmacy technicians are responsible for checking medicine stock, the Hospital is waiting for the findings of its own report into the incidents of October before any individual action may be taken.
As a result of the inspectors’ findings the Hospital has introduced weekly unannounced spot checks, including checking expiry dates on medication, to ensure clinical practice standards are followed.
A number of immediate changes have been made at the Hospital to address the most pressing areas of concern, these include:
More senior staff- including consultants, doctors and nurses- being on duty at all times especially after 5pm and at weekends,
A new dedicated team of nursing staff with additional senior doctor presence in the Paediatric Assessment Unit
The re-issuing of guidance to all Trust staff explaining how to report concerns they may have and a review of the system to make sure it works correctly.
As a result, and in addition to the warnings, CQC has also told the trust it must commission an independent investigation into the paediatric services provided by the trust.
Both CQC and Monitor, the regulator for Foundation Trusts, will have close contact with the investigation team throughout and will be holding the trust board to account over any decisions made with regard to it improving services.
Clare Panniker added: “We need to do better to ensure that every child who comes to Basildon Hospital gets good, high quality, safe care only by doing this well we address the CQC’s concerns.”
A deadline of 13 January 2013 has been set for improvements to be made.