As you will be aware, the Care Quality Commission (CQC) visited the Trust in April to undertake a core services inspection and returned this week to inspect the ‘well-led’ aspect.
The CQC has provided initial feedback which noted how positive and open our people were with the CQC inspection teams across the areas they visited in April.
The CQC also noted the progress we had made on our work to optimise our Make Ready service and our work to mitigate handover times at hospitals.
As we expected, they also identified several areas for improvement, including:
- Issues around morale, including people’s access to training, and the impact on apprentices of the changes around education provision.
- The impact of the Trust being on heightened surge levels for extended periods of time, including the management of clinical risk on the stack and the knock on impact to our discharge teams and audit.
- Staffing issues within AOCs, including the impact of the significant increase in the number of call handlers, the culture of the AOCs and the challenges of meeting planned staffing levels.
- Issues around estates and equipment, particularly around Chelmsford AOC in advance of the planned refurbishment of the facility this year, the impact of the move to Fiat Ambulances and instances of cleaning chemicals being inappropriately stored.
- Some concerns where medicines management best practice arrangements were not being consistently followed.
- Some incidences where COVID related infection control were not being followed.
We have taken the feedback very seriously, and are taking immediate actions to address these issues:
- We are progressing a recovery plan for providing mandatory training, particularly focused on core clinical skills alongside values and behaviours training. This programme of work continues to improve training rates for our people. For apprentices, we continue to focus on marking outstanding paperwork and preparing learners for their end point assessment in a priority order.
- We have recognised the impact of the extended use of surge actions because of the intense pressure on the urgent and emergency care system. We are currently re-evaluating our surge action plan and other procedures to reflect the sustained pressures we have seen, particularly learning from clinical incidents we have seen as a result of the pressure our service has been under.
- A deep clean of the Chelmsford AOC has now being undertaken as we advance our work to undertake a full refurbishment of the centre.
- We have set out again PPE and COVID infection control guidance across the Trust, alongside targeted work with specific sites, and have increased the frequency of surveillance so that we can assess the impact of these measures.
We have not yet had written feedback from the well-led inspection, but did receive some verbal feedback from the inspection team yesterday evening (5th May 2022), this included:
- Thanking everyone who took part in the interviews and sessions over the two days for their openness and honesty in the way they approached the inspection and the feedback they received.
- They highlighted that we have a new executive team in place who are working well together, but being new there was more development to be undertaken.
- That we have a clear plan for the next 12 months but we need to do more work to develop a longer term plan and will need to engage our people and stakeholders in developing this plan.
- They heard that more of our people were feeling able to escalate concerns and speak out.
- They described that they felt we had improved our governance systems and processes but there was more work to do to improve the way we worked within those structures, and work to ensure we develop our risk registers further.
- They recognised that we understood QI expertise was going to be required as we moved forward but at present this was not embedded day to day practice within the Trust.
This is clearly very high level verbal feedback. We will know more once we receive a letter summarising their feedback. We expect to receive this in the next few days and will share it with you all.
In terms of next steps, we are still under inspection as an organisation until we receive the draft inspection report. However, it is likely to be documentary and evidence requests that the CQC will ask for us from this point. They expect to be able to share a draft of their full report which will cover all aspects of their inspection, in June. We will keep you updated on this as we know more.
Thank you again to everyone who took part in the inspection. If you would like to read more, you can read both the CQC feedback letter on our core services and our response attached, we will also be discussing this at our next Board meeting on Wednesday 11th May.
Tom Abell - Chief Executive
Published 6th May 2022
