The improvements to services and leadership made by teams across University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT) have been recognised in an inspection report, published by the Care Quality Commission (CQC) today (Wednesday 23 August 2023).

On 4 and 5 April 2023, inspectors from the Care Quality Commission carried out an unannounced inspection of Medicine at the Royal Lancaster Infirmary (RLI) and Maternity services at Furness General Hospital (FGH) and the RLI. The inspection team returned between 15-18 May 2023 to carry out the well led aspect of the inspection, which assesses the leadership, management and governance of the organisation.

The Trust’s overall Trust rating remains ‘requires improvement’ – as does the rating for safety, effectiveness and responsiveness. The rating for caring also remains as good with inspectors noting that: “Patients said staff treated them well and with kindness”. The Trust rating for well-led has improved from ‘inadequate’ to ‘requires improvement’.

The Inspectors identified many examples of good practice in all areas, including:

• Evidence which demonstrated an improvement in both governance and long-term sustainability
• Leaders and colleagues actively and openly engaging with patients, colleagues, equality groups, the public and local organisations to plan and manage services

• The commitment of all colleagues to continually learning and improving services
• The Trust’s commitment to further developing an open culture where patients, families and colleagues could raise concerns without fear
• The promotion of equality and diversity in daily work and opportunities for career development
• Collaboration with partner organisations to help improve services for patients

The report also notes two examples of ‘outstanding practice’ in maternity services with award winning development of HOPE boxes for those women who were separated from their babies either temporarily or permanently; and the multi-disciplinary approach to planning complex births that may require input from safeguarding, children’s services and mental health services.

There were also areas identified where the Trust needs to further improve, including:

• The effectiveness and timeliness of the complaints process
• Ensuring adequate numbers of midwives and clinical colleagues with the right skill mix in maternity services

• Pursue the plans to develop and invest in pharmacy workforce to improve performance
• Ensuring there is a clear protocol for identifying women for prioritisation of induction of labour and that it is recorded in the care records
• Consistently achieving completion targets for mandatory training in all areas

Aaron Cummins, Chief Executive, UHMBT, said: “This report is a very welcome sign that we are on the right path. The dedication, passion and tenacity of our colleagues has led to some significant improvements in our services over the last 18 months and I am extremely pleased that that was witnessed firsthand by the inspectors that visited our Trust earlier this year.

“We all know that the NHS has seen significant challenges recently with COVID-19 recovery, various incidences of industrial action, and increasing pressure on services. The fact that our teams have not only managed to maintain safe services during this period, but improve them, is testament to the kind of people we have working here.

“Whilst we are rightly pleased to see the improvements recognised by the inspectors, we are by no means where we need or want to be. Inspectors noted areas where we still need to improve, including taking our culture and leadership development work further, handling and responding to concerns and complaints in a more effective and responsive way, and ensuring that we see actions through to make sure we know that they are still making a positive difference in the coming weeks, months and years.

“It’s important that we take the time to fully digest the report and recognise all the good work with our teams. However, the vital thing is for us all to keep moving and pushing to be better. Progress has no finish line, and I know that our teams are dedicated to continuing to work hard to keep improving our services to be the best they can be for their patients, colleagues and our local communities.”

Following the Trust’s previous inspection in 2021, the CQC imposed regulatory conditions on the Trust’s license for stroke services at FGH and the RLI and maternity services at both FGH and the RLI. This meant that teams were required to improve and correct any concerns raised by inspectors in those services – with detailed action plans and regular updates to the CQC on progress. Following this year’s inspection, the CQC confirmed that all the remaining regulatory conditions had been removed.

Some improvements noticed since the CQC’s last inspection at the Trust, included:

• The creation of dedicated space for patients who require Thrombolysis and the ‘ring-fencing’ of beds for patients suffering from a stroke
• An increased focus on antimicrobial stewardship
• An improvement in Sentinel Stroke National Audit Programme (SSNAP) scores – going from E to C and comparing well against regional and national peers
• The relocation of the Day Assessment Unit to the Antenatal clinic at FGH making it more accessible
• Local leadership in the services inspected

• Increased access to support from medical colleagues in maternity services 24 hours a day, seven days a week

Professor Mike Thomas, Chair, UHMBT, said: “As a Board, we are incredibly proud of all our colleagues have achieved to improve the services we off to local people. The inspectors noted several areas of good practice in the services inspected, including the overall culture, visibility of senior leaders and Executive Directors, colleagues working well together for the benefit of patients, the completion of risk assessments; and the speed of responding to patients at risk of deterioration.

“As a health system in Lancashire and South Cumbria, we have an ambition to all be rated as ‘good’ overall by the CQC, and the progress noted in this report signals that we are heading in the right direction. However, we can’t and won’t slow down. There is still a lot of work to do to ensure we are a great place to be cared for and a great place to work but I believe that we have strong plans in place and the right teams to deliver them.”

The full inspection report for the Trust can be found on the CQC’s website.