Hospitals told medical services need to improve

MEDICAL care and surgical services at the Royal Devon & Exeter Hospital (RD&E) and North Devon District Hospital (NDDH) have been rated as ‘requires improvement’ following an unannounced inspection, instigated by 16 ‘never events’ being reported at the sites between March 2021 and November 2022.

Never events are serious, largely preventable patient safety incidents that should not occur if healthcare providers have implemented existing national guidance or safety recommendations.

Areas of concern found included a ‘high number’ of staffing shortages, long increasing waiting lists, surgical outcomes not always meeting national standards, action not always being taken quick enough for patients at risk of deterioration and significant challenges with the new integrated electronic patient record system. The results of the inspection of diagnostic services, published yesterday, state the RD&E has declined from a rating of ‘good’ to ‘requires improvement’ overall for medical care. It was rated as ‘requires improvement’ for being safe and wellled. Effective, caring and responsive categories were inspected but not rated.

Surgery at both sites dropped from good to ‘requires improvement’ overall as did the ratings for safe and well-led. How responsive, caring and effective the service is was inspected but not rated. Medical care at North Devon District Hospital remains ‘requires improvement’ overall. It was rated as ‘requires improvement’ in safe and well-led. Effective, caring and responsive were inspected but not rated.

Diagnostic imaging at both locations was rated as good overall. It was also rated as good for being caring, responsive and well led, and requires improvement for safe. As per all CQC inspections, diagnostic services were inspected but not given a rating for how effective they are as it is not usually used for treatment.

This is the first inspection of the trust since the Royal Devon and Exeter NHS Foundation Trust and Northern Devon Healthcare NHS Trust merged to form the Royal Devon University Healthcare NHS Foundation Trust in April 2022. The aim of the merger was to combine resources and expertise to provide acute, community and specialist services across North Devon, Mid Devon East Devon and Exeter.

Corporate and clinical services are in the process of being merged. The inspection was one of a number of CQC visits that will form the Royal Devon’s overall trust rating. The trust had a separate well-led inspection earlier in May which looked at the leadership and governance of the organisation. A further report and an overall trust rating is expected in the coming weeks.

Cath Campbell, CQC deputy director of operations in the south, said: “Although we understand the pressures that healthcare providers have faced, and continue to face, ‘never’ events are precisely that – they should never occur.

“If they do, it’s important they are thoroughly investigated to ensure they don’t happen again. Once an investigation has taken place, learning should be shared with all staff and that wasn’t always happening.”

Chris Tidman, the trust’s Deputy Chief Executive Officer, said: “We are pleased that our diagnostic imaging services have been rated good. We are of course disappointed by the results in our medical and surgical services, however, we feel it is a fair reflection of the challenges the trust and our teams were under at the time of the inspection.”