Agenda item

The Committee received an Inspection report from the Northern Care Alliance (NCA) NHS Foundation Trust which describes their judgement of the quality of care provided by the trust. It is based on a combination of what the NCA found when they inspected and other information available to them. It included information given to the NCA from people who use the service, the public and other organisations.

Northern Care Alliance NHS Foundation Trust was formed on 1 October 2021 when Salford Royal Hospital NHS Foundation Trust legally acquired Pennine Acute Hospitals NHS Foundation Trust.

The trust operates a range of acute, community health and social care services which are provided by the trust's four care organisations; Salford, Oldham, Rochdale and Bury.

The trust has over 20,000 staff and has four acute hospitals – Salford Royal Hospital, Royal Oldham Hospital, Fairfield General Hospital and Rochdale Infirmary which provide a full range of acute services, including acute medicine, urgent and emergency care, acute frailty units, rehabilitation services, dental services and surgical services, to a population of approximately 1 million people within hospital settings and the community. The trusts had been working in partnership from 2016 until the acquisition. This included a shared executive leadership team.

When a trust acquires another trust in order to improve the quality and safety of care, the trust do not aggregate ratings from the previously separate trust at trust level for up to two years from date of acquisition. The ratings for the trust in this report are therefore based only on the ratings for Salford Royal Hospital and their rating of leadership at the trust level.

NCA’s normal practice following an acquisition would be to inspect all services run by the enlarged trust. However, their usual inspection work has been curtailed by the COVID-19 pandemic.

At the Northern Care Alliance, we inspected only those services where they were aware of current risks. They did not rate the hospitals overall. In the ratings tables shown in the report they show all ratings for services run by the trust, including those from earlier inspections and from those hospitals we did not inspect this time. This was NCA’s first inspection since the formation of the Northern Care Alliance NHS Foundation Trust.

The trust had a vision for what it wanted to achieve and a strategy to turn it into action, developed with all relevant stakeholders. The vision and strategy were focused on sustainability of services and aligned to local plans within the wider health economy. Leaders and most staff understood and knew how to apply them and monitor progress.

All staff were committed to continually learning and improving services. They had a good understanding of quality improvement methods and the skills to use them. Leaders encouraged innovation and participation in research.

Improvement projects were at various stages of development and completion across the trust. The trust reported and investigated complaints and incidents. However, these were not always completed in a timely manner and learning was not always shared with relevant departments across the trust.

The report highlighted outstanding practice at Royal Oldham Urgent and Emergency Care Services. It also referred to action the trust must take and is necessary to comply with its legal obligations. The action a trust should take is because the trust was not doing something required by a regulation, but it would be disproportionate to find a breach of the regulation overall, to prevent it failing to comply with legal requirements in future, or to improve services.

During our inspection they spoke with a variety of staff including consultants, doctors, therapists, nurses, healthcare support workers, pharmacists, patient experience staff, domestic staff, administrators and the trust’s board. During the inspection they also spoke with patients and relatives. They visited numerous clinical areas across the hospital sites. They reviewed patient records, national data and other information provided by the trust. They held several staff focus groups with representatives from all over the trust to enable staff who were not on duty during the inspection to speak to inspectors. The focus groups included junior and senior staff from pharmacy, junior and senior nursing staff, junior doctors and consultants, allied health professionals, staff representing equality, diversity and inclusion. They also had focus groups for the non-executive directors and governors.

The Areas of Inspection for Royal Oldham Hospital, findings and proposed actions as a result of findings are set out in the report.

Heather Caudle, Group Nursing Officer representing NCA presented the Inspection report.

A Member made reference to the current ratings for Oldham hospital set out on page 39 in the agenda and suggested that comparisons of current ratings with previous Inspection ratings would have been useful.

The Chairman suggested that a summary of the report circulated with the Inspection report which made particular reference to Royal Oldham Hospital inspection and findings would have been helpful to Members.

Heather Caudle expressed her apologises that a summary had not been circulated with the report. She indicated that a summary of that report appertaining to Oldham Hospital and setting out the actions needed to be taken following up on the Inspection findings together with comparison ratings from previous inspections would be prepared and presented to the Committee at its next meeting.

With reference to a point raised regarding how the NCA deal with the concerns of Salford, Rochdale and Bury, Heather Caudle informed Members  that a Localities Board has been established to coordinate concerns and issues raised.  She would ensure that the membership of the Board would be made available for the next meeting of this Committee.

Resolved: That

1.    NCA be requested to submit a summary of the Inspection report to this Committee for consideration at its next meeting with specific focus on Royal Oldham Hospital to include previous inspection ratings for comparison and the actions needed to improve as a consequence of the current Inspection findings; and

2.    the Committee be circulated with the NCA Localities Board membership and its Terms of Reference.