THE organisation which runs Airedale Hospital has been told by a watchdog that it requires improvement.

Inspectors from the Care Quality Commission (CQC) found staffing levels in many clinical areas at Airedale NHS Foundation Trust were regularly below strength.

There were not enough doctors to meet national guidelines in the emergency department and too few specialist consultants in critical care. There was also a deterioration in the quality of some services, including medicine, since the previous inspection.

Today’s report says the Trust needs improvement to be safe and well led, but it also highlights a number of positives. It praised the Trust’s services as caring, effective and responsive.

Inspectors made an initial visit in March, which was followed-up with two unannounced inspections. Also included were Castleberg Hospital near Settle and the Trust’s community services at Coronation Hospital, Ilkley, and Skipton Hospital.

Ellen Armistead, deputy chief inspector of hospitals at the CQC, said: “Since our last inspection in 2013, we have found deterioration in the quality of some services – particularly in critical care and medicine.

“While staff reported feeling proud to work at Airedale, some felt there was a less open and positive culture.

“Although the executive team had taken steps to address some of the issues raised by staff regarding support from managers and confidence to raise concerns, there remained concerns particularly in the critical care, medicine and surgery services.

“Following this inspection, the Trust has told us it is taking action to improve its services and our inspectors will return to Airedale in due course to check that the improvements we require have been made.”

Improvements needed include the safe storage and administrations of medicines and engagement with staff.

Ms Armistead said, in contrast, inspectors had found “a culture of continual service improvement and innovation” in community services.

“We were impressed with the community-based collaborative care teams which were an outstanding example of multidisciplinary team working,” she said.

“The teams worked across acute and community services and in collaboration with other agencies to provide a responsive service for patients 24 hours a day, seven days a week – providing a valued service to help people to remain in their own homes and avoid unnecessary time in hospital.”

Areas of outstanding practice included telemedicine services - which provide remote video consultations around-the-clock between hospital staff and patients in their own homes, care homes and in prisons - and end-of-life care.

The Trust said it recognised there were areas for improvement and was addressing staffing issues.

Chief executive Bridget Fletcher said the Trust was “delighted” that many examples of good practice had been identified and praised staff.

“We know we have areas to improve on, and the breadth and depth of the CQC’s report has given us useful feedback on which we can build,” she added.

“We are addressing the issues around staffing and culture and had already put in place action plans to address areas that we felt required improvement. Our teams have risen to the challenge and have already made significant improvements in a number of key areas.

“We have over recent months strengthened our comprehensive nurse recruitment strategy, which includes initiatives such as developing our health care support workers, participating in the Return to Practice programme and international recruitment. Earlier this year the trust was named as one of the CHKS 40 Top Hospitals 2016 and was also amongst the top five for the national patient safety award for the third year running, which is a direct reflection of the high standards of care we provide.

“We focus on promoting an open and transparent culture. In the 2015 national NHS staff survey, Airedale scored above the national average for staff recommending the trust as a place to work or receive treatment, which was also reflected in the recent friends and family staff test results.

“We are not complacent; we know there are areas we have to work on, but we are encouraged by these results.

“I would like to pay particular tribute to our people. The first two inspections took place during our busiest winter month and it is a testament to them that they coped with sustained demand, as well as a full CQC inspection.

“Whether they work in direct patient care or in a supporting role, all our teams care deeply about the community we serve, and it is right that this is recognised.”

Healthwatch Bradford and District shared insight and patient/carer feedback with the CQC prior to it inspection of the Trust.

Andrew Jones, manager of Healthwatch Bradford and District. said: "When local people talk to Healthwatch, they are often very positive about the services they receive at Airedale Hospital and in the community, telling us how much they value the high-quality care and compassionate attitude of staff. 

“Healthwatch share the CQC’s concerns about staffing levels because when there are not enough suitably qualified and experienced staff patients report unsatisfactory care. Inadequate staffing levels can cause delays and put patients at risk. We know the Trust are working to recruit more staff.

“We recently carried out a visit to the new A&E department at the hospital, and patients using this service spoke very highly of the environment, the efficiency of the department, and the way they were treated. This is echoed in the CQC report which gives the Emergency Department a ‘good’ rating.

“Clearly there are significant issues raised in the report about patient safety in certain areas of the hospital, we will be attending the Quality Summit with the CQC and the Trust to learn about how these issues are being addressed.

“Healthwatch will continue to work collaboratively with the Trust to ensure that patient experience is at the heart of the action plans they create in response to the CQC report.

“We know that local people might be concerned by the CQC rating, and Healthwatch will continue to gather people’s views and experiences of the Trust during our regular outreach sessions, via our website, and through volunteer-led visits to services.”

Dr Phil Pue, Chief Clinical Officer at NHS Airedale, Wharfedale and Craven Clinical Commissioning Group, said: “As the main Commissioner of health services from Airedale NHS Foundation Trust for our local population, we expect services to be high quality, safe and effective; patient safety is a key priority.

“We are pleased that the CQC report has highlighted many areas of good practice and recognised the continual service improvements and innovation in community services to integrate health and social care services. We are particularly pleased to see the good rating for delivering caring hospital and community based services.

“The report has highlighted some areas of concern where the Trust’s services are not performing as well as they should. It identifies a number of areas for improvement, particularly in relation to critical care services and staffing levels in general.

“Following the findings of this report, we will continue to work in partnership with the Trust to support them to address the areas that require improvement.

"We will monitor progress very closely and will work with the CQC and other relevant bodies, such as Healthwatch, NHS Improvement and NHS England. A local Quality Summit with key stakeholders will take place to develop an action plan and make recommendations based on the findings of the inspection.”

See the full CQC report at cqc.org.uk/provider/RCF.