ENGLAND'S Chief Inspector of Hospitals has told bosses at Bradford Royal Infirmary and St Luke's hospitals they must continue to make improvements to services.

Bradford Teaching Hospitals NHS Foundation Trust got an overall Requires Improvement ranking after a team of Care Quality Commission inspectors and specialist advisors paid an unannounced visit in January this year.

The Trust was rated as Requires Improvement for safety, responsiveness and well led and rated as Good for effectiveness and caring. The BRI and St Luke’s Hospital were individually rated as Requires Improvement with the in-patient community services rated as Good.

Inspectors found  there had been some improvements since the last comprehensive CQC inspection in October 2014, when the trust was also told it needed to improve.

Particular improvements included work addressing issues within the outpatients’ services which was now starting to have a positive effect, noted inspectors.

Overall ratings for urgent and emergency services, medicine and surgery were unchanged however and still need to imrprove.

The Chief Inspector of Hospitals, Professor Sir Mike Richards, said: “Since our last inspection in 2014, we have found some real improvements in some of the core services - notably in critical care services and outpatients and diagnostic and imaging. Changes across outpatient services included a strengthening of governance arrangements and the introduction of improved training and development, which has been having a positive impact.

“At the previous inspection, concerns were raised about the out of hours medical cover at St Luke’s Hospital and the management of the deteriorating patient. At this inspection CQC found that all staff had a good understanding of the arrangements for medical cover out of hours. The trust had also commissioned an external review of medical staffing at St Luke’s and had concluded the medical cover was adequate for the service."

Inspectors also found that the out of hour’s medical cover at St Luke’s had improved. During the 2014 inspection, CQC had raised this as a concern. At this inspection CQC found that was much better organised. An external review had found that adequate cover was now in place at all times."

Staffing and waiting times were still a concern at the Trust.

The CQC will now present its findings to a local Quality Summit, including NHS commissioners, providers, regulators and other public bodies to develop a plan of action and recommendations based on the inspection team’s findings.

Cllr Vanda Greenwood, chairman of Brdford's Health and Social Care Overview and Scrutiny Committee, said: “The Trust have come to the Health and Social Care Overview and Scrutiny Committee on a number of occasions since the initial CQC inspection. They have presented the various inspection findings and, more importantly, their responses to the findings.The reports to the Committee have been frank and honest and have demonstrated the progress being made towards addressing those areas where improvements were required. The Committee recognises the progress being made and the Trust’s commitment to get things right. The improvements will take time, particularly if they are to become embedded into the day to day working of the hospitals. The Committee will continue to monitor progress against the latest recommendations by CQC.”

Bradford Teaching Hospitals NHS Foundation Trust’s Chief Executive, Professor Clive Kay said he was delighted with the huge improvements thetgrust had made and that it no longer had any services  judged to be ‘inadequate’. This is a testament to the hard work and commitment of our 6,000 staff and volunteers.

“This follow-up inspection of Bradford Royal Infirmary, St Luke’s Hospital, and our community hospitals of Westbourne Green and Westwood Park, has resulted in more ‘good’ ratings than our previous inspection in 2014.

“Importantly, these refer to how effective and caring we are in services such as our emergency department, surgery and critical care, maternity, and children and young people’s services. We have also been rated ‘good’ in how responsive we are in relation to medical care and end of life care.

“Our community hospitals have been rated ‘good’ in every single domain which is a tremendous leap forward since last year’s inspection when inspectors rated some areas as ‘requires improvement.’

“I am pleased that the report highlighted a number of areas of ‘outstanding practice’ including our work towards recruiting and retaining a workforce that reflects the ethnicity of our local population, our leadership of the ‘Well North’ programme, aimed at improving the health of some of the poorest communities in the most deprived areas in the north of England, and the Bradford, Airedale, Wharfedale and Craven Managed Clinical Network of Specialist Palliative Care winning the British Medical Journal ‘Palliative Care Team of the Year’ award in 2015.

“As you would expect following a robust re-inspection of such a large and complex organisation as ours, there are some areas where further improvements are recommended. Robust action plans are being developed to address those areas and progress is underway.

“It is heartening that the CQC’s Chief Inspector of Hospitals, Professor Sir Mike Richards, has stated that: ‘This report shows that the trust is heading in the right direction. There is a lot to look forward, to – the introduction of new models of care, the further integration of services and the opening of the new hospital wing in November, all of which I hope will bring real benefits to patients in the near future.’

“I am incredibly proud and privileged to work with such a fantastic team of people who have made many improvements since our last inspection and I am proud of our achievements and the progress we have accomplished in these difficult and challenging times for the NHS.”

Andrew Jones, Manager of Healthwatch Bradford and District, said: “Healthwatch has talked to lots of people about their experience at Bradford Teaching Hospitals during our outreach and engagement work in the hospital over the last year.  We shared our insight with the CQC inspection team prior to their visit and we are pleased to see this public voice reflected in parts of the report.  Healthwatch has heard many positive accounts of good quality treatment and caring staff at Bradford Teaching Hospitals NHS Foundation Trust, but we also raised concerns about areas such as waiting times, staffing levels, and communication. Patients and carers often tell us they are unhappy with waiting times in both Outpatients departments and Accident & Emergency; the CQC requires reductions in the length of time between referral and treatment, and we urge the Trust to continue to take action to address this."

And he added: "We are aware that the Trust has taken a range of actions to address issues around staffing but Healthwatch continues to hear from members of the public concerns about staffing levels in some areas.  We recently spent 36 hours in the Accident & Emergency Department at Bradford Royal Infirmary. We saw first-hand the pressure on staff and long waiting times for the public – the CQC also reports staff shortages in A&E, as well as other departments.  Healthwatch support the Trust’s efforts to address this issue as it has a direct impact on patient experience."

And Dr Akram Khan, clinical chairman of NHS Bradford City CCG said the Cityand Duistrict CCG commissioners of local hospital services were pleased with the improvements that the Trust has made to ensure that patients get high quality, safe and effective care.

“We have met with the trust’s senior management team to discuss the action plan and we will closely monitor its progress on this. We share the trust’s commitment to improving its ratings, and know that many of the issues highlighted are already being addressed as a priority. Patients in Bradford can have confidence in their local health services and medical teams and we will work closely with the hospitals to ensure that this is strengthened further,” said Dr Khan.