Tuesday, 22 September 2015

What's gone wrong at Addenbrookes?

Addenbrooke's and Rosie Hospitals placed in special measures


Addenbrooke's hospital signImage copyrightPA
Image captionCambridge University Hospitals controls the Addenbrooke's and Rosie facilities in the city

One of the biggest NHS trusts has been placed in special measures after inspectors found it was "inadequate".
NHS regulator Monitor is taking action to improve Cambridge University Hospitals Trust, which runs the city's Addenbrooke's and Rosie Birth Centre.
Inspectors found concerns about staffing levels, delays in outpatient treatment and governance failings.
The trust, which Monitor said was predicting a £64m deficit this year, has apologised to patients.
Monitor said the trust had an average overspend of £1.2m a week.
The trust's chief executive, Keith McNeil, stepped down suddenly last week, citing "a number of very serious challenges".
Chief finance officer Paul James also quit ahead of the CQC's report.

'Rapid action'

The Care Quality Commission (CQC) found staff shortages and long-standing "serious" problems had been ignored. 
The watchdog's report said the trust must develop and implement a recovery plan to address its financial deficit and strengthen leadership by working with an "improvement director" appointed by Monitor.
The trust's chairwoman Jane Ramsey said: "I would like to say sorry to our patients for a lack of effective systems and processes across our trust, which led to the CQC rating our hospitals as inadequate.
"We take this, and being placed in special measures by our regulator Monitor, very seriously.
"We will take rapid action to address concerns and maintain our record of safety and high-quality care."
Monitor has also imposed a new condition on the trust's licence, enabling the regulator to take further action, such as replacing senior staff, if improvements are not made swiftly enough.

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Analysis 


By Nick Triggle, Health Correspondent

Perhaps the most worrying aspect of the Addenbrooke's story is not that such a world-renowned hospital has ended up in a predicament like this, but rather that it happened so quickly.
A year ago the trust which runs the hospital - Cambridge University Hospitals NHS Foundation Trust - wasn't even on the Care Quality Commission's radar in terms of being a failing centre. 
In fact, two years ago - as the regulator was embarking on its new inspection regime - it was among the band of hospitals considered to be the safest, according to the risk-rating system at the time.
But now a hospital which can boast to being a centre of excellence for major trauma, transplants, cancer, neurosurgery, genetics and paediatrics, has been judged to be a basket case and will join the 12 other failing hospitals already placed in special measures.
So what does this tell us about the state of health of the NHS? Sir Mike Richards, the CQC's chief inspector of hospitals, believes Addenbrooke's problems are largely of its own making, criticising the trust's management for "losing grip". 
Certainly it seems to have made mistakes - as the troubles with its £200m computerised patient records programme illustrates - but it's hard to escape the feeling that this is just the tip of the iceberg.

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The CQC also found routine operations were frequently cancelled and maternity services regularly closed.
It said high levels of nitrous oxide, used as pain relief in childbirth, were detected at Rosie Hospital's birthing centre, but the only action taken to address it was to open windows.
It also said workers were prepared to go the extra mile for patients, rating the quality of care as "outstanding".

Dr Keith McNeil
Image captionDr Keith McNeil left the trust last week, citing "serious challenges"

Stephen Hay, Monitor's managing director of provider regulation, said: "Patients treated at Cambridge University Hospitals NHS Foundation Trust deserve to receive the highest possible care, and so the failings that we and the CQC have identified in the trust's services are disappointing.
"It's reassuring that the trust has already started to address some of the issues, but much more needs to be done.
"Special measures will ensure it gets the extra help and support it needs."

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