Full response to CQC report by Medway NHS Foundation Trust

The Trust takes patient safety and patient experience very seriously. It has made a number of organisational changes and put in place a number of actions since this visit to begin to address the issues raised in the report.

Leadership and staffing

One of the major first steps the Trust has taken is to stabilise the Board of Directors. A number of experienced executives have been appointed and the new chair of the board commenced on 8 September 2014. The focus of the board is on improving standards of care across the hospital, improving operational efficiency and to work with our staff to provide the high quality of care our patients deserve. The Trust appointed Morag Jackson as the new chief operating officer and in her role she will focus on improving operational processes to improve patient flow and experience through the hospital – ensuring our patients receive the treatment and care they need whilst maintaining operational efficiency. Steve Beaumont has been appointed as new chief nurse at Medway to lead improvements in standards and to embed the best patient care practices.

Changes within the emergency department

The managerial structure within the emergency department has been reviewed to ensure there is experienced and visible management in place.

Two new emergency care consultants took post in September and October, there is now a dedicated head of nursing in the department and three new emergency care matrons will all be in post by 2 December. An emergency consultant lead, Dr Laurence Gant, and an experienced matron from Homerton University Hospital have worked in a support and advisory capacity over the last two months. The Trust has appointed Dr Laurence Gant for a year to manage improvements to the way in which emergency patients are cared for.

Initial patient assessment within 15 minutes

The Trust has reviewed its initial assessment process against standards set by the College of Emergency Medicine, and fully replaced the previous STAR (Senior Treat and Refer) system. Over 95 percent of patients who arrive at the department by ambulance now have an initial assessment completed within 15 minutes of arrival, and this is being sustained week on week.

Patient flow through the hospital

Work is taking place to improve patient flow throughout the hospital and to alleviate congestion in the emergency department. This includes increasing consultant presence during weekends so patients who are fit and ready to go home, can be safely discharged on Saturdays and Sundays. Operational plans are being developed to assist effective patient flow, from arrival to discharge.

Additional winter funding has been received by the Trust and this is being invested to accelerate these changes.

New emergency department for children

The new children’s emergency department is due to open next month. This new department will have a dedicated entrance, three additional treatment bays – increasing the number to six – and new examination rooms to allow faster and better initial assessment and treatment.

The new layout will provide complete segregation from adults and will an enhanced environment for children, their parents, relatives and carers.

Dr Phillip Barnes, Acting Chief Executive said: “We realise the challenges before us and are fully committed to providing the high quality of care our patients deserve. With the direction now being provided by the new Board of Directors, work is taking place across the organisation in a number of areas to ensure we can provide high quality and efficient healthcare in a sustainable way.

“Some longer-term projects are also nearing completion. In February next year a brand new IT system will go live which will revolutionise the way we manage patient records, and developments in our emergency care environments are taking shape, with the new children’s department opening next month.

“We appreciate the cooperation and support from our local healthcare partners, who recognise that we must all work together to improve the way in which we provide care and treatment for our patients. We will continue to build on these important partnerships for an effective local healthcare system.”