CQC finds improvements needed at Aintree University Hospital NHS

England's Chief Inspector of Hospitals has found improvements are needed at Aintree University Hospital NHS Foundation Trust following an inspection by the CQC.

A team of inspectors visited University Hospital Aintree to check on the quality of four of its core services
in October 2017. CQC also looked specifically at management and leadership to answer the key question: Is the trust well led?   

The CQC found some deterioration in the quality of services being provided by the trust since a comprehensive inspection that was undertaken in 2014.

As a result of this inspection, the trust’s overall rating has changed from Good to Requires Improvement. In the key questions of whether the trust is providing care that is safe, effective and responsive, the trust’s ratings have moved from Good to Requires Improvement. The ratings for whether services are well-led remain as Requires Improvement and the trust remains rated as Good for being caring.

Although inspectors found staff that are caring, there is work to do in order improve services in some areas for the people that are using them.   

Ellen Armistead, Deputy Chief Inspector of Hospitals said:

“Inspectors found there had been some deterioration in the quality of patient care across a number of services on their return to Aintree University Hospital NHS Foundation Trust, and a number of improvements are needed. That is why the trust’s overall rating is now Requires Improvement, whereas previously it was rated as Good.

“We found concerns in urgent and emergency services that there weren’t always enough staff with the right skills and training on duty to keep people safe. We found that patients were waiting too long for treatment and the service consistently struggled to meet their emergency department four hour target.  

“On the medical wards, we found environments which weren’t always fit for purpose, and affected the privacy of patients. We also found some patients didn’t always receive a timely response to requests of help, on one ward there were no call bells for them to get the attention of staff. 

“This is a large trust with around 4800 staff. Whilst we found an open culture and the senior leadership were experienced and stable, they must find a way to engage more effectively with staff to create a culture of empowerment that will help to drive forward improvement.

“The trust board knows what it must do to ensure improvements are made. We will continue to monitor the service and re-inspect to check on their progress.”

           Urgent and emergency services

           Medical care (including older people’s care)


           End of life services



Inspectors found seven breaches of regulation at this inspection, some of the areas where the trust must improve are:

·         The trust must ensure that the processes in place to protect people in vulnerable circumstances are fully implemented.   

·         In urgent and emergency services, there should be sufficient numbers of staff to look after patients in the department at all times.

·         The trust must ensure that medicines are managed properly and safely on the medical wards.

·         Patients’ information should not be visible, to ensure their privacy on the medical wards.

·         The trust must ensure that Do Not Attempt Cardio Pulmonary Resuscitation decisions are consistently documented, and discussions are held and documented to reflect the preferences of the patient and their family in end of life services.

Inspectors did also find some areas of outstanding practice in the pharmacy. A clinical portal had been developed by staff in the department with the support of IT colleagues. It allowed staff to prioritise high risk patients ensuring they were seen quickly. It also provided a range of information to the pharmacy team to enable them to effectively monitor and manage the medicines of all patients. Technology within the department was in constant development and the team were using automated dispensing and auto production of labels to decrease the dispensing error rate.

Full details of the ratings, including a ratings grid, are given in the report published online at: http://www.cqc.org.uk/provider/REM.