Northampton General Hospital rating drops from 'good' to 'requires improvement' amid reports of 'bullying culture'

CQC inspectors visited NGH in June and July 2019 to assess the quality of three core services  urgent and emergency care, medical care and maternity.
CQC inspectors visited NGH in June and July 2019 to assess the quality of three core services urgent and emergency care, medical care and maternity.

Northampton's hospital has been given orders to improve after a watchdog found issues ranging from bullying to an unexpected maternity ward death during an inspection.

The Care Quality Commission (CQC) also found incidents of staff failing to store medicines properly while waiting times for those requiring treatment were found to be consistently worse than national standards.

The hospital, which employs almost 4,500 staff, has been rated as requires improvement overall today, falling from good, which it was awarded in its previous report in 2017.

One line in the inspection report said hospital staff did not all feel respected, supported and valued. Staff feedback showed a "culture of bullying behaviour" - though it stated staff were focused on the needs of patients receiving care.

In June 2018 there was an unexpected maternal death - one of four serious incidents reported by the maternity service between March 2018 and February 2019.

The chief inspector of hospitals at the CQC, Professor Ted Baker, said: “Although Northampton General Hospital NHS Trust maintained good ratings in some areas, there were others where it was not meeting standards seen previously.

“Some staff had not completed mandatory training. This included safeguarding children training in urgent and emergency care and mental capacity training, to support patients with reduced ability to make decisions, in medical care.

“Medicines were not always stored properly and poor record-keeping meant out-of-date drugs may have been administered. There was evidence some patients had been discharged without their medication. Clinical waste was not consistently well managed, with used gloves and aprons present in black bags on some wards without assurances this was uncontaminated waste."

In addition to its overall rating, the trust was rated as requiring improvement to be 'safe and well-led' - though it was rated as good for being effective, caring and responsive.

But Northampton General Hospital bosses say they are disappointed by the findings - with the hospital chief claiming medics have seen a rise in demand for their services.

Dr Sonia Swart, chief executive at Northampton General Hospital, said: "Of course we’re disappointed, given our previous overall rating of good.

"However, we know that since our last CQC inspection we’ve seen unprecedented levels of activity as demand for our services has risen. This has impacted on our ability to sustain and improve our services even further.

"We know there is more we have to do."

The health watchdog told the trust to improve the way it manages medicines and prescribing documents safely.

Staff must now follow guidelines to check patients receive the correct medicines and there must be systems to ensure staff are aware of safety alerts and incidents.

Also information on how to raise a complaint must be appropriately available in maternity.

Professor Baker added: “In maternity, there was not always enough staff with the right qualifications, skills and experience to keep people safe from avoidable harm; managers recognised and were addressing this.

“We also found this service needed to make information about how to complain more accessible."

Outstanding practices included the trust’s support of breastfeeding and early childhood development, which won UNICEF UK’s baby-friendly accreditation.

The trust has also won an international award for being a positive workplace for nurses and midwives and the maternity service fully complied with safety standards that helped protect it against clinical negligence claims.

Professor Baker said: “Staff were caring. They treated people respectfully with kindness and compassion, helping them emotionally when required such as following baby loss.

“People could generally access services when they needed, and staff worked as a cohesive team to benefit patients.

"Following the inspection, CQC reported its findings to the trust. The trust’s board knows what it must now do to ensure improvements are made. We will continue to monitor the trust and will return to carry out further inspections to check on progress with improvements.”