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Stakeholder Briefing - Trust welcomes CQC report

County Durham and Darlington NHS Foundation Trust has welcomed the publication of the Care Quality Commission's report following its inspection in September 2017.

The inspection covered Urgent and Emergency Services, Medical Care, Surgery and Maternity across Darlington Memorial Hospital and University Hospital of North Durham. Each of the areas are rated under five domains: Caring, Safe, Well-Led, Effective and Responsive.

While the CQC has rated the Trust as 'requires improvement' it did highlight areas of good and outstanding practice. Notably, the leadership of the Trust was highlighted as having improved with a 'good' rating for well-led. The CQC highlights the strong link between the quality of overall management of a trust and the quality of its services.

Similarly, improved ratings were noted for well-led in our Urgent and Emergency Care and Maternity Services, and for the safety of our medical care. The Trust was also rated 'good' for caring and responsive and credited for achieving improvements required in areas such as the care of patients on non-invasive ventilation, a key theme underpinning findings from the 2015 inspection.

Summary areas of good practice recognised in the report include:

  • As noted above, in our previous 2015 inspection, non-invasive ventilation (NIV) was included as an area requiring improvement and the Trust has done much work in this area. This was recognised within this report with the care and treatment of patients requiring NIV highlighted as an area of improvement during our latest inspection.
  • Nurse staffing levels were highlighted as an area of improvement reflecting our recruitment efforts and focus on this area.
  • Staff cared for patients with compassion, treating them with dignity and respect.
  • Patients, families and carers gave positive feedback about their care.
  • Staff involved patients and those close to them in decisions about their care and treatment.
  • There was effective multi-disciplinary (MDT) working to secure good outcomes and seamless care for patients across the trust.
  • The wards and department areas were clean and equipment well maintained.
  • Services were planned and delivered in a way that met the needs of local people. They worked with commissioners, external providers and local authorities.

The report also noted areas of outstanding practice within the Trust's maternity services in particular award winning work by the transitional care team which has identified a way of providing care for vulnerable babies outside of the neonatal unit.  Improvements to the leadership were also highlighted with services receiving a 'good' for well-led.

In total, 31 of the 40 individual indicators (77.5%) were "good" and 9 indicators were "requiring improvement".






The CQC carried out unannounced inspections across services between 12 - 15 September 2017. Verbal feedback following the inspections meant that the Trust was able to begin reviewing and addressing some key areas noted for improvement straight away.

In addition, some areas noted for improvement in particular those within surgery are being addressed through continuations of work programmes including focused actions addressing learning, safety and culture -  and these were well underway at the time of the inspection and are being further embedded across the Trust. There has also been a significant improvement in mandatory training across surgery with compliance having increased to 89% since the inspection.

Whilst CQC have highlighted the need for further improvement in the responsiveness of our emergency care services, and we continue to seek such improvements through on-going work-streams shared with, and monitored by, the Local A&E Delivery Boards. The Trust consistently sees the highest levels of Type 1 activity within its Emergency Departments comparatively across the North East. It is recognised that demand on services across the region is increasing and that this is having an impact on achieving national targets. However, against this challenging backdrop, the Trust, prior to the winter period and further increasing pressures on services, was in the top third of Trust nationally based on performance against the 4 hour wait standard. This is the result of the Trust proactively undertaking extensive work internally and engaging with support from NHS Improvement's Emergency Care Intensive Support Team to drive forward improvements.

 Chief Executive Sue Jacques said:

 "We are pleased that the CQC report recognises the many improvements made since our previous inspection in 2015 against a context of significant challenges for the NHS. We will continue to strive for a 'good' rating overall. We recognise the need for and are fully committed to a continuous improvement journey and indeed much work has already taken place since the inspection last autumn.

 "Our patients should be assured that their safe, quality care and experience remains our highest priority. This is recognised both through the Trust's consistent 'good' rating under the caring domain with the report highlighting the compassionate care provided by CDDFT colleagues and the respect and dignity with which patients are treated. It was also particularly pleasing to note the areas of outstanding practice highlighted across our maternity services.

 "In addition, the Trust's 'good' rating for well-led reflects our commitment to quality and developing clinical leaders, learning and innovation as well as promoting an open and transparent culture which all support the delivery of high quality, person-centred care- in line with our mission 'with you all the way'.

 "CQC chose not to re-inspect end of life care services at this inspection, hence the ratings remain those from the 2015 inspection.  The Trust has invested significantly in improving the leadership and delivery of these services since 2015. It is unfortunate that the Trust's request for re-inspection could not be accommodated on this occasion. We look forward to a re-inspection, which can consider the improvements made, at the appropriate time in CQC's review cycle.

 "The well-led rating also confirms we are sighted on what more needs to be done to continually improve safe and effective integrated care and the Trust Board is fully committed to ensuring those further improvements are addressed.

 "We have action plans in place to address areas where the need for improvements have been identified and there is a strong commitment and dedication running through CDDFT to deliver on these improvements and beyond."

The full CQC report is available on the Care Quality Commission's website: CLICK HERE


Published 1st March 2018




'In recent times, I have utilised admissions to Richardson for respite direct from my fracture clinic, even at weekends. I have never worked anywhere with this efficiency before - it is reassuring and invaluable for the patient.'

Patient, Lowson / Starling Wards, Richardson Hospital