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Bosses at east Kent’s troubled hospitals trust have been given an early Christmas present this week after England’s chief inspector said it should be taken out of special measures.
It follows a rigorous re-inspection of facilities which two years ago were found to be failing in almost 40 clinical areas.
Now there are deemed to be no inadequate services at Kent and Canterbury, with urgent care, critical care, services for children and outpatient and diagnostic imaging all considered good.
The William Harvey Hospital in Ashford has an overall rating of requires improvement but good ratings for critical care and outpatient and diagnostic imaging.
The QEQM Hospital in Margate also requires improvement overall, but medical care, critical care, services for children and young people, and outpatient and diagnostic imaging are all rated as good.
Overall the East Kent Hospitals University NHS Foundation Trust is still rated as requiring improvement and the Care Quality Commission says it must tackle ongoing issues with recruiting skilled staff and enabling more patients to access treatment sooner.
Trust chief executive Matthew Kershaw says it is a major step forward at a time of increasing pressures on the service and he praised his “hardworking and dedicated” staff for the progress.
He believes coming out of special measures will also help support the radical changes the trust is proposing across east Kent, which includes creating one super hospital for all specialist services.
Its emerging plan for healthcare in east Kent is aimed at reducing the deficit, partly by widening the services offered by GPs and reducing the reliance on agency hospital staff.
The trust was put into special measures in 2014 and wrestling with a near £40 million deficit when Mr Kershaw took charge in January.
He said: “The tangible improvements recognised by the CQC are the result of our thousands of dedicated and hardworking staff who have together driven improvements for patients in their wards, clinics, theatres, laboratories, workshops and offices over the last two years.”
“This is a major step forward in our ongoing journey to improve how we care for our patients, their relatives and our staff.
"We have made significant progress which means that hospitals provide better care for our patients and are better places for our staff to work.”
The CQC reports also highlights further areas for improvement such as recruiting and retaining more staff, enabling more patients to access treatment sooner, improving the flow of patients through hospitals, fully embedding early signs of improvement in maternity and end-of-life care and making financial savings.
Mr Kershaw added: “The CQC rightly highlights the ongoing challenges we face and further improvements we still need to make.
"Encouragingly, these are things we know about and are already working hard to improve, through our improvement plan and as part of efforts to transform how patients are cared for, both in and out of hospital, with our partners in Kent and Medway.
"We will not take the foot off the gas now that we are recommended as being out of special measures but instead continue the momentum of improvement at pace to deliver services that better meet the needs of patients both now and in the future."
The recommendation to remove the trust from special measures is expected to be approved by NHS Improvement in the new year.
Among the positive improvements inspectors found were safer emergency services and better medical care at all hospitals.
All hospitals have been rated 'good' for caring, with a culture of compassion.
Also praised was the improved leadership, who were described as a "highly engaged team with a clear and common view on Trust strategy", and better staffing to address previous gaps.
But inspection has identified a number of areas for further improvements.
They include:
One of the financial headaches which has weighed down on the trust has been the cost of using agency nurses and doctors.
It has been largely responsible for its growing deficit which hit an alarming £39 million two years ago.
But chief executive Matthew Kershaw insists that a vigorous and innovative recruitment campaign is underway which is already producing results.
He predicts the deficit will drop to between £20 and £25 million by the end of March but admits there are still hundreds of clinical jobs which need filling.
He said: “The agency bill is reducing and is significantly lower than last year and we have also made savings in equipment procurement and more efficient use of our theatres.
“There is always a turnover of nurses and doctors as some move on to find certain specialities or posts we cannot offer.
"But coming out of special measures should also make our hospitals a more attractive place to work."
He added: “We are looking at a variety of innovative measures to help with recruitment including working with Canterbury Christ Church University and developing the skills of our existing staff to take on more extended roles.”
He said the trust might also look abroad to fill some roles.
The decision to take the trust out of special measures has been welcomed by Canterbury MP Julian Brazier.
He said: “I was disappointed at the original decision given the many stories I had received about the quality of the care and the dedication of the staff.
“But I’m delighted to see that the CQC has recognised progress in most of the areas it was concerned about.
“Life is hard at the sharp end in the NHS and it is a measure of the dedication of doctors, nurses and supporting staff in the Kent and Canterbury and its sister hospitals that they are making such good progress.
“I very much hope that this will be confirmed by a final decision to remove the hospital from special measures in February.”
