Mount Vernon Hospital

We carried out this inspection as part of our comprehensive inspection programme of all NHS acute providers.

Overall, this hospital was rated as requires improvement and we found that each of the four core services we inspected at Mount Vernon Hospital require improvement.

Our key findings were as follows:

• Data from April to September 2014 showed that over 99% of patients were seen within the national target of 95% of patients being admitted, transferred or discharged within four hours of attending the Minor Injuries Unit.

• Staff training records showed low compliance with some areas of mandatory training including safeguarding children and management of medicines.

• Two thirds of nursing staff on the elderly care ward were agency staff.

• The trust performed better than expected in the number of patients acquiring clostridium difficile, however, they performed worse than expected for patients acquiring MRSA bacteraemia.

• Letters to GPs were not being sent within the five-day period in line with trust policy.

• System and processes did not make sure that staff checked the child protection register when necessary.

We saw several areas of good practice including:

• The nurse practitioners in the Minor Injuries Unit made direct referrals to specialities both internally and externally to the hospital; this included tertiary referrals to specialists such as plastic surgery.
• The effective management of 18 week referral to treatment times for patients.
• Good access to physiotherapy and occupational therapy and good multidisciplinary team working for surgical patients at the hospital.
• Good multidisciplinary team working to support one stop outpatient clinics.
• The trust had a proactive specialist nurse for organ donation.

However, there were also areas of poor practice where the trust needs to make improvements:

The trust MUST

• Make sure of the effective operation of systems to enable the trust to identify, assess and manage risks relating to the health, welfare and safety of patients.
• Manage the risks associated with the numerous staffing establishment shortages across the trust.
• Make sure that all staff receive the full suite of mandatory training that is required to manage risks to patient safety.
• Make sure that all staff understand their responsibilities in relation to the trust’s systems and processes that exist to safeguard children.
• Make sure agency staff receive an appropriate local induction on to wards.
• Complete venous thromboembolism assessments as appropriate.

The trust should:

• Review the resourcing of medical secretaries to make sure they can meet patient need and the trust’s own targets for sending GP letters.
• Consider implementing the Friends and Family Test for all wards at the hospital.
• Consider whether patient outcomes could be improved through dedicated consultant cover and / or consultant oversight for the Minor Injuries Unit.
• Consider auditing pre-operative starvation to make sure patients are not starved for significantly longer than required.

Professor Sir Mike Richards

Chief Inspector of Hospitals