Warrington and Halton Teaching Hospitals NHS Foundation Trust

Updated 24 July 2019

Warrington and Halton Hospitals NHS Foundation Trust comprises three hospitals across two sites – one in the borough of Warrington and two co-located in Runcorn in the borough of Halton. The trust serves a population of approximately 330,000 across both boroughs and employs around 4,200 staff.

Warrington hospital is the home of the emergency and acute care services supported by intensive care, acute cardiac care unit, stroke unit and the country’s largest inpatient acute dementia ward. Maternity and paediatrics, ophthalmology, and screening services are all located here.

Halton General Hospital is where all elective work is carried out together with two integrated/ intermediate care wards; the Clatterbridge chemotherapy Centre, Macmillan Delamere Centre. The Runcorn Urgent Care Centre is located at this site.

The Cheshire and Merseyside Treatment Centre is also located on the Halton General site which is a centre for orthopaedic surgery and sports medicine.

The trust reports that it has 539 beds: 431 at Warrington; 44 elective and 22 intermediate care beds at Halton and 42 trauma and orthopaedic beds at the Cheshire and Merseyside Treatment Centre.

In the year before the inspection there were 112,000 visits to the emergency department at Warrington Hospital and 30,000 to the urgent care centre at Halton General hospital. In the same period there were approximately 500,000 individual patient appointments, procedures and stays and approximately 3,000 babies were born.

Updated 24 July 2019

Our rating of the trust improved. We rated it as good because:

• We rated safe, effective, caring, responsive and well-led as good. All five core services we inspected during this inspection we rated as good. In rating the trust, we took into account the current ratings of the six services not inspected this time.
• We rated well-led for the trust overall as good.
• Our rating for Warrington Hospital and Halton General Hospital were both good which was an improvement since the last inspection.
• Our ratings for medical care and critical care at Warrington Hospital were both good which was an improvement from the last inspection. Our ratings for surgery at Warrington Hospital and Halton General Hospital were both good which was the same rating as the last inspection.
• We rated maternity at Warrington Hospital as good. We previously inspected maternity jointly with gynaecology so we cannot compare our new ratings directly with previous ratings. We rated outpatients at Halton General Hospital as good. We previously inspected outpatients with diagnostic imaging so we cannot compare our new ratings directly with previous ratings.

Updated 24 July 2019

Updated 24 July 2019

Updated 10 July 2015

Staff reported incidents via the electronic reporting system used within the trust, and learning from incidents was shared via team meetings. Incidents were investigated where appropriate. However, staff told us that they didn’t always receive feedback about the final outcome of these investigations. Staff followed good practice guidance in relation to the control and prevention of infection. The clinical rooms were clean and well organised. Equipment was clean and well maintained. There were systems in place for the safe procurement, administration and disposal of medicines. However, systems for monitoring and recording stock levels were not robust.

All staff had received training in the safeguarding of both adults and children. Staff were aware of their role and responsibilities and knew how to raise matters of concern appropriately. Fraser guidelines were used in line with best practice for assessing and obtaining consent from children and young people. Staff had access to online training and education including the latest guidance (e.g. NICE guidelines) to ensure practice was evidence based. Staff were able to describe the new post exposure prophylaxis information and were up to date about trends in genitourinary medicine (GUM) care.

Patients were treated with dignity and respect. Staff were sensitive to the nature of the services provided and the needs of anxious patients. If patients required further emotional support, staff would signpost them to the relevant advisory and support services. A sexual health advisor was employed 22 hours a week to provide information, advice and counselling to patients diagnosed with a sexually transmitted infection (STI). The trust did not undertake under age or social termination of pregnancy. As a result concerns had been raised about the timely access to these services. To address this issue a pathway for under age/social termination of pregnancy had been developed and the process in these circumstances was to refer the patient to the British Pregnancy Advisory Service.

The clinic did not have the ‘You’re Welcome’ status for younger people. However, the clinic aimed to provide a young-person friendly environment by offering appropriate information and advice to help young people make informed, safe choices about their sexual health. There was accessible information on a range of sexual health issues.

There was evidence of good local leadership. Staff told us they received excellent support from the divisional management team and matron. Staff were patient focused and the culture of the service centred on the needs and experience of patients in a very positive way. However, staff did not feel involved and valued, particularly in light of the recent retendering process. Staff were uncertain as to the future of the service and what this meant for their roles and responsibilities.

There was limited evidence of trust oversight of the service provided at Bath Street. Although the service sat within the women’s, children’s and clinical support services division, it was not clear what systems were in place for the day-to-day quality measurement and governance of this service. Although the service contributed to trust-wide audits and health and safety inspections, staff told us that since the clinic had moved to Bath Street Health and Wellbeing Centre they did not receive feedback about the findings and outcomes from these audits. This meant the potential for learning and improvement was limited.