Care Quality Commission finds improvements at Great Western Hospital - but...

Written by Tony Millett on .


The Care Quality Commission (CQC) has found improvements in the services provided by Great Western Hospitals NHS Foundation Trust.

Inspectors visited the hospital in March to review progress following their inspection in October 2015 when the CQC issued a Warning Notice requiring improvements in the hospital’s emergency department.

Following this latest inspection the trust have been rated as Good for being effective, caring and well led, and Requires Improvement for being safe and responsive to people’s needs. However, the CQC did not change the overall rating of the trust - which remains at Requires Improvement.

The CQC found (in March) improvement in most areas, but it calls for further progress: "During the inspection in in October 2015 CQC found the trust had struggled to manage the flow of patients through the main hospital."

"Patients could not be discharged because there were no suitable places for them to go to. Within the emergency department the design and layout meant that waiting patients, including children, were not adequately observed."

"The leadership team had developed a clear vision for improvement with realistic goals.  The urgent care centre was working in partnership with medical care, surgery, services for children and young people and outpatients and diagnostic imaging to improve patient admissions and flow through the hospital."

The inspectors found that the Emergency Department was often full, but staff worked hard to ensure safe care could be maintained as much as possible. There were times that it was not safe due to over crowding.


The Board Meeting held the day before the CQC report was published, heard that the four hour time limit in the Emergency Department (or A&E) for discharge, tteatment or admittance was at 87.8 per cent in June against the 95 per cent target. One reason cited was that bed days lost to delayed discharge from wards was 80 per cent higher than in June 2016.  They are confident that figures for July will be better.

The CQC says that in all areas feedback from patients was consistently positive. Care was described as being compassionate and involved patients as partners.

The Chief Inspector of Hospitals, Professor Ted Baker was pleased to have found these improvements:  "However it is clear that this is work in progress – and further work is needed."

"I am aware that there are wider challenges within the local healthcare system in Swindon – particularly in the provision of primary and community services – which are creating pressure on the hospital at a time when demand continues to rise."

A statement from Great Western Hospitals welcomed the latest CQC report and acknowledged the overall rating of Requires Improvement: "While this is the same rating that was awarded following the 2015 inspection, the CQC have commended the Trust for taking 'significant action' over the last two years and noted that progress was being seen across the whole organisation."

GWH's Chief Executive, Nerissa Vaughan, says that while there is still more to do, specifically around maintaining safe care during busy periods, the feedback shows the Trust to be in a much stronger position than eighteen months ago: "We’ve been on a journey of improvement for the last two years. It’s one we are still on and one the CQC recognised as being 'underpinned by realistic goals'.

“I’m pleased that nearly two thirds of our services are now rated as either good or outstanding and I’m delighted for our incredibly dedicated Emergency Department team, whose caring approach to patients was rated as outstanding."

“Of course, some areas are not where they should be and I’m in no way complacent about the work that’s still ahead of us."

The CQC report brought a joint statement from Healthwatch Wiltshire and Healthwatch Swindon: “We are pleased to see that improvements have been made at GWH, but recognise that there is still more work to be done. We will continue to meet with the Trust regularly to monitor progress and feedback any concerns that have been raised to us by both Swindon and Wiltshire people."

The CQC has produced three reports following their March inspection:  one - two - three.