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The Royal Devon University Healthcare NHS Foundation Trust – A CQC Inspection

Recent inspections carried out by the Care Quality Commission (CQC) have found that improvement is required in some of the services run by the Royal Devon University Healthcare NHS Foundation Trust.

The Royal Devon University Healthcare NHS Foundation Trust governs both the North Devon District Hospital and Royal Devon & Exeter Hospital (RD&E). Inspections of these hospitals were carried out in November and December 2022 after the Trust reported 16 “never events” between March 2021 and November 2022. NHS England defines “never events” as serious preventable incidents which should not occur if healthcare providers have implemented existing national guidance or safety recommendations.

The CQC is an independent regulator of all health and social care services in England and ensures the quality of care and safety of patient care in hospitals, dentists, ambulances and care homes.

In its report published on 26 May 2023, the CQC has reviewed and rated the quality of care provided by the Royal Devon University Healthcare NHS Foundation Trust in its surgical, medical and diagnostic imaging services.

The CQC rated both North Devon District Hospital and the RD&E as ‘requiring improvement’ in its medical care overall. This saw the RD&E fail to retain its ‘good’ rating which it was awarded in inspections carried out in 2019. The CQC found that patient’s documentation and risk assessments were not always completed correctly which meant that staff did not always identify and quickly act upon patients at risk of deterioration. It also found that there were some instances when medicines were not stored and monitored according to trust policies.

The CQC rated both hospitals as ‘requiring improvement’ in their surgical services. This saw both hospitals decline from their previous ‘good’ rating. The CQC identified both hospitals as not always having enough nursing and support staff with the right skills, training and experience to provide the right care and treatment, and to keep patients safe from avoidable harm. It also found that the service did not always manage patient safety incidents well and that managers did not always share lessons learnt with the whole medical team and the wider service.

Both hospitals’ diagnostic imaging services were rated as good.

This is the first inspection of the Trust since the Royal Devon and Exeter NHS Foundation Trust and Northern Devon Healthcare NHS Trust merged in April 2022.

Although it is understandable that the Trust, like many other healthcare providers, is currently facing an unprecedented amount of pressure, it is hoped that the recent report will prompt it into taking immediate and essential action to improve the services provided to its patients. In response to the report Mr Chris Tidman, Deputy Chief Executive Officer of the Trust, said “We are a learning organisation and we welcome feedback from the CQC and their response to our never events, which will help us to continuously improve our services for our patients and communities. We are reassured that the majority of the areas for improvement were already known to us, and work is underway to raise standards and performance.”

Darren White, Head of Dunn & Baker Solicitors’ Medical Negligence Department, said “Unfortunately we are continuing to see an increasing number of enquiries and claims against the Royal Devon University Healthcare NHS Foundation Trust including never events. This CQC report demonstrates some of the issues we are being told about by patients who consult us regarding potential medical negligence claims.”

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