Care Quality Commission
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Sustaining improvement - the stories of four hospital trusts

In 2017 and 2018, we reported on seven NHS acute and eight mental health trusts. These trusts had achieved significant improvements in their CQC ratings.

Yesterday (Thursday 5 March) we published updated case studies on four of those trusts. They explore how each has sustained the improvements and, in some cases, improved further.

The case studies draw on interviews with a range of trust staff and describe the approach taken to maintain high quality care.

At the heart of their success has been the continued focus on strong and accessible leadership. The trusts invested in staff through training and support. Alongside this, staff were clear that sustaining and improving in the long term is only possible by working in partnership. They worked with local primary, community and social care to better manage demand.

While each trust has had a different experience, leaders at all four spoke of similar challenges. Their stories of sustaining and driving further improvement reveal some common themes. These include:

  • using formal Quality Improvement programmes and directly involving staff in improvement work
  • providing opportunities for staff to contribute ideas and voice concerns - giving feedback to show that they have been heard and action taken
  • applying self-evaluation, quality assurance and accreditation schemes to audit performance, measure impact and identify learning
  • thinking creatively about recruitment and retention with initiatives to make the trust a good place to work
  • realising the benefit of involving patients and the local community and using their feedback to improve services

Ted Baker CQC’s Chief Inspector of Hospitals yesterday said:

“A key challenge for hospital trusts that have achieved a good or outstanding rating is how to keep a continued focus on providing the best possible care. CQC inspection reports can be a springboard for action but fully embedding improvements across the organisation and maintaining momentum in driving positive change is not easy.

“Despite the pressure of staff shortages and the increasing demand, these case studies show the commitment and efforts of staff at all levels to learn and improve. They also demonstrate just how important it is to have open, honest and accessible leadership that engages and empowers staff across all departments to contribute to improving patient care.

“I hope their stories will encourage and inspire other trusts in their own improvement work.”


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