Care Quality Commission
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CQC requires improvement at Alder Hey Children’s NHS Foundation Trust

The Care Quality Commission has told Alder Hey Children’s NHS Foundation Trust that it must make improvements to comply with national standards of quality and safety.

This follows an unannounced inspection at Alder Hey Hospital in Liverpool on 2 and 3 December 2013. The inspection was carried out in response to concerns raised with CQC regarding standards of quality and safety in the Theatre Department. We therefore undertook a focused inspection in this area and a number of wards within the surgical division

The CQC’s inspection report, which is published last week, identifies that the Trust was failing to meet four of the five national standards reviewed.

Some of the issues of concern identified by our inspectors included:

  • At the time of our inspection we found the theatre department had a high level of staff sickness which had, on occasion, led to operations being cancelled.
  • Operations had also been cancelled due to a shortage of the right numbers and skill mix of available staff.
  • The ratio of staff available in the theatre recovery area was potentially unsafe and meant that patient welfare and safety was at increased risk.
  • Although corporate quality assurance systems were in place, local implementation in the theatre department was of concern. We found staff in this department had not always followed published national guidance on the availability of equipment and that maintenance checks on some items of essential equipment were not taking place routinely.
  • We were told that operations schedules could often overrun, meaning that staff had to work longer shifts and take on extra hours.
  • Theatre staff told us that that they felt unsupported during the recent reorganisation of the department and the management team had not listened to them, adversely affecting relationships within the department.
  • Whilst overall staffing numbers on the surgical wards visited were satisfactory, staff shortages on some wards meant that nursing staff were rushed to meet the needs of patients.

We found that senior managers in the Trust were aware of the problems in the theatre department and had started taking steps to address them although, at the time of our inspection, this management response was at early stage.

Following our inspection we informed other agencies, including Monitor and NHS England, of our concerns. We continue to monitor the Trust extremely closely and will return to check that the necessary improvements have been made.

Malcolm Bower-Brown, CQC’s Regional Director for the North said:

“Undertaking unannounced inspections in response to information of concern is a vital part of CQC’s role and we encourage anyone with concerns about any registered service to contact us immediately.

“The problems we identified at the Alder Hey Hospital are very worrying. We have told the Trust where further action must be taken to ensure national standards are met and that patients receive the quality of care they are entitled to expect.”

“Inspectors will return to the Trust to ensure the necessary improvements have been made. In the meantime, we continue to monitor the Trust carefully, working closely with NHS England, Monitor and others.”


For further information please contact the CQC Regional Communications Team, David Fryer 07901 514 220 or Kirstin Hannaford 0191 233 3629.

For further information please contact the CQC press office on 0207 448 9401 or out of hours on 07917 232 143.


CQC has further published a full report on our website here.

Inspectors found that the Alder Hey Children’s NHS Foundation Trust was failing to meet four standards:

  • Care and welfare of people who use services
  • Staffing
  • Supporting workers
  • Assessing and monitoring the quality of service provision.

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care. 

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