County Durham and Darlington NHS Foundation Trust has welcomed
the publication of the Care Quality Commission's report following
its inspection in September 2017.
The inspection covered Urgent and Emergency Services, Medical
Care, Surgery and Maternity across Darlington Memorial Hospital and
University Hospital of North Durham. Each of the areas are rated
under five domains: Caring, Safe, Well-Led, Effective and
While the CQC has rated the Trust as 'requires improvement' it
did highlight areas of good and outstanding practice. Notably, the
leadership of the Trust was highlighted as having improved with a
'good' rating for well-led. The CQC highlights the strong link
between the quality of overall management of a trust and the
quality of its services.
Similarly, improved ratings were noted for well-led in our
Urgent and Emergency Care and Maternity Services, and for the
safety of our medical care. The Trust was also rated 'good' for
caring and responsive and credited for achieving improvements
required in areas such as the care of patients on non-invasive
ventilation, a key theme underpinning findings from the 2015
Summary areas of good practice recognised in the report
The report also noted areas of outstanding practice within the
Trust's maternity services in particular award winning work by the
transitional care team which has identified a way of providing care
for vulnerable babies outside of the neonatal unit.
Improvements to the leadership were also highlighted with
services receiving a 'good' for well-led.
In total, 31 of the 40 individual indicators (77.5%) were "good"
and 9 indicators were "requiring improvement".
The CQC carried out unannounced inspections across services
between 12 - 15 September 2017. Verbal feedback following the
inspections meant that the Trust was able to begin reviewing and
addressing some key areas noted for improvement straight away.
In addition, some areas noted for improvement in particular
those within surgery are being addressed through continuations of
work programmes including focused actions addressing learning,
safety and culture - and these were well underway at the time
of the inspection and are being further embedded across the Trust.
There has also been a significant improvement in mandatory training
across surgery with compliance having increased to 89% since the
Whilst CQC have highlighted the need for further improvement in
the responsiveness of our emergency care services, and we continue
to seek such improvements through on-going work-streams shared
with, and monitored by, the Local A&E Delivery Boards. The
Trust consistently sees the highest levels of Type 1 activity
within its Emergency Departments comparatively across the North
East. It is recognised that demand on services across the region is
increasing and that this is having an impact on achieving national
targets. However, against this challenging backdrop, the Trust,
prior to the winter period and further increasing pressures on
services, was in the top third of Trust nationally based on
performance against the 4 hour wait standard. This is the result of
the Trust proactively undertaking extensive work internally and
engaging with support from NHS Improvement's Emergency Care
Intensive Support Team to drive forward improvements.
Chief Executive Sue Jacques said:
"We are pleased that the CQC report recognises the many
improvements made since our previous inspection in 2015 against a
context of significant challenges for the NHS. We will continue to
strive for a 'good' rating overall. We recognise the need for and
are fully committed to a continuous improvement journey and indeed
much work has already taken place since the inspection last
"Our patients should be assured that their safe, quality
care and experience remains our highest priority. This is
recognised both through the Trust's consistent 'good' rating under
the caring domain with the report highlighting the compassionate
care provided by CDDFT colleagues and the respect and dignity with
which patients are treated. It was also particularly pleasing to
note the areas of outstanding practice highlighted across our
"In addition, the Trust's 'good' rating for well-led
reflects our commitment to quality and developing clinical leaders,
learning and innovation as well as promoting an open and
transparent culture which all support the delivery of high quality,
person-centred care- in line with our mission 'with you all the
"CQC chose not to re-inspect end of life care services at
this inspection, hence the ratings remain those from the 2015
inspection. The Trust has invested significantly in improving
the leadership and delivery of these services since 2015. It is
unfortunate that the Trust's request for re-inspection could not be
accommodated on this occasion. We look forward to a re-inspection,
which can consider the improvements made, at the appropriate time
in CQC's review cycle.
"The well-led rating also confirms we are sighted on what
more needs to be done to continually improve safe and effective
integrated care and the Trust Board is fully committed to ensuring
those further improvements are addressed.
"We have action plans in place to address areas where the
need for improvements have been identified and there is a strong
commitment and dedication running through CDDFT to deliver on these
improvements and beyond."
The full CQC report is available on the Care Quality
Commission's website: CLICK
Published 1st March 2018
'As I was very, very nervous, I must have been the worst patient
ever and they were brilliant with me and I can't thank them enough
- could you please pass on my sincere thanks.'
Patient, Hysteroscopy Unit, Chester-le-Street Community