Major Norfolk hospital still 'requires improvement'

The Norfolk and Norwich University Hospital is struggling to recruit staff in some areas, CQC inspectors found

The health watchdog has raised concerns over safety and quality in surgery, outpatients and diagnostic imaging services at one of the region's largest hospitals.

Norfolk and Norwich University Hospital (NNUH) has again been rated as "requires improvement" by the Care Quality Commission (CQC).

The delayed report follows a series of unannounced inspections last autumn.

NNUH said it had "come a long way" since then and had a new leadership team in place.

The CQC highlighted NNUH's use of corridors to house patients as it tackled ambulance handover delays.

And it said staff had felt pressured to admit extra patients on wards that were already at full capacity.

In May the BBC's Newsnight programme revealed concerns over this practice at the hospital.

It was supposed to be a short-term measure, the CQC said, but at the time of the inspection management had been unable to give a date for ending the policy.

Prof Lesley Dwyer joined the Norfolk and Norwich University Hospitals NHS Foundation Trust as chief executive after the CQC inspections

At the time of the visits, the CQC said NNUH was the worst in the East of England for ambulance handover times, waits between referral and treatment, and cancer treatment waiting times.

Within the surgical department, it found not all staff had completed mandatory training and almost a third of the equipment it checked was overdue testing or servicing.

Workforce pressure meant that on one ward there were 50% fewer staff than had been planned for.

Patient records were not always up-to-date and stored securely, the inspectors found.

Within diagnostic imaging, the service was found to be safe but equipment was not always in good working order.

"Staff told us that replacing aged equipment was often delayed due to contractual processes secondary to being a private finance initiative (PFI) site," the CQC report said.

It added that between August and September 2023, 160 radiology appointments had been cancelled due to staff shortages.

There was also a lack of wheelchairs throughout the hospital, staff told the inspectors.

A patient's bed in a corridor at the Norfolk and Norwich University Hospital

In the outpatients department, infection control was flagged as a concern by the CQC.

Inspectors spotted dirty oxygen cylinders in a cancer treatment area.

The report highlighted how the service "did not always have enough nursing and support staff to keep patients safe".

In the orthodontics department, medical staffing vacancies were at 52% at the time of the visit.

Bullying and harassment

Publication of the CQC report was delayed due to a "large-scale transformation programme" and staff sickness.

Rob Assall, the CQC director of operations in the East of England, said there had been improvements since the visit.

But he added: "We identified areas for improvement in leadership at the trust overall and also at Norfolk and Norwich University Hospital.

"Our experience tells us that when a trust isn’t well led, this has a knock-on effect to the level of care being given, which is what we found when we inspected the trust."

He also highlighted ongoing concerns about bullying and harassment, particularly among ethnic minority and disabled staff.

Prof Lesley Dwyer, Norfolk and Norwich University Hospitals NHS Foundation Trust's new chief executive, said: "We have a significantly changed leadership team and have developed leaders in all areas of the organisation, we are seeing a sustained period of good emergency-department performance, and we’ve worked together to reduce escalation beds and increase early discharges.

"We are resolved to make this a great place to work for everyone and to reduce the pressures our hard-working staff face.

"Since the inspection we have made progress in improving our culture and are clear about the way we want to be as an organisation."