Royal Cornwall Hospitals Trust remains in special measures

Royal Cornwall Hospitals Trust has been in special measures since October 2017.

A troubled hospital trust will remain in special measures despite making significant improvements.

The Royal Cornwall Hospitals Trust (RCHT) has been rated as requires improvement by the Care Quality Commission (CQC), following inadequate ratings in 2016 and 2017.

However, inspectors said leadership at the trust "remains inadequate".

The hospital declared the top level of alert, Opel 4, on 134 days in a year - the highest number in England.

Ratings for the safety and effectiveness of the trust's services were upgraded from inadequate to requires improvement.

The report highlighted particular improvements in surgery, maternity and end of life care.

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Critical care, children and young people's services and community sexual health remained good, while diagnostic imaging received an outstanding rating after new state-of-the-art scanners were unveiled earlier this year.

The CQC will continue to monitor the hospitals closely.

England's chief inspector of hospitals, Ted Baker, welcomed the improvements but said more work was needed.

"Royal Cornwall Hospitals has had a challenging recent history, so I am pleased to report that the trust is making progress in improving the quality of its services, albeit with further work to be done.

"We did find some remaining concerns during the inspection and while we are aware the trust is addressing these, I am recommending the trust should remain in special measures for a further period."

Some of the continuing concerns highlighted by inspectors:

• The emergency department at the Royal Cornwall Hospital was frequently crowded and the layout did not always keep patients safe from harm

• Patients were not always assessed within the 15-minute target

• Processes to monitor patients were not always followed

• The systems in place to assess and manage individual patient risk were not always being followed

• Records were not kept in a way which kept patients safe

• There was a risk to the stability of the leadership of the board with an interim chief executive and an acting chair.

RCHT chief executive Kate Shields said: "This is a positive report for us and shows that the work we have been doing to improve care and safety is starting to show through.

"The improvement we have seen is down to our great staff. They are the people who really hold the quality of care for the people of Cornwall in their hands."