The trust were previously inspected in June 2014 and were rated at that time as requiring improvement. In response to the requires improvement rating the trust acknowledged they had 'more improvement work to do'.
They also stated that:
The CQC have provided us with a clear view of what is required by our regulator to achieve a "good" rating'.
With the publication of this new report, just over two years later - it would seem that standards have fallen.
There have been several warning signs for the trust, including the 2016 results of the CQC survey of people who use community health services. This revealed that the IW NHS Trust is one of the worst under performers in the community mental health care survey.
We raised concerns to the trust in January 2015 around people's experiences of IW mental health services and our update report: Adult Mental Health Services in the Community report made several recommendations to the trust including:
- the need for collaboration between mental health services and housing providers
- the need for the trust to listen to people's experiences of services.
Despite their previous assurance that they had action plans in place to address all the issues identified in the 2014 CQC inspection report, it would seem that to date, these initiatives have not proved to contribute to a long term solution. It is particularly disappointing that some issues picked up in 2014 have been reflected in the most recent report with;
- poor risk management and care planning in community mental health services again being identified as a continuing problem
- insufficient clinical staff in some areas of the hospital means that the safety and care of seriously ill patients is compromised.
We are aware of the considerable financial constraints faced by the IW NHS Trust and the difficulties in recruiting staff, however, this is a national problem not restricted to the Island.
To put this into perspective:
- Of the 136 acute non-specialist Trusts in the UK, 6 are currently rated as 'outstanding', 43 currently have a 'good' rating, 78 are currently rated as 'requiring improvement' and 9 are currently rated as inadequate.
- Of the 55 mental health Trusts 3 are currently rated as 'outstainding', 28 are currently rated as 'good' and 24 are currently rated as 'requiring improvement'.
These figures demonstrate that other Trusts who face similar problems, are able to deliver better quality services.
Throughout the course of 2016 we have received feedback from a number of members of the public, praising the dedicated and caring staff and consultants at the IW NHS Trust. However, a number of people have also shared their experiences with us and have reported a series of failings within the care they received.
Although we are in the unique position of having a combined Trust, St Marys hospital is the only hospital based on the Island and it is in everyones best interests to ensure that the care given to patients if consistently good and that noone falls 'between the gaps'. Potential solutions to the difficulties faced by the IW NHS Trust lie in the programme of integration between health and social care services and in the development of person centred, community based facilities. We are aware that the Trust is already taking action to address many of the issues identified by the CQC in their 2016 inspection, but the real test will be how these actions translate into rapid and sustained improvement of patient services.