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Alder Hey Statement Regarding Publication of CQC Report


Alder Hey is one of only four stand alone children’s hospitals in England and is one of the biggest and busiest hospitals in Europe. Due to the specialist nature of Alder Hey’s work, the Trust is facing significant challenges with demand for services increasing, particularly within emergency surgery and critical care. Alongside this increasing demand the Trust is also making changes to its services that will ensure a smooth and most importantly, safe transition to a new state of the art children’s hospital set to open in 2015.

We understand that this is an incredibly challenging time for all our staff and the Trust is grateful to them for their commitment and contribution to the changes taking place. The wellbeing of our staff is of the highest priority and the Trust is therefore working closely with staff to ensure that they continue to be supported.

Theatre departments are by nature highly stressful working environments; the Trust recognises this and wanted to ensure it was giving staff in the department every support. A report to the Board in 2011 highlighted concerns of a group of theatre support staff relating to workplace stress within the Department. Comprehensive measures were taken to improve this and since then the Board and management team have continued to take steps to support staff working in this area.

The recent concerns within the department relate to the working environment; there is no evidence that patients have been harmed as a consequence. Patient safety and the wellbeing of staff remain paramount at Alder Hey and the Board continues to work closely with the theatre team to identify issues and enable the Trust to actively make improvements.

The Board received a progress update in October 2013 and as a result Alder Hey’s Director of Nursing undertook further work with theatre staff to understand their concerns and ensure these were being addressed. In December 2013, she provided the Trust Board with her initial findings on the ongoing improvement work being undertaken within the theatre department. At the December Board meeting it was agreed that a steering group, led by the Trust Chairman Sir David Henshaw, would be set up to ensure that the concerns of staff were fully addressed.

An action plan has been developed and with the valuable support of the theatre team, many of these actions have already been implemented.

The CQC was contacted by members of theatre staff in November 2013 about concerns relating to their working environment. The Trust has responded to the Care Quality Commission about these concerns and the actions taken to address them. The CQC was also provided with an update during a recent inspection in December 2013. The CQC inspectors were present at the Trust’s Board meeting in December and received a copy of the Director of Nursing’s report.

Response from Louise Shepherd, Chief Executive of Alder Hey Children’s NHS Foundation Trust

We welcome the report from the Care Quality Commission following an unannounced inspection in December 2013.

Many of these concerns echo those raised by our Director of Nursing at a public Board meeting in December after she had already begun working closely with theatre staff to make improvements. At the December Board meeting it was agreed that a steering group, led by Trust Chairman Sir David Henshaw, would be set up to ensure that the concerns of theatre staff were fully addressed and this is now in place. An action plan was also developed and with the valuable support of the theatre team, many of these actions have already been implemented. The report and action plan are both available on Alder Hey’s website. Actions have already been taken to improve training, staffing allocation and quality processes in theatre.

During their visit the CQC inspection team attended this December Board meeting where urgent recommendations to improve the theatre department were discussed. The CQC stated in their report that they had ‘found the Trust Board were supportive of the need to address these concerns as a matter of urgency and some of this work has already commenced’.

I would like to reiterate that there is no evidence that patients have been harmed as a result of these concerns and we remain confident that we are providing a safe service for our children and young people.

The CQC report does raise some questions about the steps Alder Hey takes to ensure patient safety. I would like to reassure all our families that the safety of patients is our highest priority and there are multiple steps we take to ensure the safety of our patients throughout the duration of their care. This means that if one step is ever missed then other steps are always in place to ensure patient safety is upheld.

The wellbeing of our staff is of paramount importance. Theatres by nature are highly stressful, demanding working environments and we are also facing an increased demand on our services. It was regrettable that a small number of theatre staff felt that they had to contact the CQC in November to raise concerns about how they are supported at work. Our Director of Nursing has provided a personal assurance to them that the Board will do everything possible to ensure their concerns are dealt with and that they feel secure in raising them.

The Board and management team recognise that changes to the culture of the department will take time and therefore have made a long-term commitment to supporting this team. We have already undertaken a range of measures to make improvements and I am pleased with the significant progress we have made since December. I would like to thank staff for their outstanding commitment which has been invaluable to achieving this. We are grateful to them for firstly raising these concerns and then supporting us as we move forward together to address them.

Response from Gary Parsons, Senior Operating Department Practitioner Anaesthetics and Recovery at Alder Hey Children’s NHS Foundation Trust

I speak from a wealth of experience, having worked all over the UK, when I say that the theatre staff at Alder Hey are without doubt the most dedicated and driven team of professionals I have ever worked with. Life in a general adult theatre is a stressful enough environment but cannot be compared to the pressures placed on the highly skilled and motivated teams of paediatric professionals, dealing with all age groups of children and young people here at Alder Hey.

The demand for services in Alder Hey’s theatres is ever increasing and with it comes new challenges for the team of highly skilled surgeons, anaesthetists and theatre staff. We are committed to not only maintaining the excellent high standard holistic care we already provide, but developing our teams in all areas ready to meet the exciting challenges of the new Alder Hey in the Park.

Speaking as a parent and as one of the team here at Alder Hey, I have been on the other side of the fence with both my children requiring surgery here. There is simply no better feeling knowing that you are in one of the very few places in the country where they could receive such an excellent high level of care.

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