Care Quality Commission reviews of our Trust 2014 to April 2016

Created 30 June 2016

Alan Rose and Frank Sims said they were standing down to help accelerate a long-term partnership between the Trust and The Ipswich Hospital NHS Trust.

Our Trust operates as an NHS Foundation Trust on special measures, led by its Board of Directors, supported by a Monitor-appointed Improvement Director.

Performance Dashboard

Latest Improvement Plan Performance Dashboard, pictured, can be found every week on our Improvements page.

Special Measures Quality Improvement Programme 2016-17 Update

Read the latest Special Measures Quality Improvement Programme 2016-17 Update.

LATEST | Statements, responses and reactions | 28 April 2016

Frank Sims

Chief Executive Frank Sims writes in his weekly email:

"The three months the Trust had to show 'significant improvement' by the Care Quality Commission (CQC) drew to a close last week.

"In the past few days the situation regarding the future of this organisation has moved rapidly.

"With the Trust in special measures since November 2013 - nearly two and a half years - the CQC is limited in what it can recommend to the Secretary of State.

"A trust is usually expected to have made improvements within 12-18 months and if not, it risks being placed into the Trust Special Administration process.

"In January, our Board of Directors agreed that the Trust was not clinically and financially sustainable as a stand-alone organisation and that to move forward we had to develop a partnership with other providers. More recently, we have linked with Ipswich Hospital NHS Trust at a very senior level, working with NHS Improvement to put plans in place quickly about how we can drive the partnership work at pace, focusing on clinical collaboration and designing new service models that provide robust and sustainable services.

"Getting out of special measures was always going to be a huge challenge. Staff have delivered some great improvements over the past six months and we should all be very proud of that. However, we have been unable to demonstrate to the CQC that the improvements were sustainable and consistent.

"We will now collaborate closely with Ipswich Hospital and NHS Improvement to work out the details of the partnership and how the arrangement will best maximise benefits for patients in north east Essex and Suffolk."

This morning the following statement was issued by NHS Improvement:

NHS Improvement logo

CQC logo

NHS Improvement and Care Quality Commission call for long-term partnership between Colchester and Ipswich hospitals

A long-term partnership between Colchester Hospital University NHS Foundation Trust and the Ipswich Hospital NHS Trust is the only way of securing services for patients long into the future.

This recommendation comes jointly from the Care Quality Commission's Chief Inspector of Hospitals, Professor Sir Mike Richards, and the Chief Executive of NHS Improvement, Jim Mackey.

The preliminary findings of a recent inspection by the Care Quality Commission have shown that services at Colchester Hospital (which has been in special measures for more than two years) are not of the required quality. Without a long-term partnership with Ipswich, the trust risks being placed under the Trust Special Administration process.

NHS Improvement will now work closely with the leadership of Ipswich and Colchester to set up a long-term partnership which will see staff with clinical and leadership expertise work across both organisations.

Jim Mackey

Jim Mackey, Chief Executive of NHS Improvement, (pictured) said:

"It was clear that significant improvement was required in Colchester, when the Trust was placed in special measures. Under the current leadership, and with the support of its staff, the trust has made many improvements for its patients and continues to focus on this.

"However, we are all agreed that long term and sustainable improvement can only be assured if the trust works with another organisation. We fully support the partnership with Ipswich hospital and will support both organisations in making this a success for the people and staff in Colchester and Ipswich."

Sir Mike Richards

Professor Sir Mike Richards, (pictured) Chief Inspector of Hospitals at the Care Quality Commission said:

"We have consistently found poor and unsafe practices which place patients at risk of harm at this trust. There have not been enough signs of improvement for me to recommend a further extension to Special Measures. I do not have confidence in the ability of the trust's current board to address the issues I have highlighted, though I do recognise that the chief executive has only been in post a short time. I believe a more radical solution is required to ensure the delivery of safe care at Colchester."

"I consider that the arrangements NHS Improvement has agreed with Ipswich offer a better route to bring about the improvements that patients urgently need to see at Colchester. We will continue to closely monitor progress."

Letter to Secretary of State

Here you can read the letter in full from the Chief Inspector of Hospitals to the Secretary of State for Health

CQC statement

Here you can read the statement issued by the CQC.

Trust's response

Here you can read the Trust's response in our news release, issued today (28th).

Healthwatch Essex "disappointed"

healthwatch essex logo

Healthwatch Essex is disappointed that the latest inspection of Colchester Hospital (CHUFT) by the Care Quality Commission (CQC) has not found sufficient improvements in the quality of patient care.

As a result, the CQC and NHS Improvement have announced that Colchester and Ipswich Hospitals will come together in a new partnership, with the aim of improving the quality and effectiveness of care in Colchester.

Dr Tom Nutt

Dr Tom Nutt, Chief Executive of Healthwatch Essex,(pictured), said:

"I am sure patients will be both frustrated and concerned that there have been insufficient improvements to the quality of care at Colchester, since the last CQC inspection in the Autumn.

"Patients may also be concerned at the suggestion that there are still some 'unsafe' practices at the hospital, and some level of reassurance around how those areas are to be addressed needs to be provided swiftly by the new partnership.

"We know from talking to patients and carers that the quality of care at Colchester has been mixed in recent years, and it's important that the new partnership builds on the good care as well as addressing the areas where weaknesses have been identified.

"We believe that this latest announcement represents a logical next step in the improvement process for Colchester Hospital, and we are optimistic that it will lead to the sorts of improvements that are obviously required. Ipswich has both a good rating and reputation.

"Healthwatch Essex has worked closely with Colchester Hospital over a number of years, and will continue to support the hospital to ensure that the voice and lived experience of patients is at the heart of care in Colchester."




Further visit from CQC | Chief Exec's update | 12 April 2016

The Care Quality Commission (CQC) visited the Trust on 4th and 5th April as part of the process for assessing the Trust's future.

In his weekly email to all staff (also published on our website), Chief Executive Frank Sims wrote: "The CQC have informed me that they have imposed two further conditions on our registration as a service provider - commonly known as a Section 31 warning notice - under the Health and Social Care Act 2008.

"The first relates to patients attending the Emergency Department (ED) being streamed to appropriate patient pathways, with a sufficient number of suitably qualified skilled and experienced nurses and doctors or clinicians to support this, compliant with Royal College of Emergency Medicine guidance. We have been told to operate a more effective process to rapidly assess and treat patients brought in by ambulances who are not able to be immediately seen in Accident & Emergency due to capacity constraints. From this week, we will ensure that there is a more effective escalation process at the front door of A&E to fast track those patients who need clinical intervention. We have also been told to ensure there are more accurate records during the streaming and assessment process with recorded observational audits of patients. This work is being led by our most senior staff in the Urgent Care Division, namely Mr Kazim Mirza (A&E Clinical Lead), Helen Bennett (Associate Director, Nursing and AHP) and Ram Seesarun (Associate Director, Operations).

"The second warning notice is about operating a more effective audit and monitoring system that provides accurate assurance that the safer surgery checklist is being consistently carried out in accordance with the recommendations of the World Health Organisation and the NHS Central Alert System. The "three at the top" of the Surgery Division are leading on this, namely Mr Chris Backhouse (Divisional Director), David Thorpe (Associate Director, Nursing and AHP) and Batsi Katsande (Associate Director, Operations). They are reviewing our systems and processes to strengthen our monitoring and auditing of compliance and this data will be triangulated to improve our reporting and our monitoring.

"We had been awaiting a decision as to the lifting of the Section 31 notice imposed in 2014 on the Emergency Assessment Unit (EAU) and so it is not good news to have two more issued at the end of last week. Whilst disappointing, I believe we can have these new conditions removed quickly, as a result of the actions we are undertaking with our senior nurses, doctors and managers working together to resolve.

"The CQC are interviewing members of the Board of Directors this Wednesday and are likely to be visiting areas in Colchester General Hospital, especially the Emergency Department (ED), surgery and theatres, outpatients and critical care. Remember that if the CQC inspection team visits your service, say hello, help them to undertake their roles and tell them about your job and how you are making a difference to improving care for your patients. We are not expecting to hear the outcome of this latest visit until 31st May.

"I want to thank everyone for their positive attitude to dealing with the inspectors and for continuing to deliver care under the tremendous pressure we have been facing."

Quality Improvement Plan submitted | 25 February 2016

On Tuesday this week, we submitted our Quality Improvement Plan (QIP) - on this page - to the Care Quality Commission in response to their inspection of last September. By engaging with staff at the Ask and Act workshops the Preliminary Improvement Plan (see above) was developed into the full Quality Improvement Plan, which is our plan to drive changes for patient care at the Trust.

Since I joined the Trust we have tackled a number of problems systematically, taking immediate action to address the major issues and inconsistencies that meant we were putting patient care at risk.

We track our improvements through a tight programme approach and share our performance improvement dashboard every week with the CQC, Monitor and other stakeholders and it's published on the Trust's website (visit ) and on the NHS Choices website too. In this way we have robust oversight and scrutiny but I have also introduced key differences to actually managing improvement. The dashboard shows improvements in:

It also shows 65% of complaints are responded to in timeframe agreed with complainant, up from 53% last September. I encourage you to have a look at the progress we have been making as an organisation, improving care and treatment for all of our patients, all of the time.

One area that is really improving is in how we safely manage medical equipment. We now have all medical devices logged in one place on eQUIP and we have risk assessed these into high, medium and low. We are now working through the high risk items and 95% will be on maintenance contacts by the end of March.

Long term success has to be built on clinical leadership, staff engagement and a clear narrative for the future of patient care that staff, stakeholders and the public understand. I have therefore begun a new organisational development programme that will see us link with the NHS Leadership Academy and build on the work we have already instigated, developing relationships with organisations such as Frimley Health NHS Foundation Trust, Ipswich Hospital NHS Trust, St Helena Hospice and others.

We have over 20 consultant clinical leads in addition to our five divisional directors and they recognise the powerful and important role that they play in leading improvements for patients. Harnessing this enthusiasm and linking to clear managerial support and leadership development is part of the cultural change I am driving and key to long term sustainable success.

We also received further external scrutiny on Tuesday through the NE Essex Clinical Commissioning Group (CCG) governing body at a Board-to-Board session specifically designed to test the Quality Improvement Plan. In addition, we are working with partners to describe a strategic narrative that ensures long-term clinical and financial sustainability for patient care in north east Essex and Suffolk as part of the sustainability and transformation plan.

Next Thursday (3 March) we have invited colleagues from Monitor and other external stakeholders, along with our own teams, to undertake a review of our improvements across the Trust. It will be in the form of an informal assurance review of the progress the organisation is making, ahead of a return visit by the CQC to assess our progress.

Remember: the CQC report said the Trust employed staff who were "highly motivated and were working through many issues to drive improvements locally."

We want our clinicians and teams to harness that enthusiasm and motivation and ensure that we are all working together in harmony to get out of special measures.

I want to thank everyone who has contributed to the new quality improvement plan, especially those who attended and provided solutions at the Ask And Act sessions. You know I am totally committed to improving care for our patients and engaging you and supporting you to take ownership of the improvements we have to make.

We are on our journey to outstanding and it is all very do-able.

Thank you

As ever, please let me have any ideas and feedback:

Performance Dashboard launched | 31 January 2016

Our Preliminary Improvement Plan submitted to the Care Quality Commission (CQC) on 6 January, is being developed into a full Quality Improvement Plan, by engaging with staff at the Ask and Act workshops. Do come along to them!

Frank Sims

Creating a successful Quality Improvement Plan - which has to be submitted to the CQC on 16 February - mean a number of priorities have to be achieved to demonstrate achievement and sustainable improvement. To demonstrate what we have achieved we have created a weekly Performance Dashboard which we are making public on the Trust website* so that everyone, including our staff and patients, can see the journey of improvement that we have been making since the CQC inspected the Trust last September.

The Performance Dashboard shows improvements in:

It also shows:

I encourage you to have a look at the progress we have been making as an organisation, improving care and treatment for all of our patients, all of the time. I will also circulate the Performance Dashboard with my weekly email message.

Frank Sims
Chief Executive

Publication of September 2015 report | 19 January 2016

On Tuesday 19 January the CQC published reports into their September four-day inspection of Colchester General Hospital, Essex County Hospital and Trust.

Frank Sims

Frank Sims (pictured), the Trust's new permanent chief executive has said he was disappointed with the reports which found aspects of the Trust's services inadequate.

Frank has pledged to use the findings of the inspection, which took place 15-18 September, as a "blueprint for improvement".

The CQC has maintained the Trust's overall rating of "Inadequate". It was downgraded from "Requires Improvement" to "Inadequate" in January last year (2015) following publication of a CQC inspection report into the Emergency Department (A&E) and Emergency Assessment Unit (EAU) at Colchester General Hospital.

But the reports also highlighted that 95% of patients would recommend using Colchester General Hospital in the latest NHS Friends and Family test, and inspectors saw "some good examples of multidisciplinary working across the trust and into the community."

Read our statement in response New chief executive's pledge to improve care, including some of the actions that have already been taken since the inspection four months ago.

Read also A statement from the Trust's Council of Governors which says the findings are at variance with what governors constantly hear about patients' experience of the Trust.

Find out what we have changed since we received our latest rating from the CQC, by
going to our Improvements page.

Improvement Plan

Action Plan

You can read our Improvement Plan (pictured) up to December 2015.

(You can read our last Cancer Action Plan below under November 2014.)

Find out what we have changed since we received our latest rating from the CQC, by
going to our Improvements page.

Section 31 notices lifted | 11 November 2015

Two of the three Section 31 warning notices imposed on the Trust by the Care Quality Commission (CQC) have been lifted, following much hard work by staff and divisional teams.

At the end of last year the CQC imposed two warning notices, following an inspection of A&E and Emergency Assessment Unit (EAU).

However, following their inspection in September, the CQC have reviewed the evidence, noted the improvements and found our A&E processes are now safe and appropriate. The Section 31 notice for A&E was lifted on 29 October (letter from CQC).

Earlier this summer, the CQC imposed a third Section 31 notice in relation to induction of staff in clinical areas, following unannounced inspections in July. The Trust responded robustly in undertaking new practices to ensure patient safety and it was lifted on 6 October (letter from CQC). This is good news and the teams who worked so hard to get these lifted are to be congratulated.

It's essential that we continue to strive to make improvements and be proud of what we are doing for patients. Meanwhile, we await a final decision as to the lifting of the final Section 31 notice for EAU.

Give the CQC feedback about how our services are performing - whether good or bad - HERE.

CQC report | 3 September 2015

On Thursday 3 September the Care Quality Commission (CQC) published a report following its two unannounced visits to the Trust in July. The CQC carried out this focused inspection on 8 July in response to concerns in relation to staffing and standards of care received by patients on a number of surgical and medical wards. Seven ward areas were visited. They returned to Colchester General Hospital on 14 July to conduct an inspection at night.

The unannounced visits precede the formal three-day CQC inspection of the Trust in September - see below.

Read our statement in response, including some of the actions that have already been taken.

Chief Executive Dr Lucy Moore

"journey of improvement"

Dr Lucy Moore, the Trust's Chief Executive, said:

"We are aware of the ongoing need for improvement. The examples of poor care identified are unacceptable to us and I apologise on behalf of the Trust to any patient or their family who has been affected.

"They do not reflect the standards which we expect to be given consistently to all of our patients. Immediate action was taken in the specific ward areas where issues were identified and we have taken the further opportunity to refocus our improvement plan and redouble our efforts to increase the pace of change.

"I am pleased that the CQC recognised that the Emergency Assessment Unit (EAU) is complying with the conditions imposed by them last December and that staffing levels have improved.

"We have a recruitment plan which will see a full establishment in our nursing teams by the end of March 2016.

"I am confident of the huge effort from all staff to drive improvement, their strong desire and determination to change, and their awareness of the issues and challenges. However, there is more to do to tackle the inconsistency of care that we provide.

"We are on a journey of improvement and not yet at the destination, but I would like to reassure people that a great deal of work has been undertaken to improve quality and safety in the past 12 months at our hospitals.

"The Trust is still on the road to recovery and we all acknowledge that there is still a way to go. However we are addressing the concerns raised by the CQC and we have taken action since the CQC inspectors visited in July.

"We want our teams to provide the quality of care we all aspire to and which patients expect and deserve. We have very good staff and with their help we are confident that we can make the necessary improvements."

Give the CQC feedback about how our services are performing - whether good or bad - HERE.

CQC inspection due | September 2015

The next formal CQC inspection of the Trust will take place in September by a large team of 50 inspectors, clinicians and "Experts by Experience" who will assess our services. It is critical that all staff understand what role they have to play in ensuring the Trust is meeting the CQC's five "domains" - safe, effective, caring, responsive to people's needs and well-led.

The inspection will take place on 15-18 September by a large team of inspectors, clinicians and "Experts by Experience" who will assess whether our service overall is: safe, effective, caring, responsive to people's needs and well-led (the CQC's five "domains").

There are bound to be unannounced inspections too.

Following the visit, the Trust, and both our hospitals will each receive an overall rating. Currently, the Trust is rated "Inadequate", Colchester General Hospital is rated "Inadequate" and Essex County Hospital is rated "Requires Improvement". Additionally, the eight core services will also be rated in the same way to provide performance information at a service, hospital and Trust level.

Our Improvement Plan is helping ensure our patients receive the best possible care. Staff all have a role to play in the success of the Improvement Plan and should look on the intranet under Info About >Improvement Plan (staff only access).

Shane Gordon, Chief Operating Officer writes: "We have an Improvement Plan because we want to improve as an organisation. It allows us to collect all sorts of opportunities to improve and build them into a programme of work over the years to come. The most important thing is the drive to become a learning organisation, so that we make sure we deliver the safest possible care to all of our patients, all of the time.

"One example of a learning organisation is the pledge at the heart of the At Our Best programme that none of us should ever walk by care that is of an unacceptable standard."

Visit I pledge to speak up.

Please find out more by watching a video of the Chief Operating Officer, recorded on 3 July, on YouTube.

Staff can read more on the intranet about the CQC inspection (staff only access).

'No criminal offences' over cancer records announce Police | 13 August 2015

essex police logo

Essex Police has said it found "no criminal offences" had been committed.

A report released in December said the inaccuracies had been down to managerial incompetence, rather than the purported bullying of staff highlighted by the Care Quality Commission (CQC) in 2013.

Staff had told inspectors they were "pressured or bullied" to change data relating to patients and their treatment to make it seem people were being treated in line with guidelines, the CQC said.

Chief Inspector Tracy Hawkings said police had interviewed staff and carried out an independent assessment of medical records.

"Throughout the investigation we have worked with NHS England, the trust and other health organisations to ensure we had access to all the information, reports and medical data that could be provided," she said.

"We have concluded that no criminal offences have been committed and there is no evidence to support any criminal charges against either any individuals or the hospital trust."

Read our statement in response Trust responds to announcement by Essex Police.

Read the BBC website Colchester Hospital: 'No criminal offences' over cancer records

Listening event in September announced | July 2015

Listening event Poster Colchester

The CQC will be inspecting our Trust and our hospitals from 15 September. Their inspectors will look at a great deal of information beforehand to decide what they need to look at during the inspection.

We would very much value your input in the process.

Give the CQC feedback about how our services are performing - whether good or bad - HERE.

There is also an independently-facilitated, CQC 'listening event' on Monday 7 September at Colchester Town Hall at 6pm.

We encourage you to attend this listening event, which is being held to ensure the views of patient, carers and the wider community are heard. At the event you will be able to meet CQC inspectors and tell them about your experiences of care at our hospitals - whether good or bad.

Download the poster for this event.

It is only with your much valued input and the views of the people we serve, that we will be able to make real lasting positive changes to the quality of care we deliver to our patients in future.

If you are unable to attend, but would still like to give your views to the CQC, you can do this by phone: 03000 61 61 61 or by email

Our Chairman Alan Rose said: "I would like to reassure you that a great deal of work has been underway across Colchester General and Essex County hospitals to improve quality and safety. We wholeheartedly welcome the CQC inspection and see this as a very important milestone on our journey of improvement.

"As we continue to put our patients, their safety and wellbeing at the very heart of everything we do, I am very positive about the future of our organisation."

NHS England Site Visit | April 2015

You can read the feedback from our last NHS England Site Visit in April 2015.

A&E and EAU report | January 2015

On Friday 30 January 2015 the Care Quality Commission (CQC) published a report following its inspection of the A&E department and Emergency Assessment Unit (EAU) at Colchester General Hospital.

See our press release.

See a Statement from the Trust's Council of Governors.

Reports | December 2014

On Wednesday 17 December 2014 two reports and press releases were published about alleged manipulation of cancer waiting lists at the Trust. Click on a report to view it and then download it (or right-click and choose "Save as").

pdf icon Retrospective Review of Cancer Care report.

The Retrospective Review of Cancer Care report involves patients being treated at this Trust between April 2010 and March 2014.

Here is the Trust's press release about the Retrospective cancer review .

pdf icon Final Report of the independent investigation (Troop/Taylor-Brown report).

The final Report of the independent investigation into concerns about bullying and the manipulation of cancer waiting lists at this Trust is also known as the Troop/Taylor-Brown report. Please note that this report has been published by Monitor.

Here is the Trust's press release into the independent investigation.

Here is Monitor's press release about the independent investigation.

Summary report on all five retrospective review studies by CHUFT audit team
pdf icon Final summary report from the retrospective review of cancer care

Individual studies
pdf icon Final report on data discrepancies in the CWT Tool study 1
pdf icon Final report on patients whose cancer pathway was over 91 days study 2
pdf icon Final Report on delayed cancer diagnosis study 3
pdf icon Final Report on the management of patients with upper gastrointestinal cancers
pdf icon Final Report on Superficial Bladder Cancer Survelliance Audit

Final Report Actions in Cancer Action Plan
pdf icon Final Report Actions in Cancer Action Plan.

Strategic Clinical network report
pdf icon Final External review Summary report.

Cancer services - one year on | November 2014

Cancer services - one year on

The November 2014 edition of our magazine Mainstream, carried five pages of news about "Cancer services - one year on".

Since being place on special measures, the Trust has been working hard to implement its Cancer Action Plan programme, which over the past 12 months has brought about many changes in the way in which cancer patients are cared for at our Trust.

The new facilities invested in, including a new ward, the £25m Radiotherapy Centre and the Mary Barron Suite & Haematology Day Unit, will help ensure that patients receive the best care we can provide.

Mainstream November 2014

Now that the building blocks are in place, in terms of structures and processes, data collection and governance, it is time to focus on using these to underpin and support improvements in the patient experience and outcomes.

Over the next two months the remaining actions will be addressed within the different cancer tumour sites, as well as ensuring actions taken become part of everyday practice.

You can read our latest Cancer Action Plan.

CQC inspection of Accident & Emergency | November 2014

On 12 November 2014 the CQC carried out an inspection of the Accident & Emergency department at Colchester General Hospital and noted a number of concerns, particularly arising from staffing levels in the Emergency Assessment Unit (EAU). Between 14-24 November we made these announcements. On 26 November we made this announcement. The CQC made two further visits, on 27 November and 23 December.

Quality reports | July 2014

Chief Executive Dr Lucy Moore

17 July 2014: Our Chief Executive welcomed the publication today of three quality reports by the Care Quality Commission (CQC). Dr Lucy Moore said our Board of Directors accepted in full the findings of all three reports - one into the Trust as a whole and separate reports for its two hospitals. They were published on 17 July following a detailed CQC inspection in May and give an overall rating of "requires improvement" to both hospitals and to the Trust.

In addition, a report was published the same day about reviews of five cancer pathways at the Trust. The NHS England publication found that all five pathways, which were not safe on 13 December last year, are now safe. The Progress Review of Five Cancer Services at the Trust was published seven months after an initial report. The December 2013 report found that six of the 17 cancer pathways reviewed were at that time not safe - brain and central nervous system, cancer of unknown primary origin (CUP), radiology, sarcoma, skin, and urology. External clinical experts have now revisited the six cancer pathways with the exception of skin and concluded they are safe with no immediate or serious concerns. Read more here: "Trust aims for cancer services that will be 'second to none'"


6-8 May 2014: The Care Quality Commission (CQC) inspected our hospitals and services in May and held "listening events" for people to share their experiences of care provided by our Trust - whether good or bad.

Our Trust was one of 20 NHS trusts inspected between April and June. The timetable:

CQC comment boxes, posters and cards were distributed to 10 key points Trust-wide, including Harwich and Clacton hospitals. Views and experiences expressed during the listening events and on the comment cards helped CQC inspectors to determine which areas to look at during its inspection on 6-8 May.

Royal Marsden logo

3 February 2014: The Royal Marsden has been appointed by health sector regulator Monitor to help our Trust fix problems with its cancer services for patients, through access to additional expertise and support.

This appointment follows on from the appointment of Mark Davies, former CEO of Imperial College Healthcare and Hammersmith and St Mary's Hospitals, to the role of Improvement Director.

Go to the 2013 CQC review page