Claire Dawson
Lincoln County Hospital is a large district general hospital in Lincolnshire, England, and is the largest hospital in the county. It is managed by the United Lincolnshire Hospitals NHS Trust (ULHT), which was placed into 'special measures' in July 2013 after a review found higher-than-average mortality rates. The trust was rated as requiring improvement in all domains except caring staff. In 2017/18, the trust was placed in financial and quality special measures.
| Characteristics | Values |
|---|---|
| Status | Placed in financial and quality special measures in 2017/18 |
| Inspection dates | 29 April - 2 May 2014, 11 May 2014, 2-4 February 2015, 5-11 October 2021 |
| Inspection type | Comprehensive inspection, unannounced inspection, follow-up focused inspection |
| Areas inspected | Urgent and emergency care, services for children and young people, medical care, maternity |
| Ratings | Requires improvement, good in terms of caring staff |
| Actions required | Ensure mandatory training is completed, ensure hourly rounding charts are completed, ensure medications are handled safely, ensure patient medical notes are stored securely |
| Trust details | United Lincolnshire Hospitals NHS Trust (ULHT), one of the biggest acute hospital trusts in England, serving a population of over 736,700 people, with an annual income of £447 million and employing nearly 8,000 people |
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What You'll Learn
- Lincoln County Hospital was placed in special measures in 2013
- The United Lincolnshire Hospitals NHS Trust was identified as high risk
- The trust serves a population of over 736,700 people
- The Keogh Mortality Review found higher than average mortality rates
- The trust was rated as requiring improvement in all domains except caring
Lincoln County Hospital was placed in special measures in 2013
Lincoln County Hospital is a large district general hospital in Lincolnshire, England. It is the largest hospital in the county and offers the most comprehensive services in the region. The hospital is managed by the United Lincolnshire Hospitals NHS Trust (ULHT), which is one of the biggest acute hospital trusts in England, serving a population of over 736,700 people.
In 2013, the hospital was placed into 'special measures' following a review by Professor Sir Bruce Keogh. The review, known as the Keogh Mortality Review, identified hospitals with higher-than-average mortality rates. Lincoln County Hospital was one of 11 trusts placed into special measures, and subsequent inspections identified several areas requiring improvement.
The Care Quality Commission (CQC) conducted comprehensive inspections of the hospital in April/May 2014 and February 2015. These inspections revealed issues with the handling of medications, patient medical notes, and the monitoring of fluid balance. The CQC also found that the trust required improvement in several areas, including the need to ensure mandatory training completion and awareness of major incident response procedures.
Following the inspections, the United Lincolnshire Hospitals NHS Trust implemented changes to address the identified issues. The trust's overall rating improved, and it was placed into the System Oversight Framework (SOF) segment 4 of the NHS England & NHS Improvement (NHSEI) Recovery Support Programme (RSP). The hospital continues to undergo inspections to ensure ongoing improvements and maintain the quality of care provided to patients.
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The United Lincolnshire Hospitals NHS Trust was identified as high risk
The United Lincolnshire Hospitals NHS Trust (ULHT) is one of the largest acute hospital trusts in England, serving a population of over 736,700 people in Lincolnshire and neighbouring counties. It has an annual income of £447 million and employs nearly 8,000 people. In the last year, the trust recorded around 642,000 outpatient attendances, 145,000 inpatient episodes, and 147,000 emergency department attendances.
The Care Quality Commission (CQC) identified the trust as potentially high risk on its Intelligent Monitoring system, leading to a comprehensive inspection in April/May 2014. The trust was one of 11 placed into 'special measures' in July 2013 following the Keogh Mortality Review, which examined hospitals with above-average mortality rates. The inspection included Lincoln County Hospital, Pilgrim Hospital, Grantham and District Hospital, and County Hospital Louth.
The inspection found that the trust required improvement in several areas, including mandatory training, major incident preparedness, patient health and safety, medication handling, timely treatment, and secure storage of patient medical records. The trust was rated as good in terms of having caring staff.
A follow-up inspection took place between February 2nd and 4th, 2015, focusing on areas previously rated as requiring improvement or inadequate. While the key questions of effectiveness and caring at Pilgrim Hospital were not initially part of the inspection plan, certain practices were observed, which impacted the ratings in these areas.
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The trust serves a population of over 736,700 people
United Lincolnshire Hospitals NHS Trust (ULHT) is one of the biggest acute hospital trusts in England. It serves a population of over 736,700 people in Lincolnshire and neighbouring counties. The trust provides acute and specialist services and has an annual income of £447 million. It employs nearly 8,000 people across its sites in Lincoln, Boston and Grantham, as well as community hospitals and centres in Louth, Gainsborough, Spalding and Skegness. In the last year, the trust had around 642,000 outpatient attendances, 145,000 inpatient episodes and 147,000 attendances at their emergency departments.
In July 2013, the trust was placed into 'special measures' after a review found higher than average mortality rates. It was rated as requiring improvement in all domains except caring. A follow-up inspection in February 2015 reviewed improvements made by the trust in areas previously rated as inadequate.
In October 2021, the Care Quality Commission (CQC) carried out an unannounced inspection of urgent and emergency care, services for children and young people, medical care and a focused inspection of maternity at Pilgrim Hospital and Lincoln County Hospital. The trust was placed in financial and quality special measures in 2017/18 and is currently in the System Oversight Framework (SOF) segment 4 of the NHS England & NHS Improvement (NHSEI) Recovery Support Programme (RSP). The CQC rated the trust overall as requiring improvement.
The CQC made several recommendations for the trust, including ensuring that mandatory training is completed, that all staff are aware of major incident response procedures, and that hourly rounding charts and fluid balance monitoring charts are completed to ensure patient health and safety. The trust should also ensure the safe handling of medications and timely prescription of venous thromboembolism treatment, as well as secure storage of patient medical notes.
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The Keogh Mortality Review found higher than average mortality rates
In 2013, the United Lincolnshire Hospitals NHS Trust (ULHT), which includes Lincoln County Hospital, was placed into 'special measures' following the Keogh Mortality Review. This review, led by Sir Bruce Keogh, investigated hospitals with higher-than-average mortality rates. The inspection, which took place between April and May 2014, revealed several areas requiring improvement to ensure the safety and welfare of patients.
The Keogh Mortality Review found that the United Lincolnshire Hospitals NHS Trust required improvement in several areas. Firstly, the trust was advised to ensure that hourly rounding charts and fluid balance monitoring charts for patients were completed consistently. This measure is crucial for maintaining the health, safety, and welfare of patients. Additionally, the review highlighted the importance of safe medication handling, recommending that the trust follow relevant legislation, policies, and best practice guidelines. This includes the timely prescription and reassessment of venous thromboembolism treatment.
The review also emphasised the need for secure storage of patient medical records. It was recommended that the trust implement measures to ensure the security and confidentiality of patient information. Furthermore, the Keogh Mortality Review underscored the importance of mandatory training for staff. The trust was advised to ensure that all staff members completed mandatory training in line with trust policies. This comprehensive training is essential for maintaining a high standard of care and patient safety.
Another key area of focus was the accessibility of information in the emergency department. The review recommended that the trust address the accessible information standard in the reception area, ensuring that important information is readily available to patients and visitors. Lastly, the review highlighted the need for the trust to be prepared for major incidents. It was recommended that all staff be made aware of the arrangements in place to respond to such incidents, ensuring a coordinated and effective response.
While the Keogh Mortality Review identified areas for improvement, subsequent inspections noted progress. Following the review, the trust implemented mortality and morbidity meetings in most departments, and HMSR rates returned to within normal limits. This indicates a positive response to the issues raised, with ongoing efforts to enhance patient care and safety.
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The trust was rated as requiring improvement in all domains except caring
The United Lincolnshire Hospitals NHS Trust (ULHT) is one of the biggest acute hospital trusts in England, serving a population of over 736,700 people in Lincolnshire and neighbouring counties. The trust provides acute and specialist services, with an annual income of £447 million and nearly 8,000 employees. In the last year, the trust recorded around 642,000 outpatient attendances, 145,000 inpatient episodes, and 147,000 emergency department attendances.
In July 2013, the trust was placed into 'special measures' after Sir Bruce Keogh's review into hospitals with higher-than-average mortality rates. An inspection of the trust in April/May 2014 found that improvement was required in several areas, except for the domain of caring, where staff were rated as good. The inspection identified several areas requiring improvement, including mandatory training completion, awareness of major incident response arrangements, and proper documentation and storage of patient medical notes.
A follow-up inspection was conducted in February 2015 to review improvements in areas previously rated as inadequate or requiring improvement. While this inspection was unannounced, practices observed at Pilgrim Hospital impacted the ratings for effectiveness and caring.
The trust was placed in financial and quality special measures again in 2017/2018 and was part of the System Oversight Framework (SOF) segment 4 of the NHS England & NHS Improvement (NHSEI) Recovery Support Programme (RSP). As of the last inspection in October 2021, the trust was rated as requiring improvement overall.
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Frequently asked questions
Yes, Lincoln County Hospital is one of 11 hospitals that was placed under special measures in July 2013. This was due to a review by Sir Bruce Keogh, which found higher than average mortality rates.
The Care Quality Commission (CQC) is an organisation that monitors hospitals in the UK. They inspect hospitals to ensure that they are providing adequate care and identify areas that require improvement.
Pilgrim Hospital, Grantham and District Hospital, and County Hospital Louth were also placed under special measures.
The hospital was inspected again in 2015, and while some improvements were noted, the hospital still required further improvements in several areas.
