THE chief executive at Queen’s Hospital has said she accepts responsibility for failings which brought it under the spotlight in a national review – but stands by the fact she is the best person to lead it forward.
Helen Ashley admitted she took her eye off the ball in the months running up to last year’s Keogh Review, which discovered some major concerns in the running of Burton Hospitals NHS Foundation Trust.
She put the issue down to the organisation focusing too much on finances and not enough on care, adding that if she had her time again, she would change the way things had been done.
In her first interview since the results of the Keogh review were published, she said: “Our financial challenges are very well documented. For a year and a half we focused very much on the money. I don’t think we did things which had a negative impact on quality in trying to save money, but I don’t think we developed the quality so much.
“I am happy to accept responsibility for the fact that we probably focused on finances, because of the challenges we had to address. Would I do things differently? Of course I would, but I am confident that with the team we have got at the trust we can get on and make the improvements we need to make.”
She confessed that she believed the hospital was ‘a couple of years behind’ in terms of the quality of care it was offering, but insisted much had been done to improve that in the months since the Keogh panel visited.
“We were talking to staff about money and not how they improved quality. It wasn’t that people weren’t doing things to improve care, but it wasn’t the focus or the organisation. In the last few months we have tried to make improvements and have more involvement from our clinical staff, but our finances have now slipped back.
“In the future, we need to find a way to balance both of those,” she said.
It is now 12 months since the Keogh panel began the review which would turn up major failings at Burton Hospitals NHS Foundation Trust.
A year on, the organisation said all of the urgent points had now been addressed, and some big changes had been made to other working practices at the site.
Chief executive Helen Ashley described the overall experience as ‘positive’ for the organisation, adding: “It has been a good thing for the hospital. Having someone coming in and looking at thing in detail gave us a really clear set of actions we needed to take to improve patient care.
“I don’t think we would have had permission to make the changes we have - and, don’t get me wrong, they clearly needed making – if we had not been part of the review.”
Issues raised by the Keogh team included problems with staffing and the complaints procedure, and a general lack of good communication both with patients and families and within the organisation.
Some nursing staff were working exceptionally long shifts for days on end, because of rota problems, the investigation found. The panel said they were concerned about the impact it could have on care.
Mrs Ashley said the biggest change at the hospitals had been in this area.
“We clearly had an issue with this. We were asking our staff to carry out their duties when they were absolutely exhausted and run ragged. Morale was really low. We have made changes and I would hope patients can see that in the staff who are caring for them. I don’t hear as often of complaints that our wards are understaffed, or staff do not seem to have time for everyone,” she added.
The chief executive admitted last year she had not been aware of the staffing issues at the trust’s three sites.
Organisational changes have also taken hold, with moves taking place to ensure there is more focus on listening and acting on the concerns of patients.
Mrs Ashley said a recent visit from the Care Quality Commission, which saw some of the Keogh panel return to the hospital, found changes had been made within the trust. A full report on their findings will be published later this month.
“From our point of view, there have been huge improvements. There are still things to do and issues and themes that come up, but it’s far better than it was,” she said.
AT the time when the Keogh panel carried out their investigations at Queens and the two community hospitals, the trust was in the midst of a staffing crisis.
Nursing vacancies left open saw gaping holes in shift cover had to be filled by agency staff, leading to crippling costs for the trust and poor team bonding for the staff that were there.
Since then, dozens of new nurses have been drafted in from Portugal and Italy, and a recruitment drive has taken place to fill other spaces within the organisation.
But it has not been easy, according to chief executive Helen Ashley, and she told the Mail it has something to do with the Keogh review.
“We have been trying to catch up, but I think we underestimated the impact the review would have. Undoubtedly, being part of a national review will mean that some people don’t want to work here. If you’ve got the choice of any organisation, would you choose Burton? Probably not.
“We shouldn’t have to go overseas for nurses. We should be able to train out own at the education centre. The nurses we have recruited have been great, and fit in really well, but we don’t really want to turn to overseas recruitment again,” she said.
There is a national issue, she said, which had exacerbated the problem, as all organisations were searching for new staff at the same time.
However, the trust aims to improve matters by promoting staffing opportunities in a better way. Staff who work there ‘really enjoy it’, she said, and she and other members of the executive team need to work to show people that.
FOR many of the people living in Burton and South Derbyshire, the idea of parking at Queen’s is almost as stressful as the appointment they are attending.
Two words provide the reason behind this – Parking Eye.
Chaos ensued last year when the company first installed its automatic number plate recognition system at the Belvedere Road site, with dozens of people complaining of confusion and unjustified penalties. This ‘money-grabbing’ system, as users have described it, should be in place at a hospital, patients said.
And it transpires that the site’s chief executive supports their argument.
“I agree with the criticisms. We are not a commercial organisation; we are here to care for people. On reflection, the way we have gone about operating the new car parking system has not been good enough and it has caused distress.
“We have tried to listen to concerns and address them, but in doing so we have made it even more complicated. We need to make it work for us, but we have not done enough yet. The position we need to get to is that one the people who come on site and do not pay their appropriate amount should be fined.
“We are working hard to make the best of a bad situation,” Helen Ashley said.
Two reviews – one internal and one independent – have now taken place to address the issues, and both have shown the system is too complicated.
New payment machines are due to be delivered, in a bid to address this, and the confusing pricing structure is due to be changed.
“It’s ridiculous at the moment. It needs simplifying. I would hope that in a few months it will be easier to use,” Mrs Ashley said.
The changes should be made ‘soon’ she said, but no timescale has been put in place.