Medical care at University Hospitals Bristol and Weston rated 'good' by CQC - but concerns raised over patient safety

The Care Quality Commission's inspection of Weston General Hospital in June left the independent regulator 'significantly concerned about the safe care and treatment of patients receiving medical care'.
An ambulance parked outside a hospital A&E department

The UHBW main site (which includes the Bristol Royal Infirmary), Weston General Hospital, and the outpatient service at Weston General were all inspected by the CQC in June 2021.

Each was assessed in five areas: whether they are safe, effective, caring, responsive to people's needs, and well-led.

Patient safety, insufficient staffing levels, and a lack of 'effective clinical leadership' are among the issues raised in CQC's latest report, which was particularly critical of care at Weston General Hospital.

The UHBW main site (comprised of the BRI, Bristol Eye Hospitals, Bristol Haematology and Oncology Centre, Bristol Heart Institute, Bristol Royal Hospital for Children, St Michaels Hospital, and the Central Health Clinic received an overall rating of good.

  • Safe : requires improvement
  • Effective, caring, responsive, well-led: good

Weston General Hospital received an overall rating of inadequate. Inadequate is described on the CQC website as meaning, 'the service is performing badly and we've taken action against the person or organisation that runs it.'

  • Safe, well-led: inadequate
  • Effective, responsive: requires improvement
  • Caring: good

The outpatient service at Weston General Hospital received an overall rating of good.

  • Responsive: requires improvement
  • Safe, caring, effective, well-led: good

You can download the full report on the CQC's website.

The CQC commended NHS staff at the trust for treating patients with 'compassion and kindness', and acknowledged that the COVID-19 pandemic 'significantly impacted' the merger of the two trusts and the integration of the two hospitals.

[We] were pleased that inspectors found many positives, including how staff treat patients with compassion and kindness and take account of their individual needs and help them understand their conditions.
— Robert Woolley, Chief Executive of University Hospitals Bristol and Weston NHS Foundation Trust

However, following the inspection, the CQC were sufficiently concerned about the safety and treatment of patients at Weston General Hospital that 'urgent conditions' were imposed, requiring the trust to take urgent action to protect patients. 

Inspectors found a lack of assurance from the trust University Hospitals Bristol and Weston NHS Foundation Trust that patients were receiving care or treatment in a ward or department to meet their needs, and said there there were insufficient medical and nursing staff.

The trust as a whole was awarded a rating of 'good', but the ratings for Weston General Hospital do not form part of the trust's overall current rating. In April 2020, the University Hospitals Bristol Trust and the Weston Area Health Trusts merged. 

When a trust merges with another service, the ratings from the previously separated services or providers are not aggregated for up to two years. In 2019, before the merger, the University Hospitals Bristol NHS Foundation trust was rated overall as outstanding.

The current ratings for the whole trust (and the rating change since each service was last inspected) are:

  • Safe: requires improvement (no change)
  • Effective: good (no change)
  • Caring: outstanding (no change)
  • Responsive: good (no change)
  • Well-led: good (down one rating)
  • Overall: good (down one rating)

The CQC reviewed 59 sets of patient records, and spoke to 238 members of staff, 51 patients, and 2 visitors. A number of staff focus groups were also held.

In a statement to the media, Robert Woolley, Chief Executive of University Hospitals Bristol and Weston NHS Foundation Trust said: "We welcome this CQC report and the overall rating of Good for the organisation and were pleased that inspectors found many positives, including how staff treat patients with compassion and kindness and take account of their individual needs and help them understand their conditions."

"However, we fully accept there are areas where we need to do better."

"We are committed to making the necessary improvements and our focus will remain on providing safe and high-quality care to our patients."

Healthwatch Bristol, North Somerset and South Gloucestershire's Area Manager, Vicky Marriott, said: "We could sometimes describe our service as listening to the canary in the coal mine -  patients share good things that happen when they need a service, and they also tell us about the bad things. This is an early warning that has been taken seriously."

In 2020 we heard from and shared ten patients' stories of concerns about care at Weston General. This was passed on the CQC and their inspection report highlights inadequate patient safety and the need for improvement to how effective and responsive the hospital is.
— Vicky Marriott, Area Manager for Healthwatch Bristol, North Somerset and South Gloucestershire

"We look forward to hearing what plans will be put in place to support the hospital to improve their Weston site, in particular, and we look forward to being a part of their Patient Safety Review across UHBW."

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