Updated 23 August 2024
Norfolk and Norwich University Hospitals NHS Foundation Trust is a 1,200-bed teaching hospital providing acute care for around 1.1 million people living in Norfolk and Waveney. The trust is one of the largest teaching hospitals in England. It operates from a large purpose-built site on the edge of Norwich and from a smaller satellite at Cromer in North Norfolk. The Norfolk and Norwich Hospital opened in late 2001, having been built under the private finance initiative (PFI). Cromer and District Hospital was rebuilt by the trust in 2012.
The trust offers a range of secondary and tertiary services and has 1,200 acute inpatient beds, 26 critical care beds and 78 maternity beds and employs around 8,011 whole time equivalent staff across the sites. Of these staff 1,165 are medical staff, 2,110 are nurses and 4,736 are classified as other staff (Insight report).
We undertook this unannounced inspection of the following services provided by the trust at the Norfolk and Norwich Hospital:
- Surgery because of concerns about the safety and quality of the service.
- Outpatient Services because of concerns relating to the safety and quality of the service.
- Diagnostic Imaging services because of concerns relating to the safety and quality of the service.
We also inspected the well led key question for the trust overall.
Our rating of services stayed the same. We rated them as requires improvement because:
- We rated safe, responsive, and well led as requires improvement. Effective was not rated in all services and caring was not inspected in surgery, diagnostic imaging or outpatient services.
- We rated all 3 of the services we inspected as requires improvement overall. In rating the trust, we considered the ratings of the other services we did not inspect this time.
- People could not always access services when they needed it and often waited too long for treatment or had their appointments cancelled. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients were not in line with national standards.
- Services did not always have enough staff to care for patients and keep them safe.
- There was a mixed staff culture at the trust and staff did not always feel supported and valued.
However:
- Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families, and carers.
- The services we inspected planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback
Since this inspection in November 2023, the Trust now has a new substantive chief executive officer (CEO). We are assured that the new CEO has a grip on the risks and concerns identified in this report and has already taken steps to drive significant and sustainable improvements in quality and performance.