HEALTH watchdog the Care Quality Commission has rated Bolton NHS Foundation Trust as “good” just four years after it was deemed to be at “red risk” over its financial position, waiting times and healthcare targets.

In a dramatic turnaround, CQC inspectors who visited the trust in March and April this year found that the Royal Bolton Hospital services are effective, caring and responsive, and are being well led.

“We found that services were provided by compassionate, caring staff and patients were treated with dignity and respect,” states chief inspector of hospitals, Professor Sir Mike Richards in the CQC report published today.

However, inspectors found that there are still failings, particularly in the hospital’s accident and emergency department, which is struggling with staffing shortages and increased demand from the public.

And while the Bolton One centre and the trust community services were found to be “good” across the board, there was criticism of the Children and Adolescent Mental Health Service, where better staff training is required and the trust is now looking to work with an outside mental health provider to develop the service.

Bolton NHS Foundation Trust chief executive Dr Jackie Bene welcomed the “good” rating, which places them in the top 25 per cent of trusts in the country, and stressed that areas criticised by inspectors were already being addressed.

These include a £2 million investment to extend the Accident and Emergency department, adding a further five cubicles and their associated staff to the current 12. Building work is already under way and should be complete by the end of the year.

To help address staff shortages, particularly in middle grade medical roles, nurses are being trained to support doctors in diagnostic and prescribing roles there are moves to change working practices to improve time taken to transfer patients to medical wards.

The A&E department was built to deal with 60,000 patient visits a year, but currently deals with 115,000 each year.

To address this, health professionals are trying to encourage non-emergency patients to seek help elsewhere, working on providing more services in the community, as well as increasing capacity at the hospital to reduce the possibility of patients being brought in by ambulance having to wait in corridors for a cubicle to be available.

Dr Bene said: “We recognise that while we would like to manage the urgent care demand between ourselves and general practice better, there will always be a need for patients to come to A&E.”

Once funding is available, the hospital hopes to increase A&E capacity even further to deal with current demand.

Dr Bene said she was confident the issues raised in the CQC report are “very fixable, very quickly”.

She said: “The important thing, in my view, is, when you have well led services and caring services, you just need the infrastructure to work properly. So staff can make this happen if we give them the resources that they need.”

CQC inspectors found several areas of outstanding practice in the trust including emergency department consultants covering to ensure safe staffing levels, bereavement meetings for families and working practice in the neonatal unit.

Considering the problems at the trust four years ago Dr Bene said the new CQC report is a “remarkable achievement”.

“It does take some years to turn a trust round from the sort of difficulties that we had. I just think it speaks volumes about the staff that we have here in their commitment and their pride,” said Dr Bene.

“That’s why we have been able to make such progress to this level so quickly. Certainly, if we were to be inspected again in another couple of years we’d be outstanding in a number of areas.”

The CQC report was welcomed by Su Long, chief officer of the NHS Bolton Clinical Commissioning Group, which works closely with the trust to provide health services in Bolton.

“A ‘good’ rating from the CQC is great news for our local trust, Bolton people and the wider health economy,” she said.

The CQC report is available at