Chief Nurse Esther Kirby’s CQC Blog 3: How responsive are we?

Esther blog photoBridging the gap

As a community provider, we find ourselves bridging the gap between the care provided by a patient’s GP and the care provided in hospital.

Being responsive is in your DNA as community practitioners and many of you couldn’t do your job as well as you do without it.

Being responsive is essential at a trust-wide and borough level to fulfil our mission to improve local health and promote wellbeing in our communities.

It’s essential if we are to achieve the goal of working more closely with our partners in each borough to deliver integrated care which keeps people well and out of hospital.

It’s also essential at an individual patient level.

Long-lasting relationships

I know many of you are involved in managing care for the most vulnerable people in our communities and those with the most intensive health and social care needs.

This means building and managing long-lasting relationships not just with patients but also with their families, carers and other professionals who support them.

It requires flexibility and insight to adjust to the changing needs of patients as they move through different stages of their lives.

When evaluating how responsive we are, the CQC looks at how we plan services to meet the needs of local people, including people in vulnerable circumstances and how we cater for diverse needs.

They also consider whether we are delivering the right care to people at the right time and how we respond to concerns or complaints.

Rated as good

Given the nature of our work, it came as no surprise that in the responsive domain we were rated as good. 

I’ve picked out some extracts from the inspectors’ report which illustrate this:

  • We saw that the majority of services were responsive to peoples’ needs and services were planned and delivered with the needs of local users in mind… Services including Halton midwifery, Warrington Sexual Health and the Parallel Young People’s Service in Bolton were highlighted for catering for specific needs.
  • Services were able to make reasonable adjustments to accommodate their needs and were flexible in their approach, including a double room, with an adjoining room, used for a couple, one of whom was living with dementia and became very unsettled when apart from their partner.
  • There were dedicated children in care nursing teams available in Warrington and Wigan as well as looked after children specialist nurses in Halton and St Helens.
  • In Warrington a carers’ support group was held for those caring for patients with Multiple Sclerosis or had suffered a stroke.
  • The Paediatric Continence Service in Halton and St Helens was available for children and young people aged 0-19 years, although young people with learning disabilities could continue to be supported and treated in the service until age 25.
  • Dental services provided patients with additional mobility sites, for example a wheelchair accessible dental chair in Wigan.
  • The trust had a comprehensive complaints policy that was clearly articulated by staff involved in the management of complaints at trust level… At service level complaints were well managed with information and signposting…Clinical risks arising from complaints could also be added to the corporate risk register. 

It never ceases to amaze me how far some of our staff and services will go to support patients, and their families, so that they can be cared for in, or close to, their own homes. 

It demonstrates this is a vocation for many, not simply a job.


Yes, the report did contain areas where inspectors concluded that we did not meet standards and must improve.

These were largely in relation to waiting times in specific services and delays in accessing some children and young people’s services.

We were aware of much of what the inspectors fed back to us so were able to quickly resolve the most significant issues soon after the inspection concluded.

It is often said that “the only thing that is constant is change”, and I have every confidence that you will continue to adapt to the changing needs of our patients and communities with the creativity and compassion that was so evident during the inspection process.

Best wishes,

Esther Kirby
Chief Nurse/Director for Quality