England’s Chief Inspector of Hospitals has rated Royal Brompton and Harefield NHS Foundation Trust as Requires Improvement following an inspection by the Care Quality Commission.
The trust was rated Requires Improvement for being safe and responsive. It was rated Good for being effective, caring and well-led, during the inspection which took place in June 2016.
CQC inspected six core services: medicine, surgery, critical care, end of life care and outpatient and diagnostic services, across both the Royal Brompton and Harefield sites and children and young people's services at the Royal Brompton site. The full report, including ratings for all the core services, is available from this website.
The Royal Brompton and Harefield NHS Foundation Trust is the only specialist heart and lung unit in the country that treats both children and adults. The trust is home to Europe's largest centre for the treatment and management of cystic fibrosis.
The Chief Inspector of Hospitals, Professor Sir Mike Richards, said:
"Royal Brompton and Harefield NHS Foundation Trust is one of the UK’s leading specialist centres for heart and lung disease. Patients at Harefield hospital have some of the best outcomes for cardiac and thoracic surgery in the country.
"We found teams from all clinical disciplines working well together – the basis of the good care provided to patients at these two hospitals.
"Wards had access to a full range of allied health professionals such as speech and language therapists, dietitians, tissue viability team, physiotherapists, clinical psychologists and a wide range of nurse specialists.
"We found patients received compassionate care by staff who spoke about their trust with passion and pride. There are many people who owe their lives to the dedication and expertise of their staff.
"However there are areas for improvement. I note that critical care services have not in the past submitted data for national audit – which means that it has been difficult to compare the trust’s quality of care with other hospitals.
"I am concerned that there was poor completion of the World Health Organisation Safer Surgery checklist at both hospitals, despite discussions among the staff about patient safety risks. The trust must also take greater care to ensure that clinical staff are monitoring patients whose condition may deteriorate, using the standard National Early Warning Score (NEWS) charts.
Inspectors found several areas of outstanding practice. These included:
- Patients undergoing surgery at the Harefield hospital had some of the best outcomes for heart, lung and heartlung transplant in the country
- The trust’s Ventricular Assist Device team is one of the most highly skilled in the UK. The team cares for patients undergoing surgery for an artificial heart without the need for the company who make the heart being present. No other service in the UK can provide this treatment without a representative from company being present
- Continuous research programmes within cystic fibrosis have gained international acclaim and use
- The trust encouraged clinical and service innovation at all levels, through their Compassionate Care Programme.
The report identifies a number of areas where the trust must make improvements including:
- The hospital must ensure surgical staff are completing patients’ observational NEWS charts fully – and escalating unwell patients
- All medical wards should ensure that patient medical records are locked away
- Medical wards must ensure that hand hygiene practices are clear throughout the wards and make antibacterial gel obvious to visitors and relatives of patients
- The trust must ensure that the World Health Organisation five steps to Safer Surgery checklist is fully embedded.
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