An unannounced focused inspection at a hospital that is part of the largest NHS trust in England has found that it has shown some improvement.
Whipps Cross University Hospital in Leytonstone in East London, part of Barts Health NHS Trust, was inspected by the Care Quality Commission over two days in May 2017. The hospital is now rated Requires Improvement overall, previously it was Inadequate.
This latest inspection was a follow up on CQC’s previous inspection of the trust in July 2016 where inspectors found a number of concerns around patient safety and the quality of care.
During the latest inspection CQC looked at three core services: surgery, end of life care and outpatients and diagnostic services. End of life care and outpatients and diagnostic imaging were both rated Requires Improvement. Surgery was rated as Inadequate.
CQC found that:
There was limited evidence of improvements to the surgical service to make it safer for patients and more responsive to their needs. Many of the areas of concern highlighted during CQC’s last inspection still needed to be addressed by the service.
Surgical site infection (SSI) data was not followed up and therefore the service did not know how many wound infections occurred after patients were discharged.
Theatre cancellations were happening on the day of surgery due to lack of available beds and over-running and late starting theatre lists.
Inspectors observed a number of infection control issues related to the operating theatre environment including loose and exposed plaster on theatre walls and damaged flooring. Not all theatre areas had records of daily cleaning checks and some items of equipment labelled as clean had visible dust and/or damage. There was no evidence of any theatre cleaning audits.
Bed shortages on wards meant recovery areas were regularly used to nurse patients overnight. Staff were concerned that patients’ needs were not being appropriately met.
The use of agency staff on some wards was high due to nursing staff vacancies.
The environment of the in-patient diagnostic imaging area was poorly maintained.
Patient outcomes were not being measured for patients receiving end of life or palliative care.
There were areas of poor practice where the trust needs to make improvements.
Importantly, the trust must now:
- Ensure governance systems are embedded in practice to provide a robust and systematic approach to improving the quality of services.
- Improve bed management, theatre management and discharge arrangements to facilitate a more effective flow of patients across the hospital and to improve theatre cancellation and delayed discharge rates.
- The trust must improve staff compliance with mandatory training including safeguarding training.
- Improve staff compliance and awareness of trust infection prevention and control policies and processes.
- Ensure the hospital’s physical environment, including operating theatres, is fit for purpose and meets required standards.
- Continue to work towards improving the organisational culture to reduce instances of unprofessional behaviours and bullying and ensure all staff feel sufficiently supported by their managers.
- Ensure there are sufficient numbers of qualified, skilled and experienced staff employed and deployed to meet the needs of patients.
- Ensure that ward staff are provided with appropriate support and training in end of life and palliative care to enable them to carry out their role effectively.
In addition the trust should now:
Act upon the results of national audits to address areas of poor performance and to help drive improvement in services.
Ensure that surgical site infection (SSI) data is appropriately captured and reviewed.
Ensure the physical environment is fit for purpose and maintained in a good state of repair.
England’s Chief Inspector of Hospitals, Professor Ted Baker, said:
“I am pleased that Whipps Cross University Hospital does now seem to be going in the right direction and there are signs of improvement."
“I want to see this continuing in the future so that the trust’s ratings improve across the board."
“Most patients we spoke with told us their experiences of care were positive. We saw that staff treated patients with compassion and demonstrated a genuinely kind and caring attitude.”
You can read the report in full on our website.
Ends
For further information please contact Ray Cooling, Regional Engagement Manager (London), on 020 7448 9136 or call the press office on 020 7448 9401 during office hours.
Journalists wishing to speak to the press office outside of office hours can find out how to contact the team here.
Please note: the press office is unable to advise members of the public on health or social care matters. For general enquiries, please call 03000 61 61 61.
I am pleased that Whipps Cross University Hospital does now seem to be going in the right direction and there are signs of improvement
England’s Chief Inspector of Hospitals, Professor Ted Baker