Whipps Cross University Hospital

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that people’s care, support and treatment reflected their needs and any protected equality characteristics, ensuring people were at the centre of their care. We checked that the service worked effectively across teams and services to support people and looked for evidence that leaders instilled a culture of improvement.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant the effectiveness of people’s care, treatment and support was good and people’s feedback confirmed this.

This service scored 29 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Assessing needs during this assessment. There is no previous rating for the Effective key question so we cannot yet publish a score for this area.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. However, staff did not always follow current evidence-based good practice and standards.

Staff assessed patient needs, and their care, was delivered in line with legislation, standards and evidence-based guidance. During the assessment we observed staff following safety protocols. Audits were completed to monitor and evaluate compliance with evidence-based good practice.  where audit results demonstrated poor compliance and documentation in completing safety screening, contrast risk assessments and in some areas with pause and check guidance this was not always addressed in a timely manner.

Leaders told us new and updated national guidelines were cascaded from the Northeast London board for imaging. Most policies we reviewed during our inspection were up to date and appropriate.

Trust policies were available to staff on the intranet system. Local policies and guidelines could be accessed via an electronic quality management system. However, there was differing responses from staff about whether all policies had been uploaded to the system. They told us that documents that could be found on the quality management system could be found on an internal electronic drive.

Staff monitored and medical physics teams audited radiation doses to ensure they were kept as low as reasonably practicable and diagnostic referral levels (DRLs) had been established for all procedures undertaken. We saw that these were displayed for ease of reference.

The service did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

The service provided one-stop screening services in the breast clinic involving different disciplines of staff working together. Radiologists attended multidisciplinary meetings (MDM). However, some radiologists told us that these were not always effective. They told us that radiologists were not always able to present their findings at breast MDMs. They gave examples of bullying they experienced as their contributions were not always received in a respectful and supportive manner by colleagues from other professional backgrounds.

There was not always good communication and coordination with the estates team which negatively impacted the ability to effectively assess and manage risks. Data we reviewed showed that issues in communication with the estates team had been ongoing since February 2024. Following the inspection, we saw that the estates department had developed an action plan to address several estates issues throughout the service, with planned completion dates before the end of August 2025.

There were positive and collaborative relationships with external partners to develop the service and meet the needs of people. There was effective coordination of care between teams in the hospital and wider trust. We observed discussions about patients with staff on medical wards and heard there was good communication about patient needs. This extended to care for people who had learning disabilities or dementia. We were told about work to introduce a neurodiversity team with staff from across the organisation and that discussions were being had about introducing patient passports.

Modality teams had daily huddles to share information. Staff told us they felt they could access support, advice and raise concerns as needed. Most staff informed us they had seen improvements in the culture of the service. They told us they worked well with other staff and there were good working relationships between colleagues.

We did not look at Supporting people to live healthier lives during this assessment. There is no previous rating for the Effective key question so we cannot yet publish a score for this area.

We did not look at Monitoring and improving outcomes during this assessment. There is no previous rating for the Effective key question so we cannot yet publish a score for this area.

The service sought consent for care and treatment from people and respected this when delivering person-centred care and treatment.

Staff understood the relevant consent and decision-making requirements of legislation and guidance. We saw staff explained procedures well, and copies of the consent form were offered to patients. Consent was sought from patients prior to their receiving care or treatment.

Staff generally understood how and when to assess whether a patient had the capacity to make decisions about their care. However, mandatory training data we reviewed showed staff did not have training in the Mental Capacity Act (2010) (MCA) and Deprivation of Liberty Safeguards (DOLs). This meant that staff did not have the necessary training to assess a person’s capacity to provide consent and perform this role consistently well.

There was a formal consent policy for the service. This policy was due for review in December 2024. A decision was approved by the Trust Safety Committee not to update the existing consent policy as the trust had embarked on a transition to an electronic consent (e-consent) process.