- NHS hospital
The Hillingdon Hospital
Report from 19 May 2025 assessment
Contents
Ratings - Surgery
Our view of the service
The assessment of Hillingdon Hospital’s surgery core service highlighted ongoing challenges, with many issues identified in previous inspections persisting. While some improvements had been made, significant concerns remained regarding patient safety, staffing, infection control, and capacity management. There were areas where patient safety and care quality were at risk due to systemic issues. Immediate action was required to address deficiencies related to patient flow, facility capacity, staffing levels, infection control, and medicines management. Strengthening these areas was essential to ensure that all patients received safe, effective, and high-quality care.
The Care Quality Commission issued a warning notice following the inspection, detailing specific areas for urgent improvement, including deficiencies in patient flow, the management of the Surgical Assessment Unit (SAU), infection control protocols, and medicines management. Attention was drawn to the prolonged stays of patients in the SAU, often exceeding 24 hours, and the unit’s inadequate facilities, which did not always support privacy, dignity, and safe care.
Since the warning notice was issued, the trust provided additional evidence of its efforts to address these concerns. Key actions included revising the SAU’s standard operating procedure, implementing enhanced escalation pathways, and introducing safety huddles to improve oversight and accountability. The trust reported a marked reduction in the number of patients exceeding the 24-hour limit in September 2024, demonstrating progress in managing patient flow. However, ongoing estate and staffing pressures meant further work was required to ensure these improvements are sustained and embedded across the service.
Strengthening these areas remains essential to ensure that all patients receive safe, effective, and high-quality care while safeguarding their privacy and dignity.
Improvements were needed to reduce delays in patient assessments, enhance adherence to clinical guidelines, and improve the usability of electronic systems. However, the service demonstrated a commitment to effective care through comprehensive needs assessment, evidence-based treatment, and multidisciplinary teamwork.
Staff members at Hillingdon Hospital showed kindness, compassion, and dedication to patient care. Nevertheless, the service environment and some operational processes limited the ability to consistently uphold the highest standards of dignity, comfort, and personalised care.
The service was dedicated to providing responsive, person-centred care, involving patients in their treatment and striving to meet their immediate needs. However, challenges remained in managing patient flow, responding to immediate needs, and ensuring equitable access to care. These issues were highlighted in the warning notice issued, which called for immediate action to address deficiencies in the management of the SAU, as well as systemic concerns regarding patient safety and dignity.
While the surgery core service benefited from capable and compassionate leadership, there were opportunities to improve leadership visibility, staff engagement, and the timeliness of responses to identified risks.
By implementing the recommended improvements across these areas, Hillingdon Hospital’s surgery core service could ensure it delivered a consistently safe, effective, and compassionate service that met the needs of all patients. In response to the warning notice, the trust provided an action plan that included revising the SAU’s standard operating procedure, introducing regular safety huddles, and enhancing escalation pathways for addressing delays in patient care. Early evidence suggested these measures have begun to have a positive impact, with fewer patients staying in the SAU beyond the 24-hour limit in recent months.
People's experience of this service
Overall, people’s experiences of using surgical services were mixed, reflecting both commendable efforts by individual staff and ongoing systemic challenges. Patients consistently described staff as kind, compassionate, and respectful, highlighting positive interactions and the emotional support they received. Staff were observed treating patients as individuals, addressing cultural, emotional, and spiritual needs, and encouraging independence and involvement in decision-making. Many patients felt well-informed about their care and appreciated the communication with clinical teams.
However, some patients experienced extended stays in the Surgical Assessment Unit (SAU) due to bed shortages, during which they did not always have access to appropriate facilities, such as bathrooms or hot meals. There were also reports of delays in surgery, variable pain management, and limited availability of information in accessible formats or different languages, which affected some patients’ overall satisfaction. In addition, operational pressures, including staffing shortages and restricted physical space, occasionally disrupted care.
Although the service demonstrated a clear commitment to person-centred care, evident in its use of interpreters and personalised approaches, these efforts were sometimes hindered by challenges in managing patient flow, medicines optimisation, and infection prevention. While frontline staff showed consistent dedication, these broader limitations occasionally led to discomfort, delays, and reduced access to services, which impacted some patients’ experiences of care.