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Chief Inspector of Hospitals rates The Princess Alexandra Hospital NHS Trust following comprehensive inspection

11 November 2015
  • Media,
  • Hospitals

England's Chief Inspector of Hospitals has told The Princess Alexandra Hospital NHS Trust that it must make improvements following an inspection in July by the Care Quality Commission.

The Princess Alexandra Hospital NHS Trust was rated as ‘Requires Improvement’ overall. The trust was rated as Good for whether its services were caring and rated as Requires Improvement for whether its services were safe, responsive, effective and well-led. The core service of maternity and gynaecology was rated as Outstanding in relation to whether it was caring.

The Princess Alexandra Hospital NHS Trust is based in Harlow, Essex and provides a comprehensive range of district acute, community and specialist services to a local population of 258,000 people. Inspectors visited the Princess Alexandra Hospital and St Margaret’s Hospital sites.

Inspectors found that the trust had significant capacity issues and was having to reassess bed capacity at least three times a day. The pressure on beds meant that patients were allocated the next available bed rather than being treated on a ward specifically for their condition. Staff shortages meant that wards were struggling to cope with the numbers of patients.

The lack of administrative staff and poor systems meant that patients waiting for outpatient appointments were often double or triple booked. This meant that patients were often waiting in the department for excessive amounts of time.

Despite these concerns and capacity issues, it was noted that staff were exceptionally caring and went the extra mile for patients despite the added pressures on their workloads.

CQC’s Chief Inspector of Hospitals, Professor Sir Mike Richards, said:

“Our inspectors found that some improvements were needed at The Princess Alexandra Hospital NHS Trust. The outpatients’ service was rated inadequate overall because patients were not consistently offered timely access to services and there was a significant backlog of patients waiting for appointments. The managers of this area were aware of the issues and had plans in place to address them. However, at the time of our inspection these had not been addressed.

“The trust did not appear to have a structured method of assessing and responding to risk as there were several ways of reporting risks in place at Board level.

“We have seen, however, that some progress has already been made across several areas and we found many areas of good practice that staff should be proud of.

“We were particularly impressed by the professionalism and efficiency of the maternity and gynaecology department which we rated as good overall. The service provided outstanding care to women and feedback from people who used the service was all positive. Women said that staff went the extra mile and the care they received exceeded their expectations.

“Since our inspection we have been monitoring the trust and working closely with the Trust Development Authority and other stakeholders, such as the local Clinical Commissioning Group and NHS England.

“The trust leadership knows what it needs to do to bring about improvement and our inspectors will return at a later date to check on what progress has been made.”

Full reports for the trust will be published on CQC’s website today at the following link:

Across the trust, the inspection team found several areas where improvements must be made, including:

  • The trust must ensure that all staff are appropriately trained, appraised and inducted for their roles, including agency and temporary staff.
  • All guidelines and policies within the children’s accident and emergency high dependency room must be up to date with current practice.
  • The trust must ensure that disposable items of equipment are not reused on patients.
  • The maternity unit must be secure and there must be an effective system in place to ensure the safety of babies from abduction from the unit.
  • Equipment must be checked in accordance with trusts policy, including resuscitation equipment.

Inspectors also witnessed some outstanding practice across the trust, including:

  • The acting ward manager for the Dolphin Children’s Ward had made a significant improvement in a short time and showed outstanding leadership and determination.
  • The outcomes for women in the maternity service were outstanding and comparable with units in the top quartile of all trusts in England.
  • The teenage zone within the children’s ward was outstanding and was responsive to the needs of teenagers.
  • The gynaecology outpatient and emergency service, including the termination of pregnancy service, was outstanding and provided a responsive service which met the needs of women.
  • The play specialist providing dedicated time to fundraise in order to purchase toys and set up playgroups for the children.

CQC’s inspection team informed the trust of its findings immediately after the inspection so that it could take steps to make any improvements.

The reports which CQC publishes today are based on a combination of its inspection findings, information from CQC’s Intelligent Monitoring system, and information provided by patients, the public and other organisations.

A team of CQC inspectors and specialists including doctors, nurses, managers and experts by experience spent four days at the trust in July 2015. CQC has published separate reports on the services provided by the trust and full reports including ratings for all core services are available at:

Under its inspection model, CQC has given individual ratings to each of the core services at the trust; urgent and emergency services, medical care, surgery, critical care, maternity and gynaecology, services for children and young people, end of life care and outpatients and diagnostic imaging.


For media enquiries, call Regional Engagement Manager, Helen Gildersleeve on 0191 233 3379. For media enquiries about the Care Quality Commission, please 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 duty press officer is unable to advise members of the public on health or social care matters).

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Last updated:
29 May 2017

Notes to editors


The Princess Alexandra Hospital NHS Trust has five sites across Essex and Hertfordshire; Princess Alexandra Hospital, St Margaret’s Hospital, Herts and Essex Hospital, Cheshunt Community Hospital and Rectory Lane Clinic.


The Chief Inspector of Hospitals, Professor Sir Mike Richards, is leading significantly larger inspection teams than before, headed up by clinical and other experts including trained members of the public. Whenever CQC inspects it will always ask the following five questions of every service: Is it safe? Is it effective? Is it caring? Is it responsive to people’s needs? Is it well-led?


The Care Quality Commission has already presented its findings to a local Quality Summit, including NHS commissioners, providers, regulators and other public bodies. The purpose of the Quality Summit is to develop a plan of action and recommendations based on the inspection team’s findings.


Since 1 April, providers have been required to display their ratings on their premises and on their websites so that the public can see their rating quickly and easily. For further information on the requirement for providers to prominently display their CQC ratings, please visit:


About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.