Hip and knee replacement service is Outstanding but trust Requires Improvement says CQC

The Chief Inspector of Hospitals has awarded an Outstanding rating to the largest hip and knee replacement centre run by the National Health Service.

The South West London Elective Orthopaedic Centre (SWLEOC) is located on the Epsom Hospital campus. SWLEOC is run in partnership with a number of local trusts and is the largest hip and knee replacement centre in the United Kingdom and is one of the largest in Europe.

Overall Epsom and St Helier University Hospitals NHS Trust has been rated as Requires Improvement following its first comprehensive inspection by the Care Quality Commission.

A team of inspectors visited the trust’s two main hospitals, Epsom Hospital and St Helier Hospital in Sutton, over a seven day period in November 2015.

Both Epsom Hospital and St Helier Hospital were rated as Requires Improvement. In addition to the South West London Elective Orthopaedic Centre being rated rated as Outstanding, the renal service (including the satellite dialysis units), outpatients & diagnostics and end of life care were rated as Good. Full reports including ratings for all key services are available at: www.cqc.org.uk/provider/RVR

The Chief Inspector of Hospitals, Professor Mike Richards, said:

“Every year thousands of people undergo hip or knee surgery in the South West London Elective Orthopaedic Centre with patients referred from around the UK and some from overseas. Our data shows that outcomes for patients having both routine and complex orthopaedic problems are consistently excellent.

“The hospital has become one of the leading referral centres for the treatment of routine and complex joint replacements and fully deserves its Oustanding rating.

“However, we also found poor practice in some important services. The trust must ensure that there are suitable numbers of suitably qualified staff. I am concerned that staffing levels have been identified as contributing factors in the number of ward-based cardiac arrests last year. And it is clear that staff shortages were affecting the ability of staff to consistently provide care that was individualised and compassionate.

"At the time of the inspection, we raised with the trust our immediate concerns about the culture and leadership of the critical care service. The trust responded by taking action to strengthen the leadership of the service, as well as to undertake a thorough review of all critical care services. We will watch their progress on this.

"The trust must improve the care and compassion shown to patients in the medicine, surgical and critical care areas on the St Helier site and it needs to review the existing estate to make sure that it is fit for the purpose of delivering modern healthcare."

Read the full report which will be published on CQC’s website today at the following link: www.cqc.org.uk/provider/RVR

Inspectors found there was a significant shortfall of staff in a number of areas including critical care, medicine, surgery, services for children and young people and maternity services. At the time of the inspection, the trust had embarked on a large recruitment drive to increase the numbers of medical, nursing and allied health professional staff to help support clinical services.

The fabric of the St Helier building was reported as difficult to maintain due to its age – affecting the overall patient experience. Staff reported difficulties in a range of areas including ensuring the building was hygienically clean; spacing between bed spaces was not in line with nationally recommended standards.

There was a lack of appropriately equipped side rooms and isolation facilities for patients who had developed an healthcare acquired infection, or were identified as being at risk of acquiring an infection.

The Care Quality Commission will present 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.

Ends

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